Protein-energy oral supplementation in malnourished nursing-home residents. A controlled trial

Objectives: to validate a nutritional intervention programme for elderly pe ople living in nursing homes. Design: in a prospective, randomized, controlled study of 88 residents, we determined nutritional status at day 0 and day 60 using a record of dietary intake, anthropometry, hand-grip strength and mini-nutritional assessment. Dietary intake, grip strength and body weight were also recorded at day 30 We divided subjects into four groups according to their mini-nutritional a ssessment score. Those with a score 24 received no oral supplementation. Th ose at risk of malnutrition (with a score of 17-23.5) were randomized to or al supplementation. Those with a score <17 received oral supplementation. W e recorded the amount of oral supplements consumed daily. Results: compliance with oral supplementation was good, and daily intake av eraged about 400 kcal. The total energy intake on day 60 was significantly higher in both of the groups that received supplements. Following supplemen tation, most subjects at risk of malnutrition improved their mini-nutrition al assessment score and increased their weight (by 1.4 +/- 0.5 kg). Neither the mini-nutritional assessment score nor weight improved in subjects at r isk of malnutrition who did not receive supplements. Supplementation in the malnourished group resulted in a mean mini-nutritional assessment score in crease (from 13.9 +/- 2.6 to 17.1 +/- 3.9) and a mean weight gain of 1.5 +/ - 0.4 kg. Conclusion: oral nutritional supplements are well accepted and result in in creased daily protein and energy intake, body weight and nutritional status in most malnourished patients and in those at risk of malnutrition.