Oral nutritional supplements in a randomised trial are more effective than dietary advice at improving quality of life in malnourished care home residents
Abstract
Background & aims Few trials have explored the effect of nutrition support on quality of life (QoL). This study examined the effects of oral nutritional supplements (ONS) vs dietary advice on QoL in malnourished care home residents. Methods 104 malnourished, care home residents (medium + high risk), identified using the Malnutrition Universal Screening Tool ('MUST'), (mean age 88.5 ± 7.9y) were randomised to receive either oral nutritional supplements (ONS) (n = 53) or dietary advice (n = 51) for 12 weeks. Dietary intake was measured using 24 h dietary recall, and QoL assessed using EuroQol (EQ-5D), including time trade off (TTO) (range -0.59 to 1) and visual analogue scale (VAS) (score 0 to 100) for self-perceived health. Results QoL (adjusted for baseline QOL, malnutrition risk, type of care received (nursing or residential)) was significantly higher in the ONS than the dietary advice group (intention to treat analysis at week 12; n = 104 ). EQ-5D TTO scores (mean ± SE) were 0.50 ± 0.04 vs 0.36 ± 0.05 (P = 0.005), VAS rescaled scores were 0.54 + 0.03 vs 0.046 + 0.03 (P = 0.006) and VAS scores were 61.3 ± 4.5 vs 54.6 ± 6.3 (P = 0.533) for ONS vs dietary advice respectively. Total energy, protein and the majority of micronutrient intakes were significantly greater in the ONS group, with energy intake being 423 kcal greater in the ONS than the dietary advice group at week 12. Conclusions This study in malnourished care home residents indicates that ONS can improve QoL and nutr…
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Better quality of life is reported in the ONS group than dietary counseling.
“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).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [112]
Higher energy and protein intake is reported in the ONS group than dietary counseling or additional snack foods.
“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).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [112]
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Desai, A. M., Dong, O. M., Gautier, S. C. Z., Johnson, T., Wong, A., Osman, A. M. Y., Harvey, J. (., Tran, T. H., Ford, D. M. H., Kerr, K. W., et al. (2026) · Value in Health · doi:10.1016/j.jval.2026.06.023
- Authors
- Parsons, E. L., Stratton, R. J., Cawood, A. L., Smith, T. R., & Elia, M.
- Affiliations
- Southampton General Hospital (GB)
- Corresponding author
- Stratton, Rebecca J.
- Elia, Marinos
- Venue
- Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2017-02
- Volume
- 36
- Issue
- 1
- Pages
- 134-142
- ISSN
- 0261-5614 (ISSN-L)
- OpenAlex
- W2237133171
- Cited by
- 89
- References
- 22
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 9 · 2023: 5 · 2022: 15 · 2021: 10 · 2020: 8 · 2019: 7 · 2018: 8 · 2017: 8 · 2016: 7 · 2014: 1
- FWCI
- 8.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Funders
- University Hospital NHS Foundation trust
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Keywords
- oral nutritional supplements, malnutrition, nursing home residents, quality of life, dietary recommendations, nutritional support, older adults, energy and protein intake, micronutrient intake, Malnutrition Universal Screening Tool, nursing homes, care homes, health perception, time trade-off, visual analogue scale, EQ-5D, dietary recall, cost-effectiveness
- MeSH terms
- Administration, Oral, Aged, Aged, 80 and over, Counseling, Diet, Dietary Proteins, Female, Follow-Up Studies, Humans, Male, Nutritional Status, Quality of Life, Mental Recall, Risk Factors, Weight Loss, Nutrition Assessment, Body Mass Index, Micronutrients, Dietary Supplements, Malnutrition
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