Compliance with an oral hyperproteic supplement with fibre in nursing home residents

Undernutrition is a common problem in older individuals that may be related to a low protein dietary intake. Oral supplements may improve the health status in this population, but their use may be limited by compliance and side effects.

To evaluate effects of an oral supplement of protein and fibre on compliance, on nutritional status, and on intestinal habits in nursing home residents.

A prospective observational study was carried out in 66 Spanish nursing homes. 358 subjects undernourished or at risk of undernutrition requiring nutritional supplements. After informed consent was given, subjects received 2 daily cartons (400 ml) of a liquid oral supplement rich in protein and fibre along 3 months. Supplement intake compliance was measured at baseline and after 6 and 12 weeks. Nutritional status was assessed using the Mini- Nutritional Assessment (MNA), weight, and Body Mass Index (BMI). Changes in intestinal habits and digestive symptoms were also recorded, as well as subject's supplement acceptance.

Compliance with the supplement intake was 97.46% at 6 weeks and 96% at 12 weeks of follow-up. Significant changes (p<0.0001) were found in nutritional status: mean value of MNA improved from baseline (MNA=14.0+/-3.9) after 12 weeks (MNA=17.0+/-4.0), as well as weight (+2.1 kg, a 4.1% increase). The BMI did not change significantly (BMI=21.43 at baseline; BMI=21.78 at 12 weeks). Undernutrition prevalence (MNA<17) decreased from 76.4 to 46.6% (p<0.0001). Intestinal habits showed a significant improvement in defecation frequency (from 4.7 to 6.1 stools per week, p<0.0001) and faeces consistency (from 53.2% to 74.5% reporting formed soft stools, p<0.0001). 48.9% of the subjects considered to have better intestinal habits after 6 weeks and 50.5% after 3 months of supplementary food intake, the rest reporting no change. Vomits and flatulence were also significantly reduced (p<0.0001).

The administration of an oral hyperproteic supplement with fibre in aged subjects who are undernourished or at risk of malnutrition can be done in nursing homes with a high level of compliance. Supplements improve their nutritional status and their intestinal habits.