Summary of a systematic review on oral nutritional supplement use in the community

Abstract

Despite a marked increase in the prescription of oral nutritional supplements (ONS) in the community (Department of Health, 1991–7), there is still uncertainty about the value of their use in patients with different diseases. To answer questions about the effects on ONS on body weight and structure, spontaneous food intake and body function, a critical systematic review was undertaken (Stratton & Elia, 1999a). Eighty-four trials were reviewed (forty-five randomized, thirty-nine non-randomized; 2570 patients; diagnoses including chronic obstructive pulmonary disease, Crohn’s disease, cystic fibrosis, human immunodeficiency virus and acquired immune deficiency syndrome and cancer). Most studies (83 %) were conducted in patients living at home. The supplements were typically mixed macronutrients in liquid form, providing < 0.42–10.5 MJ/d for 1 week–2 years. The studies reviewed in patients with predominantly chronic conditions living in the community suggested that: (1) ONS produce demonstrable clinical (including functional) benefits, but the nature and extent of these benefits varies with the underlying chronic condition; (2) ONS increase total energy intake with > 50 % of the energy from ONS typically additional to that from habitual food intake; (3) improvements in body weight, total energy intake and body function following ONS appear to occur more frequently in individuals with a BMI < 20 kg/m2 than in those with a BMI > 20 kg/m2.

A study in four European countries to examine the importance of sensory attributes of oral nutritional supplements on preference and likelihood of compliance

“…Studies have shown that in malnourished patients, ONS can improve overall nutritional intake, increase body weight and functional outcomes, and reduce morbidity and mortality (3)(4)(5).…”

Nutritional Supplementation in Community-Dwelling Elderly People

“…In a systematic review of oral nutritional supplements used in the community (451 elderly patients of 2,570 participants) Stratton [4] found that the supplements used in the majority of trials are liquid oral nutritional supplements (ONS) -either commercial sip-feeds or powders reconstituted to form a liquid supplement. A minority of studies used solid supplements (bars, puddings), powders added to normal food and drink and homemade supplements.…”

“…The amounts prescribed ranged from ! 0.42 to 1 10.5 MJ/day, for periods ranging from 1 week to over 2 years [4] .…”

Malnutrizione associata a patologie, una problematica da risolvere

“…Di conseguenza, sono stati sviluppati diversi indici e la percentuale di pazienti identificati come pazienti a rischio di malnutrizione nei diversi gruppi diagnostici varia a seconda dei criteri utilizzati per definire o diagnosticare questo stato. Tuttavia, gli studi presi in considerazione, effettuati in Europa e in altri paesi occidentali (ad esempio USA ed Australia), hanno rivelato che qualsiasi sia il criterio utilizzato la malnutrizione associata a patologie sembra essere un problema significativo in tutti i gruppi diagnostici, sia nel contesto ospedaliero, sia in comunità (2,3).…”

“…Percentuale di popolazione nei paesi europei con BMI inferiore a 20 kg/m² (EC-15 rappresenta la media dei 15 paesi europei) nerici per i quali viene utilizzato l'indicatore BMI inferiore a 20 kg/m²) rispetto alla situazione ospedaliera (2).…”