Abstract
Background/ObjectiveMorning consumption of a single dose of high-energy oral nutritional supplement (ONS) in females with a lower BMI displaces some of the food eaten at breakfast but increases overall daily energy intake. This study investigated the effectiveness of ONS intake in the late afternoon and for longer duration.Subjects/MethodsTwenty-one healthy females (mean ± SD, age 25 ± 5 years; BMI 18.7 ± 1.2 kg/m2) participated in a randomised, crossover study with two experimental trials. In the afternoon of days 1–5, participants consumed either ONS (2.510 MJ) or low-energy PLACEBO drink (0.377 MJ) and recorded food eaten at home. On day six, energy intake was measured during buffet meals, and energy expenditure, appetite measurements and blood samples were collected throughout the day.ResultOver the 5-day period, in the ONS trial energy intake from evening meals was lower (ONS, 2.7 ± 0.25 MJ; Placebo, 3.6 ± 0.25 MJ, P = 0.01) but averaged total daily energy intake was higher (ONS, 9.2 ± 0.3 MJ; PLACEBO, 8.2 ± 0.4 MJ, P = 0.03). On day six, energy intake, appetite scores, plasma GLP-1 and PYY, and energy expenditure were not significantly different between the two trials but fasting insulin concentration and HOMAIR, were higher (P < 0.05) and insulin sensitivity score based on fasting insulin and TAG lower (P < 0.05) in ONS trial.ConclusionLate afternoon consumption of ONS for five consecutive days by females with a lower BMI has only a partial and short-lived energy intake suppression and thus increases daily energy intake but reduces insulin sensitivity.
Highlights
Disease-related malnutrition is common among patients admitted to hospitals and among outpatients [1,2,3]
This study aimed to investigate the impact of five days of supplementation with oral nutritional supplement (ONS) in the late afternoon on energy intake from home meals and total daily energy intake, and subjective appetite scores, postprandial concentrations of plasma glucagon-like peptide1 (GLP-1) and peptide YY (PYY) and energy expenditure measured under controlled laboratory conditions
Glucose and insulin after 5 days of supplementation After 5 days of supplementation, fasting insulin concentration and HOMAIR were significantly higher and insulin sensitivity score based on fasting insulin and TAG significantly lower in the ONS than in the PLACEBO trial, and insulin sensitivity index by Matsuda calculated from fasting and post-breakfast (0–120 min) and post-lunch (120–270 min) plasma glucose and insulin concentrations showed a borderline difference (P = 0.08) between ONS and PLACEBO trials (Table 3, Supplementary Fig. 2)
Summary
Disease-related malnutrition is common among patients admitted to hospitals and among outpatients [1,2,3]. A single dose of ONS typically increases the daily energy intake by an average of 1.57 MJ/d, their overall benefit is lower than expected [8, 9]. It seems that the effectiveness of ONS in increasing energy intake is compromised by the partial displacement of food from habitual meals [10] rather than low adherence to the ONS prescription [11]. The degree of energy intake compensation for ONS taken in the evening remains to be investigated
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