Nutrition Supplementation Enables Elderly Residents of Long-term-care Facilities to Meet or Exceed RDAs Without Displacing Energy or Nutrient Intakes from Meals

https://doi.org/10.1016/S0002-8223(98)00330-7Get rights and content

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Methods and Materials

Ninety-one residents from 4 LTC facilities were recruited to participate in this study. Residents had to be at least 60 years old, have no known allergies to any product ingredients, and not be receiving nutrition by tube or vein.

Eligible residents were determined to be at risk by the Omnibus Budget Reconciliation Act of 1987 if they had had either a 10% weight loss during the past 6 months or a 5% weight loss in the previous month (15). An additional study criterion was current weight less

Results and Discussion

Of the 91 residents screened for nutritional risk, 68 were identified as being at risk for poor nutritional status. Ten residents were not included in the statistical analyses because of a requested change in feeding regimen (n=2), noncompliance with the protocol (n=4), insufficient data (n=2), and adverse events (n=2). The adverse events involved complaints of bloating and the presence of mucus and phlegm after consumption of the supplement.

No differences were observed between snack and

Applications

Many clinicians hesitate to recommend medical nutrition supplements because they believe supplements replace the energy and nutrients consumed at meals or traditional snacks served at LTC facilities contain energy and nutrients equivalent to those of the supplements. Proper nutrition should be delivered in the form of a variety of foods to ensure a balanced diet. Unfortunately, elderly residents in LTC facilities often do not consume enough food at meals to meet their requirements. This has

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  • Cited by (53)

    • ESPEN practical guideline: Clinical nutrition and hydration in geriatrics

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      Only very few studies have compared the effectiveness of ONS to that of “normal food” support strategies in older persons. Greater weight gain [111], higher energy and protein intake [104,112] and better quality of life [112] are reported in the ONS group than dietary counseling [111,112] or additional snack foods [113]. However, dietary counseling and food modifications may be better accepted for longer durations and are cheaper, so we suggest that in chronic clinical situations such as observed in the community or nursing homes, they may be proposed first and that ONS be offered when dietary counseling and food fortification are not sufficient to reach nutritional goals.

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      In frail elderly people living at home, the weight gain was greater and the number of falls was lower in the group receiving a high energy ONS provided by a dietician than in the dietician visit only group [12]. Compared to snacks or dietary advice, ONS provided higher energy and protein intake and better quality of life in elderly people [13,14]. Economic studies address patients at risk of malnutrition or malnourished, with different surgical or medical diseases, in the hospital, post-discharge or in the community nursing home [6,15–18].

    • Oral nutritional supplements in a randomised trial are more effective than dietary advice at improving quality of life in malnourished care home residents

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      ONS largely added to rather than replaced energy intake from food, and was not associated with more satiation or fullness (indeed it was found to be associated with less fullness) according to the subjective ratings. The largely additive effect of ONS to food intake has been observed in other trials [6,13,23], some of which have suggested that liquid ONS are more effective than solid food snacks at increasing total intake [23–25]. It is unlikely that the significant results in QoL were due to any major differences in subject characteristics between groups, partly because baseline characteristics generally did not differ between the groups, and partly because the analysis controlled for confounding variables (intervention, type of care, ‘MUST’ category).

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