Elia Marinos, Smith Trevor R, Cawood Abbie L, Walters Emily R, Stratton Rebecca J
Human Development and Health, Faculty of Medicine, MP113, Southampton General Hospital, University of Southampton, Southampton SO16 6YD, UK.
Department of Gastroenterology, University Hospitals Southampton NHS Foundation Trust, Southampton General Hospital, Southampton, SO16 6YD, UK.
Nutrients. 2025 Jul 29;17(15):2474. doi: 10.3390/nu17152474.
There is little information about the effectiveness of oral nutritional supplements (ONS) in combatting nutrient inadequacies in primary care, where most malnutrition exists. To examine the extent to which readymade ONS add or displace the nutrients consumed in the diet and their impact on combatting dietary inadequacies. 308 free-living people >50 years with medium + high risk of malnutrition (Malnutrition Universal Screening Tool) were randomised to receive readymade low volume (2.4 kcal/mL), liquid ONS plus dietary advice (ONS + DA) or dietary advice alone (DA). Intake was assessed at baseline (24 h recall) and 4-weekly for 12 weeks (3-day diet record). Total nutrient intake was benchmarked against UK and European dietary reference values (DRVs). The proportion of energy and nutrients from the ONS that added or displaced those from the diet (net addition/displacement) was calculated. ONS + DA led to significantly greater total energy and nutritional intakes, with 25/29 nutrient intakes significantly higher than with DA alone. There were no significant differences in dietary energy and nutrient intakes from food between the groups. There was little or no displacement of nutrients from the diet, with over 90% of the energy and nutrients consumed in the ONS additive to the diet. ONS + DA more than halved the number of people with nutrient intakes that failed to meet DRVs and the number of nutrients per person that did not meet DRVs compared to DA alone. Supplementation with readymade, low volume (2.4 kcal/mL) liquid ONS overcomes most nutrient intake inadequacies in malnourished older people in primary care without significantly reducing intake from the diet. This makes ONS an effective way to improve nutritional intakes above dietary advice alone to improve the outcomes for the management of older people at risk of malnutrition.
关于口服营养补充剂（ONS）在初级保健中对抗营养不足的有效性的信息很少，而大多数营养不良情况都发生在初级保健中。为了研究即食型ONS在多大程度上增加或替代了饮食中摄入的营养素，以及它们对对抗饮食不足的影响。308名年龄超过50岁、营养不良风险为中+高（营养不良通用筛查工具）的自由生活者被随机分为接受即食型低容量（2.4千卡/毫升）液体ONS加饮食建议（ONS+DA）组或仅接受饮食建议（DA）组。在基线时（24小时回顾法）评估摄入量，并在12周内每4周（3天饮食记录）评估一次。将总营养素摄入量与英国和欧洲的膳食参考值（DRV）进行对比。计算了ONS中增加或替代饮食中能量和营养素的比例（净增加/替代）。ONS+DA组的总能量和营养摄入量显著更高，25/29种营养素的摄入量显著高于仅接受DA组。两组之间来自食物的膳食能量和营养素摄入量没有显著差异。饮食中营养素的替代很少或没有，ONS中超过90%的能量和营养素是饮食的补充。与仅接受DA组相比，ONS+DA组中营养素摄入量未达到DRV的人数以及每人未达到DRV的营养素数量减少了一半以上。补充即食型低容量（2.4千卡/毫升）液体ONS可克服初级保健中营养不良老年人的大多数营养素摄入不足问题，且不会显著减少饮食摄入量。这使得ONS成为一种有效的方法，可在仅靠饮食建议的基础上提高营养摄入量，从而改善有营养不良风险的老年人的管理效果。
