title: Nutritional supplementation of very old people at hospital discharge increases muscle strength: a randomised controlled trial.
abstract: BACKGROUND
  Undernutrition is common in older people admitted to hospital, but little is known about how nutritional state changes after discharge.
  
  
  OBJECTIVE
  This randomised controlled trial was designed to examine the effect of oral nutritional supplementation of undernourished very old people prepared to take supplements after hospital discharge following acute illness.
  
  
  METHODS
  Participants aged>or=75 years with a BMI<or=24 kg/m2 and triceps skin fold thickness or mid-arm muscle circumference below the 10th centile and/or weight loss>or=5% during an acute hospital stay were allocated at random to either oral nutritional supplementation for 8 weeks from hospital discharge or to usual care. Primary outcome was change in weight, secondary outcomes were handgrip strength and anthropometry.
  
  
  RESULTS
  Of 198 patients eligible to participate, 136 patients (mean age 85 years) were randomised and 76/136 (56%) completed the study. Twenty percent (13/66) of the intervention group withdrew after only 2 weeks, citing intolerance of the supplements. Using intention-to-treat analysis, body weight increased by a mean of 1.6 and 2.2% in the control and intervention groups, respectively, but this between-group difference was not significant (p = 0.188). However, handgrip strength increased more (p=0.055) in the intervention group (13.9%) than in the control group (7.2%).
  
  
  CONCLUSIONS
  Oral nutritional supplementation was associated with a greater increase in handgrip strength than in non-supplemented controls and this observation merits further study.
authors.affiliation: Division of Medicine and Therapeutics, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Price
authors.forename: Fergus
authors.initials: F
authors.lastname: Daly
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Pennington
authors.forename: Marion E T
authors.initials: ME
authors.lastname: McMurdo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D019587:Dietary Supplements; D002149:Energy Intake; D005260:Female; D006761:Hospitals; D006801:Humans; D044342:Malnutrition / Q000178:diet therapy*; D009132:Muscles / Q000503:physiopathology*; D009752:Nutritional Status; D010351:Patient Discharge; D016896:Treatment Outcome