Malnutrition in Older Adults

MiOA: Intervention Community: Oral Nutrition Supplements (2023)

• Intervention
  In older adults living in the community, what is the effect of oral nutrition supplements on calorie and protein intake?

  • Conclusion

    Oral nutrition supplement intake may increase calorie and protein intake in older adults who are at nutritional risk and living in the community,

  • Grade: Moderate (B)
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In older adults living in the community, what is the effect of oral nutrition supplements on calorie and protein intake?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Bauer J, Verlaan S, Bautmans I, Brandt K, Donini L, Maggio M, McMurdo M, Mets T, Seal C, Wijers S, Ceda G, De Vito G, Donders G, Drey M, Greig C, Holmbäck U, Narici M, McPhee J, Poggiogalle E, Power D, Scafoglieri A, Schultz R, Sieber C, Cederholm T. Effects of a vitamin D and leucine-enriched whey protein nutritional supplement on measures of sarcopenia in older adults, the PROVIDE study: a randomized, double-blind, placebo-controlled trial. Journal of the American Medical Directors Association 2015; 16:740-7
      • Biesek S, Vojciechowski A, Filho J, Menezes Ferreira A, Borba V, Rabito E, Gomes A. Effects of exergames and protein supplementation on body composition and musculoskeletal function of prefrail community-dwelling older women: a randomized, controlled clinical trial. International Journal of Environmental Research and Public Health 2021; 18:
      • Bo Y, Liu C, Ji Z, Yang R, An Q, Zhang X, You J, Duan D, Sun Y, Zhu Y, Cui H, Lu Q. A high whey protein, vitamin D and E supplement preserves muscle mass, strength, and quality of life in sarcopenic older adults: A double-blind randomized controlled trial. Clinical Nutrition (Edinburgh, Scotland) 2019; 38:159-164
      • Gray-Donald K, Payette H, Boutier V. Randomized clinical trial of nutritional supplementation shows little effect on functional status among free-living frail elderly. Journal of Nutrition 1995; 125:2965-2971
      • Kim C, Lee K. Preventive effect of protein-energy supplementation on the functional decline of frail older adults with low socioeconomic status: a community-based randomized controlled study. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 2013; 68:309-316
      • Kim H,Kojima N,Uchida R,Somekawa S,Inoue N,Kobayashi H,Osuka Y. The additive effects of exercise and essential amino acid on muscle mass and strength in community-dwelling older Japanese women with muscle mass decline, but not weakness and slowness: a randomized controlled and placebo trial. Aging clinical and experimental research 2021; 33:1841-1852
      • Nabuco H, Tomeleri C, Fernandes R, Sugihara Jr P, Cavalcante E, Cunha P, Antunes M, Nunes J, Venturini D, Barbosa D, Burini R, Silva A, Sardinha L, Cyrino E. Effect of whey protein supplementation combined with resistance training on body composition, muscular strength, functional capacity, and plasma-metabolism biomarkers in older women with sarcopenic obesity: A randomized, double-blind, placebo-controlled trial. Clinical Nutrition ESPEN 2019; 32:88-95
      • Ottestad I, Løvstad A, Gjevestad G, Hamarsland H, Šaltyt Benth J, Andersen L, Bye A, Biong A, Retterstøl K, Iversen P, Raastad T, Ulven S, Holven K. Intake of a protein-enriched milk and effects on muscle mass and strength. A 12-week randomized [lacebo controlled trial among community-dwelling older adults. Journal of Nutrition, Health & Aging 2017; 21:1160-1169
      • Park Y, Choi J, Hwang H. Protein supplementation improves muscle mass and physical performance in undernourished prefrail and frail elderly subjects: a randomized, double-blind, placebo-controlled trial. The American Journal of Clinical Nutrition 2018; 108:1026-1033
      • 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. Journal of the American Dietetic Association 2002; 102:1088-1095
      • Smith TR, Cawood AL, Walters ER, Guildford N, Stratton RJ.. Ready-Made Oral Nutritional Supplements Improve Nutritional Outcomes and Reduce Health Care Use—A Randomised Trial in Older Malnourished People in Primary Care. Nutrients 2020; 12:
  • Search Plan and Results: MiOA: Intervention Oral Nutrition Supplements 2023
     
  In older adults living in the community, what is the effect of oral nutrition supplements on weight and BMI?

  • Conclusion

    Oral nutrition supplement intake may have little to no effect on weight or body mass index in older adults living in the community,

  • Grade: Moderate (B)
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In older adults living in the community, what is the effect of oral nutrition supplements on weight and BMI?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • de Carvalho Bastone A, Nobre L, de Souza Moreira B, Rosa I, Ferreira G, Santos D, Monteiro N, Alves M, Gandra R, de Lira E. Independent and combined effect of home-based progressive resistance training and nutritional supplementation on muscle strength, muscle mass and physical function in dynapenic older adults with low protein intake: A randomized controlled trial. Archives of Gerontology and Geriatrics 2020; 89:104098
      • Biesek S, Vojciechowski A, Filho J, Menezes Ferreira A, Borba V, Rabito E, Gomes A. Effects of exergames and protein supplementation on body composition and musculoskeletal function of prefrail community-dwelling older women: a randomized, controlled clinical trial. International Journal of Environmental Research and Public Health 2021; 18:
      • Björkman M, Suominen M, Kautiainen H, Jyväkorpi S, Finne-Soveri H, Strandberg T, Pitkälä K, Tilvis R. Effect of Protein Supplementation on Physical Performance in Older People With Sarcopenia-A Randomized Controlled Trial. Journal of the American Medical Directors Association 2020; 21:226-232.e1
      • Bo Y, Liu C, Ji Z, Yang R, An Q, Zhang X, You J, Duan D, Sun Y, Zhu Y, Cui H, Lu Q. A high whey protein, vitamin D and E supplement preserves muscle mass, strength, and quality of life in sarcopenic older adults: A double-blind randomized controlled trial. Clinical Nutrition (Edinburgh, Scotland) 2019; 38:159-164
      • Chapman I, Visvanathan R, Hammond A, Morley J, Field J, Tai K, Belobrajdic D, Chen R, Horowitz M. Effect of testosterone and a nutritional supplement, alone and in combination, on hospital admissions in undernourished older men and women. The American Journal of Clinical Nutrition 2009; 89:880-9
      • Gray-Donald K, Payette H, Boutier V. Randomized clinical trial of nutritional supplementation shows little effect on functional status among free-living frail elderly. Journal of Nutrition 1995; 125:2965-2971
      • Kim C, Lee K. Preventive effect of protein-energy supplementation on the functional decline of frail older adults with low socioeconomic status: a community-based randomized controlled study. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 2013; 68:309-316
      • Kim H,Kojima N,Uchida R,Somekawa S,Inoue N,Kobayashi H,Osuka Y. The additive effects of exercise and essential amino acid on muscle mass and strength in community-dwelling older Japanese women with muscle mass decline, but not weakness and slowness: a randomized controlled and placebo trial. Aging clinical and experimental research 2021; 33:1841-1852
      • Ottestad I, Løvstad A, Gjevestad G, Hamarsland H, Šaltyt Benth J, Andersen L, Bye A, Biong A, Retterstøl K, Iversen P, Raastad T, Ulven S, Holven K. Intake of a protein-enriched milk and effects on muscle mass and strength. A 12-week randomized [lacebo controlled trial among community-dwelling older adults. Journal of Nutrition, Health & Aging 2017; 21:1160-1169
      • 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. Journal of the American Dietetic Association 2002; 102:1088-1095
      • Peng L, Yu P, Hsu C, Tseng S, Lee W, Lin M, Hsiao F, Chen L. Sarcojoint®, the branched-chain amino acid-based supplement, plus resistance exercise improved muscle mass in adults aged 50 years and older: A double-blinded randomized controlled trial. Experimental Gerontology 2022; 157:111644
      • Smith TR, Cawood AL, Walters ER, Guildford N, Stratton RJ.. Ready-Made Oral Nutritional Supplements Improve Nutritional Outcomes and Reduce Health Care Use—A Randomised Trial in Older Malnourished People in Primary Care. Nutrients 2020; 12:
      • Tieland M, Dirks M, van der Zwaluw N, Verdijk L, van de Rest O, de Groot L, van Loon L. Protein supplementation increases muscle mass gain during prolonged resistance-type exercise training in frail elderly people: a randomized, double-blind, placebo-controlled trial. Journal of the American Medical Directors Association 2012; 13:713-719
      • Zdzieblik D, Oesser S, Baumstark M, Gollhofer A, König D. Collagen peptide supplementation in combination with resistance training improves body composition and increases muscle strength in elderly sarcopenic men: a randomised controlled trial. British Journal of Nutrition 2015; 114:1237-45
  • Search Plan and Results: MiOA: Intervention Oral Nutrition Supplements 2023
     
  In older adults living in the community, what is the effect of oral nutrition supplements on physical function?

  • Conclusion

    Oral nutrition supplement intake has little to no effect on handgrip strength, gait speed, or activities of daily living in older adults living in the community.    
     

  • Grade: Moderate (B)
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In older adults living in the community, what is the effect of oral nutrition supplements on physical function?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Assantachai P, Jirapinyo P, Densupsoontorn N, Intalapaporn S, Chatthanawaree W, Muangpaisan W, Chalermsri C, Suraarunsumrit P, Wongviriyawong T, Pengsorn N, Jongsawadipatana A, Pisalsarakij D, Udompunturak S. The benefits of a novel chicken-based oral nutritional supplement for older adults: A double-blind randomized controlled trial. Asia Pacific Journal of Clinical Nutrition 2020; 29:743-750
      • de Carvalho Bastone A, Nobre L, de Souza Moreira B, Rosa I, Ferreira G, Santos D, Monteiro N, Alves M, Gandra R, de Lira E. Independent and combined effect of home-based progressive resistance training and nutritional supplementation on muscle strength, muscle mass and physical function in dynapenic older adults with low protein intake: A randomized controlled trial. Archives of Gerontology and Geriatrics 2020; 89:104098
      • Bauer J, Verlaan S, Bautmans I, Brandt K, Donini L, Maggio M, McMurdo M, Mets T, Seal C, Wijers S, Ceda G, De Vito G, Donders G, Drey M, Greig C, Holmbäck U, Narici M, McPhee J, Poggiogalle E, Power D, Scafoglieri A, Schultz R, Sieber C, Cederholm T. Effects of a vitamin D and leucine-enriched whey protein nutritional supplement on measures of sarcopenia in older adults, the PROVIDE study: a randomized, double-blind, placebo-controlled trial. Journal of the American Medical Directors Association 2015; 16:740-7
      • Biesek S, Vojciechowski A, Filho J, Menezes Ferreira A, Borba V, Rabito E, Gomes A. Effects of exergames and protein supplementation on body composition and musculoskeletal function of prefrail community-dwelling older women: a randomized, controlled clinical trial. International Journal of Environmental Research and Public Health 2021; 18:
      • Björkman M, Suominen M, Kautiainen H, Jyväkorpi S, Finne-Soveri H, Strandberg T, Pitkälä K, Tilvis R. Effect of Protein Supplementation on Physical Performance in Older People With Sarcopenia-A Randomized Controlled Trial. Journal of the American Medical Directors Association 2020; 21:226-232.e1
      • Bo Y, Liu C, Ji Z, Yang R, An Q, Zhang X, You J, Duan D, Sun Y, Zhu Y, Cui H, Lu Q. A high whey protein, vitamin D and E supplement preserves muscle mass, strength, and quality of life in sarcopenic older adults: A double-blind randomized controlled trial. Clinical Nutrition (Edinburgh, Scotland) 2019; 38:159-164
      • Chapman I, Visvanathan R, Hammond A, Morley J, Field J, Tai K, Belobrajdic D, Chen R, Horowitz M. Effect of testosterone and a nutritional supplement, alone and in combination, on hospital admissions in undernourished older men and women. The American Journal of Clinical Nutrition 2009; 89:880-9
      • Fielding R, Travison T, Kirn D, Koochek A, Reid K, von Berens Å, Zhu H, Folta S, Sacheck J, Nelson M, Liu C, Åberg A, Nydahl M, Lilja M, Gustafsson T, Cederholm T. Effect of structured physical activity and nutritional supplementation on physical function in mobility-limited older adults: results from the VIVE2 randomized trial. The Journal of Nutrition, Health & Aging 2017; 21:936-942
      • Gray-Donald K, Payette H, Boutier V. Randomized clinical trial of nutritional supplementation shows little effect on functional status among free-living frail elderly. Journal of Nutrition 1995; 125:2965-2971
      • Kim C, Lee K. Preventive effect of protein-energy supplementation on the functional decline of frail older adults with low socioeconomic status: a community-based randomized controlled study. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 2013; 68:309-316
      • Kim H,Kojima N,Uchida R,Somekawa S,Inoue N,Kobayashi H,Osuka Y. The additive effects of exercise and essential amino acid on muscle mass and strength in community-dwelling older Japanese women with muscle mass decline, but not weakness and slowness: a randomized controlled and placebo trial. Aging clinical and experimental research 2021; 33:1841-1852
      • Nabuco H, Tomeleri C, Fernandes R, Sugihara Jr P, Cavalcante E, Cunha P, Antunes M, Nunes J, Venturini D, Barbosa D, Burini R, Silva A, Sardinha L, Cyrino E. Effect of whey protein supplementation combined with resistance training on body composition, muscular strength, functional capacity, and plasma-metabolism biomarkers in older women with sarcopenic obesity: A randomized, double-blind, placebo-controlled trial. Clinical Nutrition ESPEN 2019; 32:88-95
      • Ottestad I, Løvstad A, Gjevestad G, Hamarsland H, Šaltyt Benth J, Andersen L, Bye A, Biong A, Retterstøl K, Iversen P, Raastad T, Ulven S, Holven K. Intake of a protein-enriched milk and effects on muscle mass and strength. A 12-week randomized [lacebo controlled trial among community-dwelling older adults. Journal of Nutrition, Health & Aging 2017; 21:1160-1169
      • 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. Journal of the American Dietetic Association 2002; 102:1088-1095
      • Peng L, Yu P, Hsu C, Tseng S, Lee W, Lin M, Hsiao F, Chen L. Sarcojoint®, the branched-chain amino acid-based supplement, plus resistance exercise improved muscle mass in adults aged 50 years and older: A double-blinded randomized controlled trial. Experimental Gerontology 2022; 157:111644
      • Roschel H, Hayashi A, Fernandes A, Jambassi-Filho J, Hevia-Larraín V, de Capitani M, Santana D, Gonçalves L, de Sá-Pinto A, Lima F, Sapienza M, Duarte A, Pereira R, Phillips S, Gualano B. Supplement-based nutritional strategies to tackle frailty: A multifactorial, double-blind, randomized placebo-controlled trial. Clinical Nutrition (Edinburgh, Scotland) 2021; 40:4849-4858
      • Tieland M, Dirks M, van der Zwaluw N, Verdijk L, van de Rest O, de Groot L, van Loon L. Protein supplementation increases muscle mass gain during prolonged resistance-type exercise training in frail elderly people: a randomized, double-blind, placebo-controlled trial. Journal of the American Medical Directors Association 2012; 13:713-719
      • Zhu L, Chan R, Kwok T, Cheng K, Ha A, Woo J. Effects of exercise and nutrition supplementation in community-dwelling older Chinese people with sarcopenia: a randomized controlled trial. Age and Ageing 2019; 48:220-228
  • Search Plan and Results: MiOA: Intervention Oral Nutrition Supplements 2023
     
  In older adults living in the community, what is the effect of oral nutrition supplements on nutrition status?

  • Conclusion

    Impact of oral nutrition supplements on nutrition status measured by valid nutrition assessment in older adults living in the community could not be determined due to insufficient evidence.
     

  • Grade: Very Low (D)
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In older adults living in the community, what is the effect of oral nutrition supplements on nutrition status?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Chapman I, Visvanathan R, Hammond A, Morley J, Field J, Tai K, Belobrajdic D, Chen R, Horowitz M. Effect of testosterone and a nutritional supplement, alone and in combination, on hospital admissions in undernourished older men and women. The American Journal of Clinical Nutrition 2009; 89:880-9
  • Search Plan and Results: MiOA: Intervention Oral Nutrition Supplements 2023
     
  In older adults living in the community, what is the effect of oral nutrition supplement intake on mortality?

  • Conclusion

    No studies were identified that evaluated the effect of oral nutrition supplement intake on mortality in older adults living in the community.

  • Grade: V
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Search Plan and Results: MiOA: Intervention Oral Nutrition Supplements 2023