Significant improvements in body weight, body-mass index, the mini nutritional assessment-short form (MNA-SF) score, and walking speed were noted following a 12-week period of intervention with a nutritional supplement drink (NSD) and nutritional education (NE) given by a dietitian.
The Thai researchers concluded on their findings: “The ONS was effective in improving the nutritional status of older nursing home residents who were at risk of malnutrition.”
The study, published in Nutrients, provides evidence for the potential for ONSs to be used as effective dietary interventions for the prevention of malnutrition in the growing aging population.
With an ever-growing elderly population estimated to surpass 1.2 billion people aged 60 years and over, the prevalence of malnutrition is also increasing in this age group. This has been noted to result from reduced intakes of protein and overall energy, which is linked with sarcopenia, frailty, and chronic disease occurrence, as well as increased risk of falls and hospitalization.
A previous study noted that this age-related malnutrition can occur due to influences of social and physiological changes, including changes in taste and swallowing abilities.
Oral nutritional supplements (ONSs) are a readily available nutrients that can provide adequate protein and energy sources to these older individuals, with studies highlighting their efficacy in reducing body weight loss and sarcopenia prevalence.
Yet, much of the previous research has focussed on the late stage of nutrition with regards to the effectiveness of ONSs. Therefore, the researchers sought to investigate the effects of NSDs on nutritional status and physical performance of older nursing home residents at risk of malnutrition.
The researchers conducted a randomised, parallel clinical trial recruiting 107 participants over the age of 65 years at risk of malnutrition from several nursing homes. The subjects were equally divided into a NE group and a NSD group.
The NE group received information from a dietician, whilst the NSD group were provided with two packs of NSD per day as a snack between meals and before bed. One 125ml NSD contained 203 kcals, with 7.5g of protein, 5.6g of fat, 31.8g of carbohydrates, 2.5g of dietary fibre, and a range of vitamins and minerals.
Subsequent measures of body composition, muscle strength, nutritional status, and blood biomarkers were obtained at baseline, at the sixth week, and following the end of the study at 12 weeks. A quality-of-life (QOL) survey was provided to subjects throughout the study, as well as a health status survey.
Following the 12-week intervention, it was reported that the NE combined with NSD intervention resulted in significant improvements in body weight, with an average increase of 1.21 ± 1.83 kg. Further significant improvements were noted for body-mass index, the mini nutritional assessment-short form (MNA-SF) score, and walking speed.
These improvements were noted to be more obvious in the group receiving both the NSD and NE, when compared to those who received only the NE, suggesting that the ONS may be effective in improving nutritional status in older nursing home residents.
For the future
The researchers concluded that their findings indicated the strong potential for ONSs to be implemented as an effective intervention for improving the nutritional status of older adults at risk of malnutrition.
Regarding the noted effects of the NE and NSE intervention on body weight improvements, it was reported that energy intake levels at baseline were insufficient. Thus, the NSE was providing significantly greater energy intakes to the subjects. The researchers stressed the importance of evaluating energy intake levels in the residents of nursing homes to prevent malnutrition in this population.
They urge for further research to validate the findings, using more controlled face-to-face interviews to gather the questionnaire information to prevent bias.
“Beneficial Effects of Oral Nutrition Supplements on the Nutritional Status and Physical Performance of Older Nursing Home Residents at Risk of Malnutrition”
Authors: Y-H. Chen, et al.