Older adults and patients in need of nutritional support: review of current treatment options and factors influencing nutritional intake.
OBJECTIVE
Many older adults and patients do not achieve sufficient nutritional intake to support their minimal needs and are at risk of, or are suffering from, (protein-energy) malnutrition. Better understanding of current treatment options and factors determining nutritional intake, may help design new strategies to solve this multifactorial problem.


METHODS
Medline, Science Citation Index, ScienceDirect and Google databases (until December 2008) were searched with the keywords malnutrition, elderly, older adults, food intake, energy density, variety, taste, satiety, and appetite.


RESULTS
37 Factors affecting nutritional intake were identified and divided in three categories; those related to the environment, the person, and the food. For older adults in nursing homes, encouragement by carers and an appropriate ambiance seem particularly important. Meal fortification, offering variety, providing frequent small meals, snacks and particularly Oral Nutritional Supplements (ONS) between meals are other possibilities for this group. Product factors that stimulate intake include palatability, high energy density, low volume, and liquid format.


CONCLUSIONS
The current review gives a comprehensive overview of factors affecting nutritional intake and may help carers to improve nutritional intake in their patients. The product factors identified here suggest that especially small volume, energy and nutrient dense ONS can be effective to improve nutritional intake.
Nieuwenhuizen
Willem F
WF
Danone Research, Center for Specialised Nutrition, Bosrandweg 20, 6700 CA Wageningen, The Netherlands. pim.nieuwenhuizen@danone.com
Weenen
Hugo
H
Rigby
Paul
P
Hetherington
Marion M
MM
D000368:Aged; D000369:Aged, 80 and over; D004032:Diet / Q000208:ethnology; D005502:Food / Q000009:adverse effects; D005504:Food Analysis; D005526:Food, Formulated; D040821:Human Characteristics; D006801:Humans; D018529:Nutritional Support / Q000379:methods*; D011502:Protein-Energy Malnutrition / Q000178:diet therapy* / Q000209:etiology / Q000517:prevention & control; D012931:Social Environment