Nutritional evaluation and supplementation of elderly subjects participating in a "meals on wheels" program

A nutritional assessment of 33 elderly subjects participating in a "meals on wheels" program revealed a high prevalence of nutritional deficiencies. Twelve of these subjects, who were considered to be at high risk for protein calorie malnutrition, received 240 ml of a polymeric dietary supplement three times daily for 16 wk. This resulted in a significant (50%) increase in total caloric and protein intake which was maintained for the entire 16 wk of study. In seven of the 12 subjects a weight gain of greater than 2 kg was found. Modest but significant elevations in serum albumin and highly significant elevations of the total iron binding capacity, serum and red cell folate, leukocyte ascorbate, and serum vitamin B12 provided strong evidence for improved nutritional status. In contrast no improvement in the hemoglobin, total lymphocyte count, T cell number, T suppressor cells, T helper, or B cells was noted. In no anergic subjects was skin test conversion found. In addition no increase in serum trace metals or vitamin B6 levels were noted. Thus this study demonstrates that nutritional supplementation results in significant improvement in selected nutritional parameters. The fact that the hematopoietic and immunological status of these patients was unchanged suggest that the abnormalities may be age rather than nutritionally related or that a critical nutritional deficiency was not corrected.