Dewiasty Esthika, Verlaan Sjors, Istanti Rahmi, Rahmah Fariza, Satryo Eugene, de Groot Lisette Cpgm, Setiati Siti
Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands; Division of Geriatric Medicine, Department of Internal Medicine - Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia; Universitas Indonesia Hospital (RSUI), Depok, Indonesia.
Department of Nutrition and Dietetics, Faculty of Health, Sport and Physical Activity, Amsterdam University of Applied Sciences, The Netherlands; Department of Operating Rooms, Radboud University Medical Center, Nijmegen, The Netherlands.
J Nutr Health Aging. 2025 Jun;29(6):100548. doi: 10.1016/j.jnha.2025.100548. Epub 2025 Mar 27.
Standard care for older outpatients who are at risk of malnutrition in Indonesia is still based on the 2017's recommendations of the Indonesian Geriatrics Society. and does not provide nutritional supplementation as recommended by ESPEN guidelines 2019/2022.
We compared the effects of supplementation of at least 400 kcal/day including 30 g or more of protein/day as nutritional intervention as recommended by the ESPEN Guideline with standard care recommended by The Indonesian Geriatrics Society, in Indonesian older adults who are at risk of malnutrition.
Older outpatients (60 years or older) at a geriatric clinic of the national referral hospital with or at risk of malnutrition were recruited. They were randomly allocated to 12 weeks of supplementation with a nutrient dense drink twice a day on top of standard care compared to standard care only. We assessed energy and nutrient intake at baseline, after 6 and 12 weeks and nutritional status, physical performance, and vitamin D level at baseline and after 12 weeks. Data analyses were blinded.
As many as 105 older outpatients (65 % women, mean age 72.5 years, SD = 6.3) were randomly assigned to the intervention (n = 54) and the control group (n = 51). One hundred and one participants completed the intervention, with an average compliance of 90% to the nutritional intervention. Nutritional supplementation significantly increased daily intake of energy, protein, total fat, vitamin D, vitamin B12, calcium (all p values <0.001) and carbohydrate (p = 0.002) in both men and women after 12 weeks. The intervention group showed an increase in vitamin D levels (p = 0.008). Furthermore, the intervention group gained more body weight than the control group did (p = 0.021)), especially in women (p = 0.017). Women in the intervention group also showed more increase in skeletal muscle mass (p = 0.023). Improvements in muscle strength and physical performance were not statistically different between the groups. No significant adverse effects were noted.
Nutritional supplementation is effective in improving nutritional intake and status among Indonesian outpatients with malnutrition risk, which has the potential to support and enhance the standard of care.
印度尼西亚针对有营养不良风险的老年门诊患者的标准护理仍基于印度尼西亚老年医学会2017年的建议，并未按照欧洲临床营养和代谢学会（ESPEN）2019/2022年指南的建议提供营养补充。
我们比较了按照ESPEN指南建议，补充至少400千卡/天（包括30克或更多蛋白质/天）作为营养干预措施，与印度尼西亚老年医学会建议的标准护理，对有营养不良风险的印度尼西亚老年人的影响。
招募了国家转诊医院老年门诊的60岁及以上有或有营养不良风险的老年门诊患者。与仅接受标准护理相比，他们被随机分配到在标准护理基础上每天两次补充营养密集型饮料，为期12周。我们在基线、6周和12周后评估能量和营养摄入，以及在基线和12周后评估营养状况、身体机能和维生素D水平。数据分析采用盲法。
多达105名老年门诊患者（65%为女性，平均年龄72.5岁，标准差=6.3）被随机分配到干预组（n = 54）和对照组（n = 51）。101名参与者完成了干预，对营养干预的平均依从率为90%。12周后，营养补充显著增加了男性和女性的每日能量、蛋白质、总脂肪、维生素D、维生素B12、钙（所有p值<0.0:01）和碳水化合物（p = 0.002）摄入量。干预组的维生素D水平有所升高（p = 0.008）。此外，干预组的体重增加比对照组更多（p = 0.021），尤其是女性（p = 0.017）。干预组的女性骨骼肌质量增加也更多（p = 0.023）。两组之间肌肉力量和身体机能的改善在统计学上没有差异。未观察到明显的不良反应。
营养补充对改善有营养不良风险的印度尼西亚门诊患者的营养摄入和状况有效，这有可能支持并提高护理标准。
