Specialized High‐Protein Oral Nutrition Supplement Improves Home Nutrient Intake of Malnourished Older Adults Without Decreasing Usual Food Intake
Open accessAbstract
Background: Reduced nutrient intake is common in patients after hospitalization, contributing to increased risk for readmission and mortality. Oral nutrition supplements can improve nutrition status and clinical outcomes, but intake of food is prioritized by clinicians. This study examines the impact of a high‐protein oral nutrition supplement (S‐ONS) on nutrient intake post discharge. Methods: In a subset of patients (14 S‐ONS and 16 placebo) from the NOURISH (Nutrition effect On Unplanned ReadmIssions and Survival in Hospitalized patients) trial, 24‐hour dietary recalls were conducted on 3 randomly selected days during the weeks of 30, 60, and 90 days post discharge. Nutrient intake was estimated using Nutrition Data System for Research software. Adequate energy and protein intake were defined as 30 kcal/kg/d and 1.2 g/kg/d, respectively. Dietary Reference Intakes (DRIs) were used for other nutrients. Results: Less than half of patients met the requirements for energy, protein, and 12 micronutrients from food intake alone during the study. Energy and protein intakes from food were not diminished relative to placebo. Considering nutrient intake from both food and S‐ONS, 50% and 71% of patients receiving S‐ONSs met energy and protein goals respectively at 90 days (compared with 29% and 36%, in the placebo group), and 100% met the DRI for total carbohydrate, iron, phosphorus, copper, selenium, thiamin, and riboflavin at all time points, all of which were consumed at higher amounts vs placebo. Conclusion: Three months of S‐ONS consumption increases intake of numerous nutrients without decreasing nutrient intake from food in older malnourished adults post discharge.
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A sub-analysis of the NOURISH study showed an increase in nutrient intake in intervention patients without decrease in dietary intake.
“A sub-analysis of the NOURISH study showed an increase in nutrient intake in IG patients without decrease in dietary intake”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [98]
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Deutz, N. E. P., Bauer, J. M., Barazzoni, R., Biolo, G., Boirie, Y., Bosy-Westphal, A., Cederholm, T., Cruz-Jentoft, A., Krznariç, Z., Nair, K. S., et al. (2014) · Clinical Nutrition · doi:10.1016/j.clnu.2014.04.007 · Cited by 1,738 · see citing works
Self-citationDeutz, N. E., Matheson, E. M., Matarese, L. E., Luo, M., Baggs, G. E., Nelson, J. L., Hegazi, R. A., Tappenden, K. A., & Ziegler, T. R. (2016) · Clinical Nutrition · doi:10.1016/j.clnu.2015.12.010 · Cited by 472 · see citing works
Self-citationPichard, C., Kyle, U. G., Morabia, A., Perrier, A., Vermeulen, B., & Unger, P. (2004) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/79.4.613 · Cited by 392 · see citing works
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Research works printed but not linked: 27
- [1]Norman K, Pichard C, Lochs H, Pirlich M. Prognostic impact of disease‐related malnutrition. Clin Nutr. 2008; 27(1): 5‐ 15. 18061312
- [2]Allaudeen N, Vidyarthi A, Maselli J, Auerbach A. Redefining readmission risk factors for general medicine patients. J Hosp Med. 2011; 6(2): 54‐ 60. 20945293
- [3]Maeda K, Koga T, Akagi J. Nutritional variables predict chances of returning home and activities of daily living in post‐acute geriatric care. Clin Interv Aging. 2018; 13: 151‐ 157. 10.2147/CIA.S154129 29416323 PMC5790089 · DOI
- [5]Hudson L, Chittams J, Griffith C, Compher C. Malnutrition identified by Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition is associated with more 30‐day readmissions, greater hospital mortality, and longer hospital stays: a retrospective analysis of nutrition assessment data in a major medical center. JPEN J Parenter Enteral Nutr. 2018; 42(5): 892‐ 897. 29385244
- [6]Curtis LJ, Bernier P, Jeejeebhoy K, et al. Costs of hospital malnutrition. Clin Nutr. 2017; 36(5): 1391‐ 1396. 27765524
- [7]Ruiz AJ, Buitrago G, Rodriguez N, et al. Clinical and economic outcomes associated with malnutrition in hospitalized patients [published online ahead of print June 1, 2018]. Clin Nutr. 10.1016/j.clnu.2018.05.016 29891224 · DOI
- [8]Somanchi M, Tao X, Mullin GE. The facilitated early enteral and dietary management effectiveness trial in hospitalized patients with malnutrition. JPEN J Parenter Enteral Nutr. 2011; 35(2): 209‐ 216. 21378250
- [9]Sanchez‐Rodriguez D, Marco E, Annweiler C, et al. Malnutrition in postacute geriatric care: basic ESPEN diagnosis and etiology based diagnoses analyzed by length of stay, in‐hospital mortality, and functional rehabilitation indexes. Arch Gerontol Geriatr. 2017; 73: 169‐ 176. 10.1016/j.archger.2017.07.010 28822255 · DOI
- [10]Sherry CL, Sauer AC, Thrush KE. Assessment of the nutrition care process in US hospitals using a web‐based tool demonstrates the need for quality improvement in malnutrition diagnosis and discharge care. Curr Dev Nutr. 2017; 1(11): e001297. 29955685 PMC5998791
- [11]Braunschweig C, Gomez S, Sheean PM. Impact of declines in nutritional status on outcomes in adult patients hospitalized for more than 7 days. J Am Diet Assoc. 2000; 100(11): 1316‐ 1322; quiz 1323‐1314. 11103653
- [12]Allard JP, Keller H, Jeejeebhoy KN, et al. Decline in nutritional status is associated with prolonged length of stay in hospitalized patients admitted for 7 days or more: a prospective cohort study. Clin Nutr. 2016; 35(1): 144‐ 152. 25660316
- [13]Keller H, Laporte M, Payette H, et al. Prevalence and predictors of weight change post discharge from hospital: a study of the Canadian Malnutrition Task Force. Eur J Clin Nutr. 2017; 71(6): 766‐ 772. 28225049
- [14]Hiesmayr M, Schindler K, Pernicka E, et al. Decreased food intake is a risk factor for mortality in hospitalised patients: the NutritionDay survey 2006. Clin Nutr. 2009; 28(5): 484‐ 491. 19573957
- [15]Pilgrim AL, Robinson SM, Sayer AA, Roberts HC. An overview of appetite decline in older people. Nurs Older People. 2015; 27(5): 29‐ 35. PMC4589891 26018489
- [16]Elia M, Normand C, Laviano A, Norman K. A systematic review of the cost and cost effectiveness of using standard oral nutritional supplements in community and care home settings. Clin Nutr. 2016; 35(1): 125‐ 137. 26309240
- [17]Milne AC, Avenell A, Potter J. Meta‐analysis: protein and energy supplementation in older people. Ann Intern Med. 2006; 144(1): 37‐ 48. 16389253
- [18]Cawood AL, Elia M, Stratton RJ. Systematic review and meta‐analysis of the effects of high protein oral nutritional supplements. Ageing Res Rev. 2012; 11(2): 278‐ 296. 22212388
- [19]Keller HH, Vesnaver E, Davidson B, et al. Providing quality nutrition care in acute care hospitals: perspectives of nutrition care personnel. J Hum Nutr Diet. 2014; 27(2): 192‐ 202. 24147893
- [20]Tappenden KA, et al. Critical role of nutrition in improving quality of care: an interdisciplinary call to action to address adult hospital malnutrition. JPEN J Parenter Enteral Nutr. 2013; 37(4): 482‐ 497. 23736864
- [21]Stratton RJ, Elia M. A review of reviews: a new look at the evidence for oral nutritional supplements in clinical practice. Clin Nutr Suppl. 2007; 2(1): 5‐ 23.
- [22]Beck AM, Holst M, Rasmussen HH. Oral nutritional support of older (65 years+) medical and surgical patients after discharge from hospital: systematic review and meta‐analysis of randomized controlled trials. Clin Rehabil. 2013; 27(1): 19‐ 27. 22643726
- [23]Gariballa SE, Forster SJ. Dietary intake of older patients in hospital and at home: the validity of patient kept food diaries. J Nutr Health Aging. 2008; 12(2): 102‐ 106. 18264636
- [24]Laudisio A, Costanzo L, Di Gioia C, et al. Dietary intake of elderly outpatients with chronic obstructive pulmonary disease. Arch Gerontol Geriatr. 2016; 64: 75‐ 81. 10.1016/j.archger.2016.01.006 26952380 · DOI
- [29]Hubbard GP, Elia M, Holdoway A, Stratton RJ. A systematic review of compliance to oral nutritional supplements. Clin Nutr. 2012; 31(3): 293‐ 312. 22257636
- [30]Conway JM, Ingwersen LA, Moshfegh AJ. Accuracy of dietary recall using the USDA five‐step multiple‐pass method in men: an observational validation study. J Am Diet Assoc. 2004; 104(4): 595‐ 603. 15054345
- [31]Moshfegh AJ, Rhodes DG, Baer DJ, et al. The US Department of Agriculture Automated Multiple‐Pass Method reduces bias in the collection of energy intakes. Am J Clin Nutr. 2008; 88(2): 324‐ 332. 18689367
- [32]Jonnalagadda SS, Mitchell DC, Smiciklas‐Wright H, et al. Accuracy of energy intake data estimated by a multiple‐pass, 24‐hour dietary recall technique. J Am Diet Assoc. 2000; 100(3): 303‐ 308; quiz 309‐311. 10719403
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ESPEN guideline on nutritional support for polymorbid medical inpatients
Wunderle, C., Gomes, F., Schuetz, P., Stumpf, F., Austin, P., Ballesteros-Pomar, M. D., Cederholm, T., Fletcher, J., Laviano, A., Norman, K., et al. (2023) · Clinical Nutrition · doi:10.1016/j.clnu.2023.06.023 · Cited by 105 · see citing works
“A sub-analysis of the NOURISH study showed an increase in nutrient intake in IG patients without decrease in dietary intake (Level of Evidence 1) [98].”
- Authors
- Loman, B. R., Luo, M., Baggs, G. E., Mitchell, D. C., Nelson, J. L., Ziegler, T. R., Deutz, N. E., Matarese, L. E., & NOURISH Study Group
- Affiliations
- Nationwide Children's Hospital (US)
- Abbott Nutrition (United States) (US)
- Pennsylvania State University (US)
- Emory University (US)
- Texas A&M University (US)
- East Carolina University (US)
- Corresponding author
- Luo, Menghua
- ORCID
- Venue
- Journal of Parenteral and Enteral Nutrition
- Publisher
- Wiley
- Published
- 2018-11-22
- Volume
- 43
- Issue
- 6
- Pages
- 794-802
- ISSN
- 0148-6071 (ISSN-L)
- 1941-2444
- PMC
- PMC6924274
- OpenAlex
- W2902942636
- Cited by
- 33
- References
- 3
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 3 · 2023: 10 · 2022: 4 · 2021: 4 · 2020: 3 · 2019: 1
- FWCI
- 1.65
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Parenteral and Enteral Nutrition (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- The Scholarship East Carolina University's Institutional Repository (East Carolina University) (submittedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutrition and Health Studies
- Keywords
- malnutrition, older adults, post-discharge nutrition, nutrient intake, energy intake, protein intake, micronutrient intake, dietary intake, hospital readmission
- MeSH terms
- Nutrients, Aged, Energy Intake, Diet Surveys, Eating, Feeding Behavior, Female, Hospitalization, Humans, Male, Nutritional Requirements, Nutritional Status, Patient Discharge, Geriatric Assessment, Nutrition Assessment, Nutrition Policy, Micronutrients, Dietary Supplements, Malnutrition
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