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Malnutrition is often the cause or the consequence of ill health (1) . BAPEN (2009) reports that care pathways for the identification and treatment of malnutrition are complex and often knowledge of the condition is poor among health-care professionals (HCP) (2) , many of whom have not received training in nutrition. Oral nutritional supplements (ONS) can play a key role in the management of malnutrition, and yet compliance is often perceived as poor.Two complementary studies that examine different aspects of compliance with ONS were conducted. The first study set out to establish factors affecting compliance in the United Kingdom from both a HCP and a patient/caregiver perspective. The second study examined the effects of sensory attributes of ONS on preference and compliance.In study 1, qualitative interviews were conducted with HCP (n 9, 6 dietitians, 2 district nurses and 1 GP). Subsequent 360 focus group sessions involving patients (n 7), caregivers (n 8) and HCP (n 4) gave insights on ONS compliance from the patient/caregiver perspective, with HCP providing interpretation and feedback. Six further one-to-one interviews were conducted with 2 patients, 3 carers and 1 pharmacist.In study 2, 174 individuals (85 men, 89 women, aged ‡ 50 years) living independently and not receiving ONS took part in a blinded study in which they received two full units each day of an ONS drink. A different product was tasted each day over a consecutive 5-d period. Evaluation of sensory attributes was by daily self-administered questionnaires and a face-to-face interview at the end of the study period.In study 1, factors that HCP cited as affecting compliance were (1) the duration and frequency of ONS, (2) the HCP's view of the palatability of the ONS, (3) patients/carers' poor understanding of the role of ONS in improving health outcomes and (4) inconsistent follow-up. The patient/caregiver focus groups also cited reasons (3) and (4) in addition to lack of patient/caregiver awareness of the need for, or willingness to, arrange a follow-up ONS prescription.In study 2, taste, mouthfeel, aftertaste, aroma and appearance were all identified as key sensory factors for determining ONS preference (P < 0.05). In terms of compliance, participants claimed they could consume more units of the supplement rated highest for sensory attributes (2.2 units/d).A 360 approach (i.e. involving patients, caregivers and HCP) identified the importance of training, education, goal setting, follow-up and the sensory attributes of ONS in improving patient motivation and compliance. These factors are key for both the duration and frequency of ONS consumption. Tailored education for both patients/carers and HCP could help to improve understanding of the clinical value of ONS.

Ensuring healthy lives and promoting wellbeing across the age spectrum are essential to sustainable development. Nutrition is at the heart of the World Health Organization (WHO) Sustainable Development Goals, particularly for Sustainable Development Goal 2/Subgoal 2, which is to End all forms of malnutrition by 2030. This subgoal addresses people of all ages, including targeted groups like young children and older adults. In recent decades, there have been marked advances in the tools and methods used to screen for risk of malnutrition and to conduct nutritional assessments. There have also been innovations in nutritional interventions and outcome measures related to malnutrition. What has been less common is research on how nutritional interventions can impact healthy aging. Our Perspective article thus takes a life-course approach to consider what is needed to address risk of malnutrition and why, and to examine how good nutrition across the lifespan can contribute to healthy aging. We discuss broad-ranging yet interdependent ways to improve nutritional status worldwide—development of nutritional programs and policies, incorporation of the best nutrition-care tools and methods into practice, provision of professional training for quality nutritional care, and monitoring health and economic benefits of such changes. Taken together, our Perspective aims to (i) identify current challenges to meeting these ideals of nutritional care, and to (ii) discover enabling strategies for the improvement of nutrition care across the lifespan. In harmony with the WHO goal of sustainable development, we underscore roles of nutrition to foster healthy human development and healthy aging worldwide.

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