Malnutrition and Associated Sarcopenia - Episode 9

The Role of Oral Nutritional Supplements in Older Adults

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Nicolaas Deutz, MD, PhD: So, for older adults that are at risk of malnutrition, or have malnutrition, it’s very important that you talk with the patient and tell them that they should increase their regular food intake. But that’s very difficult. That’s why we usually advise to also consume oral nutritional supplements. What I think is very important is that we not replace their regular food intake, but use it as a supplement, supplementation on their regular food intake. The advice that I usually give is, start eating your regular meal and after half an hour, take a nutritional supplement so that there is still the pleasure of different types of foods—but also assuring that there is enough food intake with your oral nutritional supplement. I don’t think that if you will not use oral nutritional supplements that patients can keep up with their requirements when they are sick. I think it’s really too complicated for people to consume more proteins or take more milk or more yogurt. It’s too complicated. That’s why oral nutritional supplements, in this case, are the only solution.

For older adults with chronic disease that are admitted to the hospital, they usually also are already malnourished. So, it’s very important that in the hospital, there is sufficient nutrient intake. And in the hospitals, it’s actually more dangerous to become more malnourished. Because there’s a reason why people are in the hospital, and usually there’s a lot of procedures that actually reduce their regular protein intake, their food intake. In the hospital setting, it’s very important to give sufficient nutrients. And usually the oral nutritional supplements are the only way to go, because people have to go to a CT scan, to an MRI scan, and then miss lunch or miss dinner. Oral nutritional supplements, in the hospital setting, are very important.

Peter A. McCullough, MD: Oral nutritional supplements are clearly therapeutic options now. We face an array of patients with chronic illness, where it’s clear that diets reach an absolute limit in terms of their ability to turn around an adverse nutritional situation for patients. And so, it’s really important for doctors to realize that oral nutritional supplements are available on hospital and dietary formularies. They can be ordered as part of an order set, and they’re widely available over-the-counter to patients. So, we don’t have to get tied up with prescriptions, or approvals, or other complicated things. We simply need to give patients and their family good guidance. One of the things that I found is that patients’ families want to help their loved one. And if there’s something they can do to help—they can go out to the store, follow the doctor’s instructions, and get the supplement that’s recommended by the physician or the care provider—they’ll do it.