Does low lactose milk powder improve the nutritional intake and nutritional status of frail older Chinese people living in nursing homes?
BACKGROUND
Malnutrition is prevalent among nursing home residents in Hong Kong. Nutrient dense oral supplements and yoghurt are unpopular among the Chinese older people because of their unfamiliar tastes and relatively high costs. Vitamin and mineral supplements do not address the problem of protein calorie undernutrition. Milk powder may be a suitable alternative supplement, but diarrhoea resulting from lactase deficiency is common in Chinese people.


OBJECTIVE
We hypothesized that a low lactose milk powder would be better tolerated in Chinese nursing home residents and result in improvement in nutritional intake without reducing habitual intake.


METHODS
Forty-seven residents were randomized to receive milk powder twice daily, or no supplement for seven weeks. Twenty-four hour food record, body weight, upper limb skinfold thicknesses and midarm circumference, grip strength, Barthel Index, and abbreviated mental test score were carried out at baseline and at seven weeks.


RESULTS
The overall compliance was nearly 100%, and no subjects developed diarrhoea. Compared with controls, milk supplementation increased intake of calcium, vitamin D, vitamin A, riboflavin and potassium. There was no significant reduction in habitual dietary intake in supplemented subjects. There was a trend of weight gain in supplemented subjects, though this did not reach statistical significance. There was no change in handgrip strength, mental function and disability level.


CONCLUSIONS
The study shows that low lactose milk powder is a well-accepted nutritional supplement without reducing habitual dietary intake.
Department of Medicine & Therapeutics, Prince of Wales Hospital, Shatin, NT, Hong Kong SAR, China.
T
T
Kwok
J
J
Woo
M
M
Kwan
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000818:Animals; D000886:Anthropometry; D003967:Diarrhea / Q000209:etiology / Q000517:prevention & control; D015930:Diet Records; D019587:Dietary Supplements; D002149:Energy Intake; D005260:Female; D016330:Frail Elderly; D006707:Homes for the Aged; D006723:Hong Kong; D006801:Humans; D007787:Lactose Intolerance / Q000517:prevention & control; D008297:Male; D008892:Milk / Q000009:adverse effects; D009735:Nursing Homes; D009748:Nutrition Disorders / Q000517:prevention & control*; D009752:Nutritional Status; D010349:Patient Compliance; D015430:Weight Gain