UWL: Medical Nutrition Therapy 2009
Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.
UWL: Medical Nutrition Therapy
Medical nutrition therapy (MNT) is strongly recommended for older adults with unintended weight loss. Individualized nutrition care, directed by a registered dietitian (RD), as part of the healthcare team, results in improved outcomes related to increased energy, protein and nutrient intakes, improved nutritional status, improved quality of life or weight gain.
Risks/Harms of Implementing This Recommendation
Conditions of Application
Potential Costs Associated with Application
Although medical nutrition therapy (MNT) costs and reimbursement vary, MNT is essential for improved outcomes.
- Five studies were evaluated regarding Medical Nutrition Therapy (MNT) in older adults with unintended weight loss
- One study reported that the prevalence of underweight or unintended weight loss may be as high as 35% (Mamhidir et al, 2006)
- Four studies report that individualized nutrition care, directed by a registered dietitian on the healthcare team, results in improved outcomes related to increased energy, protein and nutrient intakes, improved nutritional status, improved quality of life or weight gain (Faxen-Irving et al, 2002; Payette et al, 2002; Keller et al, 2003; Splett et al, 2003).
Recommendation Strength Rationale
Conclusion statement in support of this recommendation received Grade I.
- Risks/Harms of Implementing This Recommendation
The recommendations were created from the evidence analysis on the following questions. To see detail of the evidence analysis, click the blue hyperlinks below (recommendations rated consensus will not have supporting evidence linked).
Faxen-Irving G, Andren-Olsson B, Af Geijerstam A, Basun H, Cederholm T. The effect of nutritional intervention in elderly subjects residing in group-living for the demented. Eur J Clin Nutr. 2002; 56(3): 221-227.
Keller HH, Gibbs AJ, Boudreau LD, Goy RE, Pattillo MS, Brown HM. Prevention of weight loss in dementia with comprehensive nutritional treatment. J Am Geriatr Soc. 2003; 51(7): 945-952.
Mamhidir AG, Ljundggren G, Kihlgren M, Kihlgren A, Wimo A. Underweight, weight loss and related risk factors among older adults in sheltered housing: A Swedish follow-up study. J Nutr Health Aging. 2006; 10(4): 255-262.
Payette H, Boutier V, Coulombe C, Gray-Donald K. Benefits of nutritional supplementation in free-living, frail, undernourished elderly people: A prospective randomized community trial. J Am Diet Assoc. 2002; 1,002: 1,088-1,095.
Splett PL, Roth-Yousey LL, Vogelzang JL. Medical nutrition therapy for the prevention and treatment of unintentional weight loss in residential healthcare facilities. J Am Diet Assoc. 2003; 103: 352-362.