Use Of Oral Nutritional Supplements Research Articles

How Can We Improve the Appetite of Older Patients on Dialysis in Japan?

It is necessary to ensure adequate energy and protein intake in dialysis patients. However, in addition to the decline in dietary intake in older dialysis patients due to aging, the rate of anorexia is high in dialysis patients, which increases the risk of protein–energy wasting (PEW), sarcopenia, and frailty. There are many causes of anorexia in dialysis patients, including older dialysis patients, and approaches to improve the appetite of such patients have been reported; however, there has been no established approach to improve appetite adequately. Therefore, a key practical goal is to identify anorexia early and implement timely interventions before weight loss occurs. Appetite assessment tools and weight loss assessments are helpful for the screening and early identification of anorectic signs. Nutritional interventions include reducing dietary restrictions, using oral nutritional supplements, and intradialytic parenteral nutrition, as well as replenishing energy, protein, and zinc to prevent the development of nutritional disorders among older dialysis patients. Appetite assessments, early intervention, and dietary and nutritional counseling are key to improving appetite in these patients. The aging rate of dialysis patients in Japan is unprecedented globally, and I believe that this is a situation that will eventually occur in other countries as well. I discuss the factors that contribute to anorexia, especially in older dialysis patients, and Japan’s efforts to address this problem, such as the relaxation of dietary restrictions and the use of oral nutritional supplements.

Prevalence of malnutrition, dietary trends, and oral nutritional supplements use among Algerian cancer outpatients undergoing chemotherapy

ObjectiveIt is widely acknowledged that patients with cancer commonly experience malnutrition, and some individuals may adopt specific dietary trends. This study investigated the prevalence of malnutrition and dietary trends among Algerian cancer outpatients undergoing chemotherapy. Material and methodsThis cross-sectional, descriptive study was conducted from January to October 2023 with 71 cancer outpatients undergoing chemotherapy. Malnutrition risk was evaluated using the Malnutrition Screening Tool (MST). The questionnaire also collected the occurrence of nutrition impact symptoms, the avoidance of specific food groups, and the use of oral nutritional supplements and dietary supplements. ResultsMalnutrition risk was identified in 57.7% (41 cases) of participants. Nutrition impact symptoms were reported by 59.2% (42 cases) of patients. A total of 36 of the patients (50.7%) altered their eating habits by avoiding at least one food group. Among malnourished cancer outpatients, only five used oral nutritional supplements. Dietary supplements were used by 23.9% (27/71) of the patients after cancer diagnosis. ConclusionOur findings underscore the necessity for a systematic malnutrition assessment in cancer patients. Qualified clinicians should provide nutritional awareness to enhance the quality of life for these patients.

Actions alimentation-nutrition pratiquées dans les établissements médicosociaux et de santé de Nouvelle-Aquitaine, intérêt et utilisation des services proposés par le centre de ressources en nutrition (Cerenut) de cette région

Introduction and objectiveThe functioning of establishments for elderly or disabled people regarding food and nutrition is poorly understood. In the French Nouvelle-Aquitaine region, there is a Nutrition Resource Center (Cerenut) responsible for helping establishments on these issues. The study aimed to find out the main food and nutrition actions practiced in medico-social and health establishments in Nouvelle-Aquitaine, their perception of the interest of the various services offered by Cerenut and the levels of use of these services. MethodA secure questionnaire was sent electronically to 2625 establishments. Declarative data was collected automatically over a period of one month. ResultsThe number of responding establishments was 172 (6.6% of establishments contacted). The use of oral nutritional supplements, weighing at least once a month and the presence of a menu committee were the most frequent actions. Nutritional issues were an important concern for establishment budgets. The nutritional assessment of residents upon entry and the use of dietary time remained infrequent, as did the practice of enteral nutrition. Establishments for people with disabilities were the worst off. Cerenut's services relating to team training were considered the most interesting and the most used. ConclusionSeveral fundamental food and nutrition actions were not carried out in the establishments surveyed, likely to hamper the nutritional assessment of residents, their care and the enhancement of their stays. Cerenut offers training and can provide structures with appropriate assistance in many cases.

Prevalence of the use of oral nutritional supplements among acute inpatients at risk of malnutrition and associated patient characteristics.

To provide a snapshot of the current use of oral nutritional supplements, its association with inpatient characteristics, and with a focus on the role of nursing monitoring of food intake and implementing nutritional interventions for patients with low intake. Retrospective cohort study. The study collected data from a hospital database regarding oral nutritional supplement initiation and variables of patients hospitalised in internal medicine departments, who did not receive enteral or parenteral nutrition. Of the 5155 admissions, 1087 fulfilled the inclusion criteria (47% female; mean age, 72.4 ± 14.6 years; mean length of stay, 14.6 ± 11.4 days). Sufficient food intake reporting was noted in 74.6% of the patients; of these 17% had decreased intake. Oral nutritional supplements and non-oral nutritional supplements groups did not differ in terms of sex, age, length of stay, Charlson Comorbidity Index, proportion of nursing reports, and absence of intake monitoring. Oral nutritional supplements were initiated in 31.9% of patients with a Malnutrition Universal Screening Tool score ≥2 and in 34.6% with decreased food intake. On multivariable analysis, hypoalbuminemia (adjusted odds ratio, 3.70), decreased food intake (adjusted odds ratio, 3.38), Malnutrition Universal Screening Tool score ≥2 (adjusted odds ratio, 2.10), and age <70 years (adjusted odds ratio, 1.56) were significantly associated with oral nutritional supplements use. The prevalence of oral nutritional intervention was suboptimal in patients at risk of malnutrition during acute hospitalisation, although decreased food intake and Malnutrition Universal Screening Tool score ≥2 independently increased the probability of oral nutritional supplements initiation. Understanding the clinical practice and nursing impact of care management in relation to nutritional intervention can assist in reviewing and improving patient care. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE IMPACT (ADDRESSING): This study informs clinical management and influences nursing practice standards related to assessing, monitoring, and managing malnutrition risk. The study impacts the quality of care for patients at risk of malnutrition. We adhered to the STROBE Checklist for cohort studies. No Patient or Public Contribution.

The effectiveness of a home-based dietetic intervention for community-dwelling older adults.

The aim of this study was to describe the characteristics of clients receiving home-based dietetic intervention and to evaluate the effectiveness of these interventions in improving nutritional status, functional status, and quality of life in a culturally and socioeconomically diverse client group. Participants referred to a home-based dietetic service were recruited to this prospective cohort study. Dietetic interventions were recommended at baseline and reviewed at 3-month follow-up. Assessment of nutritional, functional and quality of life markers was measured using the Mini Nutritional Assessment (MNA), Timed Up and Go (TUG) and EQ-5D-5L, respectively, at baseline and after home-based dietetic intervention. Participants (n = 99) were recruited from consecutive referrals. Participant's weight, body mass index (BMI), total daily energy and protein intake, MNA total score, and TUG significantly improved after a 3-month nutrition intervention (effect sizes 0.257, 0.257, 0.580, 0.533, 0.577 and 0.281, respectively). The most common interventions dietitians utilised were nutrition education, use of oral nutritional supplements (ONS) and meal fortification. In total, 339 dietetic interventions were recommended to participants at baseline with 197 (58.11%) implemented at 3 months, with meal planning and referral to other relevant allied health or Commonwealth Home Support Program (CHSP) services the most implemented interventions. Home-based dietetic intervention improves nutritional status, functional status and quality of life in community-dwelling older adults referred for dietetic input. Improvements observed in nutritional and functional status were consistent with benchmarks of change from published literature.

Nutritional interventions in frailty in older adults: a narrative review on the current evidence

In recent years there has been an increase in elderly population and frailty. Although there is no universal definition of frailty, the most used is the frailty phenotype defined by Fried et al. (2001). Unbalanced eating habits and/or an inadequate nutritional status are modifiable risk factors for frailty. The aim of this literature review is to analyse the role of nutrition in frailty’s treatment in community-dwelling, institutionalized and hospitalized older adults. Regardless the setting, educational strategies, food fortification, supplementation, multidisciplinary and individualized interventions are important and effective strategies for frailty’s treatment. In community-dwelling older adults, multifactorial interventions that combine nutritional education and supplementation seem to be effective in treating frailty. In institutionalized older adults, multifactorial intervention that include protein-energy, vitamin D, calcium and fiber and physical exercise improves nutritional status and also physical capacity. In hospital setting, the most effective strategy is an individualized approach regarding patients’ favourite foods, additional snacks, the use of oral nutritional supplements or use protein-enriched foods and artificial nutrition when necessary. Further studies are needed in order to establish specific recommendations for the intervention in the prevention and treatment of frailty in older adults.

Use of oral nutritional supplements in irradiated patients with head and neck cancer.

Malnutrition is common among patients with head and neck cancer (HNC) and associated with poorer outcomes. Oral nutritional supplements (ONS) are often prescribed, with concerns raised about their cariogenicity. This study examined ONS use and caries experience in patients with HNC 12 months post-diagnosis. Fifty-four patients with HNC referred for pre-radiotherapy dental assessment were recruited. Data collected included: age, gender, residential postcode, smoking, alcohol use, HNC characteristics, dental history, oral hygiene habits, dietary advice and ONS use. Data was collected at diagnosis, during radiotherapy and 6 weeks, three, six- and 12-monthspost-treatment completion. Fifty-one subjects completed the study. 76.5% of the participants used ONS for an average of 13.8 weeks. Caries developed in 22.9% of ONS users and 11.1% of non-users (p = 0.6585). The mean overall duration of ONS use was 18.7 weeks for the caries group and 8.5 weeks for the caries-free group (p = 0.1507). Lack of collaboration and disconnection was noted between dietary advice given by dieticians and dentists. ONS use is common among patients with HNC. Larger studies are needed to establish the reasons for caries development and impacts of ONS use on oral health. Importance of multidisciplinary management of malnutrition is highlighted.

Community oral nutritional supplement use in oncology patients reduces complications: A systematic review and meta-analysis

Community oral nutritional supplement use in oncology patients reduces complications: A systematic review and meta-analysis

Oral Nutritional Supplements Enhanced Recovery After Orthopedic Surgery: An Application-Based Study

This research clarifies the application value of oral nutritional supplements in enhanced recovery after orthopedic surgery nursing for patients. One hundred patients from the orthopedics department of the First Affiliated Hospital of Harbin Medical University were recruited between June 2021 and December 2022 and were divided into control and experimental groups using the random number table method. After admission, both groups underwent a comprehensive evaluation and were scheduled for surgery. The control group received conventional nutrition propaganda and education, while the experimental group underwent enhanced recovery after surgical nursing nutritional management. After surgery, the time of getting out of bed for activity, postoperative hospitalization time, total hospitalization time, recovery time of intestinal sounds, anus exhaust time, and anus defecation time in the experimental group were lower than those in the control group. Serum albumin and hemoglobin levels were lower in the experimental group than in the control group. The incidence of complications in the experimental group decreased compared to that in the control group. Overall, use of oral nutritional supplements in orthopedic surgery patients can reduce postoperative recovery time of gastrointestinal function and hospitalization duration. It can help improve their nutritional status, prevent complications, and provide good conditions for the postoperative rehabilitation of patients.

Dental and oral implications of prescribed Oral Nutritional Supplements for disease related malnutrition- A systematic review

BACKGROUND AND OBJECTIVES: The use of Oral Nutritional Supplements (ONS) is widespread among patients with long- and short-term medical conditions. Although ONS serve an important purpose in the management of malnutrition, their effect on the oral hard and soft tissues is not well understood. The aim of this article is to conduct an analysis of the available literature relating to ONS and their impact on the oral environment. METHODS: This study was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines adapted by Liberati. The PICO question is as follows: Population: Individuals (both children and adults) Intervention: Use of Oral Nutritional Supplements Comparison: Individuals not taking Oral Nutritional Supplements Outcome: Increased risk of oral disease (specifically dental caries, periodontal disease or candida) The research question was “Are people who take ONS at higher risk of oral diseases than the general population?” Eligibility criteria The results obtained from the literature search were filtered, according to these inclusion and exclusion criteria: Inclusion criteria • Individuals were prescribed Oral Nutritional Supplements • All studies were included, including, case–control, cohort, cross-sectional or case studies. • Studies were included if they directly compared the association between ONS and oral health i.e. Effect of ONS on the oral environment had to be one of the aims of the study • Studies on human subjects or in vitro experiments • Published in English language • Studies from 1960 to the present day Exclusion criteria • Studies not in English • Review articles and case series were excluded • Studies including the use of other nutritional supplements such as vitamin or herbal supplements were not included. • Other supplemental feeding methods such as enteral or parenteral feeding were not examined 4 databases were searched: Medline (via Ebsco), Embase, Web of Science Core Collection, Google Scholar. Risk of bias was assessed using the ROBINS-I tool. RESULTS: A total of 58 records were identified through databases and searching bibliographies. 50 publications were excluded from the review, based on study title and abstract. The full text of eight articles were assessed for eligibility. No article answered the primary aim of the systematic review. Three articles discussed the secondary aim of the systematic review and these were included in the qualitative systematic review. The main outcome of the first study showed that the ONS had higher cariogenic potential than milk due to it’s higher acidogenicity. However, there was no statistical difference in dentine demineralisation and no significant difference in viable micro-organisms present. The main outcome of the second study showed that Escherichia coli, Staphylococcus aureus and C. albicans all grew at room temperature in the dairy-based ONS collected, and that C. albicans also grew in the juice which was milk protein-free and lipid-free. The third study showed that ONS were “potentially cariogenic” on enamel. DISCUSSION: Two studies were deemed as being at “low” of bias, however another study was deemed to be at “serious” level of bias. All studies stressed the possibility of dental disease caused by oral nutritional supplements, however there is not enough research available to imply causation. Due to the high sugar content of these supplements, and the known dental implications of this, it would be beneficial to carry out more research into this area.

“More2Eat” in patients at nutritional risk during hospital stay lowers the risk of three-month mortality

Malnutrition is a common problem among hospitalized patients due to increased nutrient requirements and reduced food intake or uptake of nutrients. The aim of this prospective cohort study was to investigate the association of nutritional risk status (at or not at risk by NRS-2002) as well as energy and protein intake, use of oral nutritional supplements (ONS) and snack meals in at risk patients during hospitalization and adverse outcomes (length of stay (LOS), readmissions and mortality) at three-months follow-up. Data were collected at baseline and at three-months follow-up in patients hospitalized at 31 units at a Danish University Hospital. Diet records were performed at baseline by using the nurses' quartile nutrition recording methods. Data about disease and clinical outcomes were collected from electronic medical records at baseline and three-months follow-up. A total of 318 patients were included. Patients at nutritional risk (n=149, 47%) had higher risk of longer LOS (≥20 days (OR=4.24 [1.81;9.95] and ≥30 days OR=2.50 [1.22;5.14])), having one readmission (OR=1.86 [1.15;3.01]) and death (OR=2.56 [1.27;5.20]) compared to patients not at nutritional risk (n=169, 53%). A longer LOS was associated with patients who achieved ≥75% of energy and protein requirements, consumed snack meals incl. and excl. oral nutritional supplements. Readmissions in patients at nutritional risk during the three-months were not associated with food intake during the index hospitalization. Mortality was observed in 43 of the 318 (13.5%) hospitalized patients. A lower mortality was associated with increased energy and protein intake in patients at nutritional risk. The results of this study indicate a longer LOS, higher readmission rate and increased mortality in patients at nutritional risk compared to patients not at risk. Patients at nutritional risk had lower risk of three-month mortality and longer LOS during index hospitalization with increased energy and protein intake. Readmissions in patients at nutritional risk were not affected by food intake. The association of nutritional risk with poorer outcomes indicates that good nutritional care including constant attention to food-intake during hospitalization can be beneficial regarding mortality.

Weight Loss and Weight Gain: Multi-Level Determinants Associated with Resident 3-Month Weight Change in Long-Term Care

This study examined factors associated with weight change in 535 residents in 32 long term care homes where 3-month weight records were available. Trained researchers and standardized measures (e.g., nutrition status, food intake, home characteristics) were used to collect data; weight change was defined as ±2.5%. Just over 25% of the sample lost and 21% gained weight. Weight stability was compared to loss or gain. Weight loss was associated with being male, malnourished (MNA-SF or BMI <25), energy and protein intake and oral nutritional supplement use, while weight gain was associated with being female, and a physically (e.g., less noise) and socially supportive dining room. Weight stability was associated with better cognition. A high proportion of residents had a significant weight change in 3 months. Modifiable factors associated with weight stability or gain suggest focusing interventions that promote food intake and improve the mealtime environment.

MEDPass versus conventional administration of oral nutritional supplements – A randomized controlled trial comparing coverage of energy and protein requirements

The use of oral nutritional supplements (ONS) in the hospital setting is important to reach individual protein and energy goals in patients at risk for malnutrition. Compliance with ONS can be challenging but may be improved by prescribing ONS in smaller portions with medication rounds (MEDPass). We compared the likelihood of meeting energy and protein requirements in patients receiving ONS with MEDPass versus conventional ONS administration. The MEDPass Trial is a randomized, controlled, open-label superiority trial conducted on medical and geriatric wards in a University Hospital in Switzerland. The MEDPass group was allocated to receive 50ml of ONS four times per day with the medication rounds. The control group received ONS per conventional care between the meals. The primary outcome was the percentage of energy in relation to the individual requirement. Secondary outcomes included the coverage of protein intake in relation to the individual requirement, the amount of daily consumed ONS, the course of handgrip strength (HGS), body weight appetite and nausea. Furthermore, we compared 30-day mortality and hospital length of stay (LOS) was studied in medical patients. From November 22nd, 2018 until November 30th, 2021, 204 patients were included in the trial (MEDPass group n=100, control group n=104). A total of 203 patients at nutritional risk were analyzed in the intention-to-treat analysis (ITT). Regarding the primary endpoint, there was no difference in the coverage of energy requirement between the MEDPass and control group (82 vs. 85% (Δ-3%, 95%CI -11 to 4%), p=0.38). Similarly, no differences were found for the secondary outcomes including coverage of protein requirement (101 vs. 104% (Δ-3%, 95% CI -12 -7%), p=0.57, average daily intake of ONS (170 vs 173ml (Δ - 3ml, 95% CI -14 to 8ml), p=0.58) and 30-day mortality (3 vs. 8 patients, OR 0.4 (95% CI 0.1-1.4), p=0.15). The course of HGS, body weight, appetite and nausea did not differ between the groups (p=0.29, p=0.14, p=0.65 and p=0.94, respectively). The per protocol analysis including 178 patients showed similar results. Within this controlled trial setting, we found a high compliance for ONS intake and high coverage of protein requirements but no further improvement when ONS was administered using MEDPass compared to conventional care. MEDPass administration may provide an alternative that is easy to integrate into nursing routines, which may lead to lower workload with cost benefits and reduction of food waste. ClinicalTrials.gov: NCT03761680.

Optimal use of oral nutritional supplements (ONS) in medical nutrition therapy: ONS consensus report from KEPAN.

Medical nutrition therapy is one of the core components of the patient management, although its implication is still limited in daily practice globally. Clinicians are in need of guidance that will ease the application of medical nutrition therapy. The first treatment choice in medical nutrition therapy is the use of oral nutritional supplements (ONS) after or concomitant with dietary interventions. The pre and post-graduate curriculum for medical nutrition therapy is limited in most regions, worldwide. A report that is short, clear, and having clear-cut recommendations that will guide the primary healthcare professionals in indications, choice, practical application, follow-up, and stopping ONS would facilitate the application and success of medical nutrition therapy. KEPAN is the Clinical Enteral and Parenteral Nutrition Society of Turkey and is an active member of the European Society for Clinical Nutrition and Metabolism (ESPEN). In this study, we present the KEPAN ONS consensus report on optimal ONS use in medical nutrition therapy as outlined by works of academicians experienced in clinical application of ONS (eight working group academicians and 19 expert group academicians). This report provides 22 clear-cut recommendations in a question-answer format. We believe that this report could have a significant impact in the ideal use of ONS in the context of medical nutrition therapy when clinicians manage everyday patients.

Validation of the Visual/Verbal Analogue Scale of Food Ingesta (Ingesta-VVAS) in Oncology Patients Undergoing Chemotherapy.

This study aimed to: (1) externally validate the Visual/Verbal Analogue Scale of food ingesta (ingesta-VVAS) that previously showed good discrimination between oncology patients who ingest more or less energy than required; (2) explore the discriminative properties of other questions. Dietitians performed 322 interviews in 206 adult oncology patients undergoing chemotherapy in two Dutch hospitals, including a 24-h dietary recall, assessment of the ingesta-VVAS and 12 additional questions related to reduced food intake. The ingesta-VVAS score was linearly associated with energy intake as % of Total Energy Expenditure (TEE) (standardized beta = 0.39, p < 0.001), with no differences between groups based on use of oral nutritional supplements, body mass index, in/outpatient setting or sex. The accuracy of the ingesta-VVAS score to predict low energy intake (<75% of TEE) was poor (Area Under the Receiver Operating Characteristic curve (AUC) = 0.668, 95% CI 0.603–0.733). The optimal multivariate model included the ingesta-VVAS score and a question on ‘feeling sick’ (AUC = 0.680, 95% CI 0.615–0.746). In conclusion, in our study the ingesta-VVAS discriminates poorly between oncology patients undergoing chemotherapy who ingest more or less energy than required. Adding a question on feeling sick only slightly improved model performance. Further external validation is warranted.

Dietitian Involvement Improves Consumption of Oral Nutrition Supplements in Hospitalized Patients.

Hospitalized patients are at an increased risk of malnutrition due to multiple factors including, but not limited to, acute and chronic diseases especially those affecting gastrointestinal tract, surgery, appetite, and frequent nil per os while undergoing diagnostic workup. Because of this, guidelines suggest the use of oral nutritional supplements (ONS) in hospitalized patients to reduce the risk of malnutrition and its complications. The current report aims to highlights key findings from a cross-sectional survey of 99 hospitalized patients who were at risk for or diagnosed with malnutrition and prescribed ONS. Data regarding ONS prescriber information as well as number ordered and consumed were collected. Of the 2.4 ± 1.5 supplements ordered per person each day, only 1.3 ± 1.1 were consumed, and there was 48% wastage of prescribed ONS. However, dietitian involvement was associated with significant reduction in wastage. Given the need and benefit, it is imperative for the nutrition community to further explore best practices to improve ONS consumption.

Ten years of tackling malnutrition in the community

British Journal of NursingVol. 31, No. 13 CommentTen years of tackling malnutrition in the communityAnne Holdoway, Hilary FranklinAnne HoldowayConsultant Dietitian and Chair of the Managing Adult Malnutrition in the Community panelSearch for more papers by this author, Hilary Franklin(E-mail Address: [email protected])Healthcare Communications Consultant and Malnutrition Pathway Co-ordinatorSearch for more papers by this authorAnne Holdoway; Hilary FranklinPublished Online:7 Jul 2022https://doi.org/10.12968/bjon.2022.31.13.S6AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Brown F, Fry G, Cawood A, Stratton R. Economic impact of implementing malnutrition screening and nutritional management in older adults in general practice. J Nutr Health Aging. 2020; 24(3):305–311. https://doi.org/10.1007/s12603-020-1331-6 Crossref, Medline, Google ScholarCawood A, Kominek N, Janik L et al. Local implementation of a pathway to manage malnourished COPD patients in the community. ERS International Congress 2017 abstracts. European Respiratory Journal. 2017; 50(suppl 61): PA1609. https://doi.org/10.1183/1393003.congress-2017.PA1609 Google ScholarElia M for Malnutrition Action Group (BAPEN) and the National Institute for Health Research Southampton Biomedical Research Centre. The cost of malnutrition in England and potential cost savings from nutritional interventions (full report). 2015. https://tinyurl.com/4atczp45 (accessed 27 June 2022) Google ScholarElia MRussell CA (eds). Combating malnutrition: recommendations for action. Output of a meeting of the Advisory Group on Malnutrition 12 June 2008. BAPEN; 2009. https://tinyurl.com/47r88529 (accessed 27 June 2022) Google ScholarHoldoway A, Anderson L, Ashworth A et al.; Malnutrition Pathway Consensus Panel. Managing adult malnutrition in the community: A guide to managing disease-related malnutrition, including a pathway for the appropriate use of oral nutritional supplements (ONS). 3rd edn. 2021. https://tinyurl.com/59bd564j (accessed 28 June 2022 Google Scholar FiguresReferencesRelatedDetails 7 July 2022Volume 31Issue 13ISSN (print): 0966-0461ISSN (online): 2052-2819 Metrics History Published online 7 July 2022 Published in print 7 July 2022 Information© MA Healthcare LimitedPDF download

Isk of malnutrition and oral nutritional support in a cohort of hospital inpatients

Introduction: The disease-related malnutrition is considered a serious problem since it is strongly related to higher mortality rates, longer hospital stays, and increased costs for medical care. A highly associated risk factor has been the decreased oral intake during the hospital stay; however, the use of oral nutritional supplements allows to heal the malnutrition burden having positive results. Objective: To evaluate the hospital malnutrition risk and the oral nutritional supplements effect for 4 days in anthropometric variables, energy, and protein intake in hospital inpatients. Materials and methods: A cohort study, in a third-level hospital in which within the first 24 hours of the admission, the malnutrition risk was assessed (NRS-2002), the prescribed oral nutritional supplements, its follow-up during a 4-day consumption and its impact on weight, body mass index and muscle strength estimated by dynamometry were analyzed; additionally, the nutritional intake (energy and proteins) was assessed. Results: A total of 290 patients (167W/123M) were assessed, with an average age of 54.7±17.3 years. The malnutrition risk prevalence at hospital admission was 50.3% and from the total patients, 10.3% (n=30) received oral nutritional supplements. After the consumption of oral nutritional supplements, an increased energy consumption was shown in those with a &gt;50% adherence during the 4 days; we found an increased energy adequacy percentage of 73.6 ± 33 to 101 ± 32 (p=0.003) and protein adequacy 75.8 ± 45 to 108 ± 58 (p=0.016), with appropriate tolerance. No differences were documented in anthropometric and arm strength variables. Conclusions: The use of oral nutritional supplements during the hospital stay increases considerably the energy and protein consumption in patients with a &gt;50% adherence with appropriate tolerance.

Managing malnutrition in older people living in residential care

Nursing and Residential CareVol. 24, No. 4 Clinical ReviewManaging malnutrition in older people living in residential careOmorogieva OjoOmorogieva OjoCorrespondence to: Omorogieva Ojo; E-mail Address: [email protected]Senior Lecturer in Primary Care, Faculty of Education and Health, University of Greenwich, Greenwich, London, UKSearch for more papers by this authorOmorogieva OjoPublished Online:2 May 2022https://doi.org/10.12968/nrec.2022.0014AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References British Dietetic Association. Malnutrition: food fact sheet. 2022. https://www.bda.uk.com/resource/malnutrition.html (accessed 11 March 2022) Google ScholarBrook S. Oral nutritional supplements: an integral part of malnutrition treatment. 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The impact of the introduction of a clinical nutrition unit in a hospital: a retrospective observational study.

Objectives: the study describes the evolution over the years of the use of artificial nutrition, in particular after the introduction of a dedicated Clinical Nutrition and Dietetic Service. Methods: a single-center, retrospective observational study performed with data collected from 2014 to 2019 at the Regional Hospital of Locarno, Switzerland. Results: from 2014 to 2019, there has been an increase in the number of patients identified as being at risk of malnutrition. We observed a reduction in the use of parenteral nutrition in all services, especially after the introduction of the dedicated Clinical Nutrition and Dietetic Service. There would seem to be a switch from enteral to oral nutrition with increased use of oral nutritional supplements. Conclusions: the introduction of a dedicated Clinical Nutrition and Dietetic Service in the care of patients with nutritional issues would seem to reduce the use of artificial invasive nutrition, despite an increase in the number of patients identified as being at risk of malnutrition.