Centro de Investigación de Endocrinología y Nutrición, Facultad de Medicina Valladolid, Servicio Endocrinología y Nutrición Hospital Clínico Universitario, Valladolid, Spain.
Postgrad Med. 2024 Jan;136(1):52-59. doi: 10.1080/00325481.2024.2307869. Epub 2024 Jan 25.
Despite the availability of a wide range of oral nutritional supplements (ONS) offerings, individuals with malnutrition are still struggling to meet their nutritional targets. A new concentrated and high-protein energy-dense ONS (≥2.1 kcal/mL;32 g protein/200 mL) with high-quality protein (60% whey protein) has emerged as a pivotal formula to reach the patient's energy-protein requirements, enhance compliance, and maximize stimulation of muscle protein synthesis, key factors driving better nutritional, functional, and clinical outcomes. The purpose of this article is to provide our clinical experience using this new nutritionally concentrated ONS as a therapeutic strategy for patients with DRM.
Three clinical cases have been examined using new assessment procedures and a new form of nutritional therapy, and their impact on the nutritional and functional outcomes in patients with moderate-to-severe DRM.
A tailored individualized nutritional interventions improved anthropometric, biochemical, and functional outcomes (Case 1,2, and 3) assessed using hand grip strength, bioimpedance and muscle ultrasound, and as well as good gastrointestinal tolerance (Case 1) and compliance to the ONS in patients with DRM (Case 1,2,3).
The use of this novel high-protein energy-dense formula with high-quality protein source (≥2.1 kcal/mL; 32 g protein/200 mL; 60% whey protein) overcome common practical challenges in the medical nutrition therapy of patients with DRM, either because these patients require a highly concentrated formulation to meet nutritional requirements due to loss of appetite, lack of interest in food, and high caloric-protein needs due to disease, and a large quantity and quality of protein to optimize muscle recovery due to sarcopenia, common in patients with moderate-severe malnutrition.
尽管有多种口服营养补充剂（ONS）可供选择，但仍有营养不良的个体难以达到营养目标。一种新型浓缩高蛋白高能量 ONS（≥2.1 千卡/毫升；每 200 毫升含 32 克蛋白质），具有高质量蛋白质（60%乳清蛋白），是满足患者能量-蛋白质需求、提高依从性和最大限度刺激肌肉蛋白质合成的关键配方，这是改善营养、功能和临床结局的关键因素。本文旨在介绍我们使用这种新型高营养浓缩 ONS 作为 DRM 患者治疗策略的临床经验。
使用新的评估程序和新形式的营养治疗，检查了三个临床病例，并评估了其对中度至重度 DRM 患者营养和功能结局的影响。
通过使用手握力、生物阻抗和肌肉超声等方法进行的个体化营养干预，改善了中度至重度 DRM 患者的人体测量学、生化和功能结局（病例 1、2 和 3），同时患者具有良好的胃肠道耐受性（病例 1）和对 ONS 的依从性（病例 1、2 和 3）。
使用这种新型高蛋白高能量配方（≥2.1 千卡/毫升；每 200 毫升含 32 克蛋白质；60%乳清蛋白）和高质量蛋白质来源，克服了 DRM 患者医学营养治疗中的常见实际挑战，因为这些患者由于食欲不振、对食物缺乏兴趣、疾病导致的高卡路里-蛋白质需求，以及由于肌肉减少症导致的大量和高质量蛋白质来优化肌肉恢复，需要高度浓缩的配方来满足营养需求，而肌肉减少症在中重度营养不良患者中很常见。
