Can fortified foods and snacks increase the energy and protein intake of hospitalised older patients? A systematic review
Can fortified foods and snacks increase the energy and protein intake of hospitalised older patients? A systematic review
Background: Undernutrition affects over 44% of hospitalised older people, who often dislike oral nutritional supplements (ONS). This review summarises the evidence for an alternative strategy, using energy and protein dense meals (via fortification) or snacks (supplementation) to increase the dietary energy and protein intake of older inpatients.
Methods: A search was conducted through PubMed, EMBASE, CINAHL and the Cochrane database of systematic reviews (May 1996 to May 2016) that used fortification or supplementation to increase the energy or protein intake of patients (mean age ≥60 years) in hospitals or rehabilitation centres.
Results: Ten articles (546 patients, mean age 60–83 years) were identified. Compared with usual nutritional care, six studies using either energy or protein based fortification and supplementation significantly increased intake of energy (250–450 kcal day−1) or protein (12–16 g day−1). Two studies enriched menus with both energy and protein, and significantly increased both energy (698 kcal day−1 and 21 kJ kg−1) and protein (16 g and 0.2 g kg−1) intake compared to usual care. ONS was similar to supplementation in one study but superior to fortification in another. Four studies reported good acceptability of enriched products and two studies that found they were cost-effective.
Conclusions: Compared with usual nutritional care, energy- and protein-based fortification and supplementation could be employed as an effective, well-tolerated and cost-effective intervention to improve dietary intake amongst older inpatients. This strategy may be particularly useful for patients with cognitive impairment who struggle with ONS, and clinical trials are required to compare these approaches and establish their impact on functional outcomes.
379-389
Mills, S. R.
4502ddb9-6da6-4249-9460-c49d3eb4ba92
Wilcox, C.R.
8975090d-75a6-49dc-b57e-cf2ff4cb4a0c
Ibrahim, K.
54f027ad-0599-4dd4-bdbf-b9307841a294
Roberts, H.C.
5ea688b1-ef7a-4173-9da0-26290e18f253
June 2018
Mills, S. R.
4502ddb9-6da6-4249-9460-c49d3eb4ba92
Wilcox, C.R.
8975090d-75a6-49dc-b57e-cf2ff4cb4a0c
Ibrahim, K.
54f027ad-0599-4dd4-bdbf-b9307841a294
Roberts, H.C.
5ea688b1-ef7a-4173-9da0-26290e18f253
Mills, S. R., Wilcox, C.R., Ibrahim, K. and Roberts, H.C.
(2018)
Can fortified foods and snacks increase the energy and protein intake of hospitalised older patients? A systematic review.
Journal of Human Nutrition and Dietetics, 31 (3), .
(doi:10.1111/jhn.12529).
Abstract
Background: Undernutrition affects over 44% of hospitalised older people, who often dislike oral nutritional supplements (ONS). This review summarises the evidence for an alternative strategy, using energy and protein dense meals (via fortification) or snacks (supplementation) to increase the dietary energy and protein intake of older inpatients.
Methods: A search was conducted through PubMed, EMBASE, CINAHL and the Cochrane database of systematic reviews (May 1996 to May 2016) that used fortification or supplementation to increase the energy or protein intake of patients (mean age ≥60 years) in hospitals or rehabilitation centres.
Results: Ten articles (546 patients, mean age 60–83 years) were identified. Compared with usual nutritional care, six studies using either energy or protein based fortification and supplementation significantly increased intake of energy (250–450 kcal day−1) or protein (12–16 g day−1). Two studies enriched menus with both energy and protein, and significantly increased both energy (698 kcal day−1 and 21 kJ kg−1) and protein (16 g and 0.2 g kg−1) intake compared to usual care. ONS was similar to supplementation in one study but superior to fortification in another. Four studies reported good acceptability of enriched products and two studies that found they were cost-effective.
Conclusions: Compared with usual nutritional care, energy- and protein-based fortification and supplementation could be employed as an effective, well-tolerated and cost-effective intervention to improve dietary intake amongst older inpatients. This strategy may be particularly useful for patients with cognitive impairment who struggle with ONS, and clinical trials are required to compare these approaches and establish their impact on functional outcomes.
Text
Main Document_R1_red
- Accepted Manuscript
Text
Mills_et_al-2018-Journal_of_Human_Nutrition_and_Dietetics
- Version of Record
Restricted to Repository staff only
Request a copy
Text
r1_JHN_12529_review
- Proof
Restricted to Repository staff only
Request a copy
Show all 9 downloads.
More information
Accepted/In Press date: 14 November 2017
e-pub ahead of print date: 10 January 2018
Published date: June 2018
Identifiers
Local EPrints ID: 416794
URI: http://eprints.soton.ac.uk/id/eprint/416794
ISSN: 0952-3871
PURE UUID: 40732cd4-ffc8-4226-aad9-f930f619d599
Catalogue record
Date deposited: 10 Jan 2018 17:30
Last modified: 16 Mar 2024 06:04
Export record
Altmetrics
Contributors
Author:
S. R. Mills
Author:
C.R. Wilcox
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics
