Nutritional supplements after hip fracture: poor compliance limits effectiveness

Area of Science:

• Geriatric Medicine
• Nutritional Science
• Orthopedic Surgery

Background:

• Undernutrition and weight loss negatively impact clinical outcomes in older hip fracture patients.
• The effectiveness of nutritional support programs in routine practice is debated.

Purpose of the Study:

• To assess if daily oral nutritional supplements for 28 days prevent weight loss and improve clinical outcomes in non-malnourished older women post-hip fracture.
• Clinical outcomes include mortality, discharge destination, activities of daily living, and hospital stay length.

Main Methods:

• Quasi-randomized trial involving 109 women (BMI 20-30 kg/m²).
• Intervention group received daily nutritional supplements (352 kcal/day); control group received usual hospital nutrition.
• Weight changes monitored at 4 and 8 weeks; clinical outcomes assessed at discharge and 6 months.

Main Results:

• No significant differences in weight change or clinical outcomes between supplement and usual nutrition groups.
• Variable compliance with oral nutritional supplements was observed.
• A negative correlation between supplement consumption and weight change was significant (r=-0.36, P=0.019).

Conclusions:

• Poor compliance with oral nutritional supplements hinders their effectiveness in preventing weight loss post-hip fracture.
• The study does not support the routine use of oral nutritional supplements in non-malnourished hip fracture patients.
• Compliance issues may explain the lack of observed clinical improvements.