Impacts of High-Protein Oral Nutritional Supplements Among Malnourished Men and Women with Sarcopenia: A Multicenter, Randomized, Double-Blinded, Controlled Trial

Cramer, Joel T.; Cruz-Jentoft, Alfonso J.; Landi, Francesco; Hickson, Mary; Zamboni, Mauro; Pereira, Suzette L.; Hustead, Deborah S.; Mustad, Vikkie A.

doi:10.1016/j.jamda.2016.08.009

Cited by 126 publications

(143 citation statements)

References 54 publications

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“…HMB has been shown to act as a potent stimulator of protein synthesis as well as an inhibitor of protein breakdown. 38 A growing body of evidence suggests that HMB or oral nutrition supplements containing HMB may help to slow or even reverse muscle loss in aging, illness, or starvation 39,40 and improve other important outcomes such as wound healing, 41 physical function, 42 and mortality. 43 Therefore, using a high-protein ONS or enteral tube feeding that contains HMB may help in the management of malnutrition and muscle mass loss.…”

Section: Identify and Assess Low Muscle Mass For Those At Risk Of Malmentioning

confidence: 99%

The Underappreciated Role of Low Muscle Mass in the Management of Malnutrition

Deutz

Ashurst

Ballesteros³

et al. 2019

Journal of the American Medical Directors Association

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a b s t r a c tPreserving muscle is not only crucial for maintaining proper physical movement, but also for its many metabolic and homeostatic roles. Low muscle mass has been shown to adversely affect health outcomes in a variety of disease states (eg, chronic obstructive pulmonary disease, cancer, cardiovascular disease) and leads to an increased risk for readmission and mortality in hospitalized patients. Low muscle mass is now included in the most recent diagnostic criteria for malnutrition. Current management strategies for malnutrition may not prioritize the maintenance and restoration of muscle mass. This likely reflects the challenge of identifying and measuring this body composition compartment in clinical practice and the lack of awareness by health care professionals of the importance that muscle plays in patient health outcomes. As such, we provide a review of current approaches and make recommendations for managing low muscle mass and preventing muscle loss in clinical practice. Recommendations to assist the clinician in the optimal management of patients at risk of low muscle mass include the following: (1) place muscle mass at the core of nutritional assessment and management strategies; (2) identify and assess low muscle mass; (3) develop a management pathway for patients at risk of low muscle mass; (4) optimize nutrition to focus on muscle mass gain versus weight gain alone; and (5) promote exercise and/or rehabilitation therapy to help maintain and build muscle mass. The need to raise awareness of the importance of screening and managing 'at risk' patients so it becomes routine is imperative for change to occur. Health systems need to drive clinicians to treat patients with this focused approach, and the economic benefits This opinion paper was sponsored by Abbott with all authors receiving honorarium for their contributions.

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Section: Identify and Assess Low Muscle Mass For Those At Risk Of Malmentioning

confidence: 99%

The Underappreciated Role of Low Muscle Mass in the Management of Malnutrition

Deutz

Ashurst

Ballesteros³

et al. 2019

Journal of the American Medical Directors Association

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146

135

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“…Table shows the main characteristics of included studies. Of the included studies, 16 studies had a two‐arm randomised controlled trial (RCT) design (Andersson, Hulander, Rothenberg, & Iversen, ; Beelen et al, ; Cramer et al, ; Deutz et al, ; Ekinci et al, ; Fernández‐Barrés et al, ; Gariballa, Forster, Walters, & Powers, ; Kim & Lee, ; Luger, Dorner, et al, ; Munk et al, ; Myint et al, ; Neelemaat, Bosmans, Thijs, Seidell, & van Bokhorst‐de van der Schueren, ; Rondanelli et al, ; Sharma et al, ; Stange et al, ; Veronese et al, ). One study had a two‐arm cluster RCT design (Salvà et al, ), and three studies had a three‐arm RCT design (Botella‐Carretero et al, ; Hin et al, ; Pedersen, Pedersen, & Damsgaard, ).…”

Section: Resultsmentioning

confidence: 99%

“…Three studies were considered to have a low risk of bias (Hin et al, ; Luger, Dorner, et al, ; Neelemaat et al, ), whereas four studies showed some concerns (Andersson et al, ; Deutz et al, ; Gariballa et al, ; Kim & Lee, ), and 14 studies were assessed to be at high risk of bias (Beelen et al, ; Botella‐Carretero et al, ; Cramer et al, ; Ekinci et al, ; Fernández‐Barrés et al, ; Munk et al, ; Myint et al, ; Pedersen et al, ; Rondanelli et al, ; Salvà et al, ; Sharma et al, ; Stange et al, ; Veronese et al, ; Ziylan et al, ; Table ). Main threats for the methodological quality were as follows: (a) blinding of participants, caregivers, assessors and/or research data analysts was either not performed in the study or reported in the article; (b) lack of reporting significance of differences in baseline characteristics between intervention and control group; (c) incomplete data for all outcomes and absence of intention‐to‐treat analysis; and (d) lack of transparency in complete reporting due to absence of detailed information from previously published study protocols.…”

Section: Resultsmentioning

confidence: 99%

“…These are oral nutritional supplements, food/fluid fortification or enrichment, dietary counselling and educational interventions. In 19 studies, single‐component interventions were described (Andersson et al, ; Beelen et al, ; Botella‐Carretero et al, ; Cramer et al, ; Deutz et al, ; Ekinci et al, ; Fernández‐Barrés et al, ; Gariballa et al, ; Hin et al, ; Kim & Lee, ; Luger, Dorner, et al, ; Munk et al, ; Myint et al, ; Pedersen et al, ; Rondanelli et al, ; Salvà et al, ; Stange et al, ; Veronese et al, ; Ziylan et al, ). In two studies, multicomponent interventions were described (Neelemaat et al, ; Sharma et al, ; Table ).…”

Section: Resultsmentioning

confidence: 99%

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Interventions to prevent and treat malnutrition in older adults to be carried out by nurses: A systematic review

Cate

Ettema

Waal³

et al. 2020

Journal of Clinical Nursing

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Aims and objectives:To identify interventions to prevent and treat malnutrition in older adults, which can be integrated in nursing care, and to evaluate the effects of these interventions on outcomes related to malnutrition.Background: Older adults are at great risk for malnutrition, which can lead to a number of serious health problems. Nurses have an essential role in nutritional care for older adults. Due to a lack of evidence for nursing interventions, adequate nursing nutritional care still lags behind.Design: Systematic review. Method:We searched for and included randomised controlled trials on interventions, which can be integrated in nursing care for older adults, to prevent and treat malnutrition. We assessed the risk of bias with the Cochrane tool and evidence for outcomes with the GRADE. The PRISMA statement was followed for reporting. Results:We included 21 studies of which 14 studies had a high risk of bias. Identified interventions were oral nutritional supplements, food/fluid fortification or enrichment, dietary counselling and educational interventions. In evaluating the effects of these interventions on 11 outcomes related to malnutrition, significant and nonsignificant effects were found. We graded the certainty of evidence as very low to moderate. Conclusion:Although slight effects were found in protein intake and body mass index, there is no convincing evidence about the effectiveness of the four identified interventions. There seems no harm in using these interventions, although it should be kept in mind that the evidence is sparse. Therefore, there is a need for high-quality research in building evidence for interventions in nursing nutritional care.Relevance to clinical practice: Nurses can safely provide oral nutritional supplements and food/fluid fortification or enrichment, and give dietary counselling and

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“…Another study [35] demonstrated that improvements in clinically relevant measures, such as strength and functionality, could be achieved by supplementation with high-quality oral nutritional supplementation.…”

Section: Nutritional Interventions To Prevent Sarcopeniamentioning

confidence: 99%

Sarcopenia and Malnutrition in the Elderly

Lardiés-Sánchez¹,

Sanz-París²

2017

Frailty and Sarcopenia - Onset, Development and Clinical Challenges

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Sarcopenia and malnutrition are both commonly occurring conditions in elderly population. As understood today, sarcopenia is a syndrome characterised by progressive and generalised loss of skeletal muscle mass, physical performance and/or strength, whereas malnutrition has been deined as a condition of an imbalance of energy, protein and other nutrients that can cause measurable negative efects. In many populations, malnutrition and sarcopenia are present simultaneously, and they appear clinically through a combination of decreased body weight and nutrient intake, along with a decrease in muscle mass and function. Moreover, malnutrition is one of the key pathophysiological causes of sarcopenia. Both entities result in numerous and substantial negative outcomes to the patients and the healthcare system, including decreased quality of life and functionality and increased healthcare costs, hospitalisation rates, morbidity and mortality. Early identiication of sarcopenia would be of great clinical relevance because the loss of muscle mass and strength with ageing can be largely reversed by proper exercise and nutritional intervention. Clinicians should integrate nutritional assessment with sarcopenia screening for optimal evaluation of these two interrelated issues to help improve clinical outcomes.

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Impacts of High-Protein Oral Nutritional Supplements Among Malnourished Men and Women with Sarcopenia: A Multicenter, Randomized, Double-Blinded, Controlled Trial

Abstract: ONS improved strength outcomes in malnourished older adults with sarcopenia. In those with mild-moderate sarcopenia, but not severe sarcopenia, consumption of the E improved leg muscle strength and quality compared with the standard C.

Cited by 126 publications

References 54 publications

The Underappreciated Role of Low Muscle Mass in the Management of Malnutrition

The Underappreciated Role of Low Muscle Mass in the Management of Malnutrition

Interventions to prevent and treat malnutrition in older adults to be carried out by nurses: A systematic review

Sarcopenia and Malnutrition in the Elderly

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