Writing in the journal Nutrients, a team of Spanish researchers investigated the effects of a combined personalized nutritional intervention with a concentrated high-protein, high-calorie oral nutritional supplement (cHPHC-ONS) on adult patients at risk of malnutrition.
“In patients with disease-related malnutrition (DRM), a personalized intervention with cHPHC-ONS significantly reduces the prevalence of malnutrition, severe malnutrition, and sarcopenia while improving muscle mass and function,” the researchers wrote.
Personalization for malnutrition
Between 28% and 73% of hospitalized individuals experience malnutrition, with older adults showing higher rates. In Europe, around 34% of hospital patients are malnourished or at risk, with similar trends in outpatient settings.
DRM can lead to muscle mass loss, decreased strength and sarcopenia, which further worsens health outcomes, including prolonged hospital stays, poor prognosis and higher mortality rates. To address this, patients with DRM require tailored diets and sometimes supplements to meet energy and protein needs.
Guidelines recommend that individuals consume 30 kcal/kg of body weight per day and a protein intake of 1.2–1.5 g/kg/day. Healthcare professionals commonly use oral nutritional supplements, particularly hypercaloric and high-protein options, but patients often struggle with compliance due to factors like taste, volume and gastrointestinal intolerance.
Nestlé Health Science developed the cHPHC-ONS to improve compliance and nutritional outcomes. It combines fast-acting whey protein and slow-digesting casein to optimize muscle maintenance and growth, providing high nutritional value in a smaller volume to enhance patient adherence.
The researchers emphasized that assessing the effectiveness of nutritional interventions should focus on body composition and muscle function, rather than relying on traditional methods like anthropometry, which other conditions may influence.
They recommend using tools like muscle ultrasonography, supported by AI software, for more accurate monitoring of DRM and sarcopenia.
Study details
The study recruited 65 participants who received a personalized nutritional plan that included dietary counseling and the oral nutritional supplement.
Researchers prescribed cHPHC-ONS, typically one or two 200 mL bottles daily for three months, based on the patients’ estimated dietary intake and specific nutritional requirements. Comprehensive assessments were conducted at baseline and three months post-intervention. The supplement contained ≥2.1 kcal/mL and 32g of protein per 200mL.
Results showed that participants experienced a significant reduction in percentage weight loss, a decrease in malnutrition prevalence and severe malnutrition, and improvements in sarcopenia.
Also observed were increases in muscle area, rectus femoris muscle echogenicity, muscle thickness, pennation angle and handgrip strength, particularly in patients over 60 years old.
While traditional metrics like BMI did not change significantly, body composition improved. Patients experienced increased muscle mass, reduced malnutrition and greater adherence to the treatment (93.85% over three months).
The researchers noted study limitations including a lack of a control group and variability in patient pathologies.
“Future studies are needed to evaluate the real effect of nutritional support,” they wrote. “It is necessary to conduct randomized control trials with enteral formulas and to evaluate the effects with diagnostic tests that can be performed in routine clinical practice from a morphofunctional assessment point of view.”
Journal: Nutrients
"Effectiveness of High-Protein Energy-Dense Oral Supplements on Patients with Malnutrition Using Morphofunctional Assessment with AI-Assisted Muscle Ultrasonography: A Real-World One-Arm Study.”
https://doi.org/10.3390/nu16183136
Authors: López-Gómez, J. et al