title: Oral nutritional supplements in a randomised trial are more effective than dietary advice at improving quality of life in malnourished care home residents.
abstract: Few trials have explored the effect of nutrition support on quality of life (QoL). This study examined the effects of oral nutritional supplements (ONS) vs dietary advice on QoL in malnourished care home residents.
  
  
  
  104 malnourished, care home residents (medium + high risk), identified using the Malnutrition Universal Screening Tool ('MUST'), (mean age 88.5 ± 7.9y) were randomised to receive either oral nutritional supplements (ONS) (n = 53) or dietary advice (n = 51) for 12 weeks. Dietary intake was measured using 24 h dietary recall, and QoL assessed using EuroQol (EQ-5D), including time trade off (TTO) (range -0.59 to 1) and visual analogue scale (VAS) (score 0 to 100) for self-perceived health.
  
  
  
  QoL (adjusted for baseline QOL, malnutrition risk, type of care received (nursing or residential)) was significantly higher in the ONS than the dietary advice group (intention to treat analysis at week 12; n = 104 ). EQ-5D TTO scores (mean ± SE) were 0.50 ± 0.04 vs 0.36 ± 0.05 (P = 0.005), VAS rescaled scores were 0.54 + 0.03 vs 0.046 + 0.03 (P = 0.006) and VAS scores were 61.3 ± 4.5 vs 54.6 ± 6.3 (P = 0.533) for ONS vs dietary advice respectively. Total energy, protein and the majority of micronutrient intakes were significantly greater in the ONS group, with energy intake being 423 kcal greater in the ONS than the dietary advice group at week 12.
  
  
  
  This study in malnourished care home residents indicates that ONS can improve QoL and nutritional intake more effectively than dietary advice alone.
  
  
  
  This trial was registered with clinicaltrials.gov on 10th August 2007. Clinical trials identifier is NCT00515125http://www.clinicaltrials.gov/ct2/show/NCT00515125?term=nutrition+support&rank=60.
authors: Institute of Human Nutrition & Faculty of Medicine, University of Southampton, and University Hospital Southampton NHS Foundation Trust, Southampton, England, UK; Mailpoint 113, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK.
authors: Emma L
authors: EL
authors: Parsons
authors: Institute of Human Nutrition & Faculty of Medicine, University of Southampton, and University Hospital Southampton NHS Foundation Trust, Southampton, England, UK; Mailpoint 113, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK. Electronic address: rjs@soton.ac.uk.
authors: Rebecca J
authors: RJ
authors: Stratton
authors: Institute of Human Nutrition & Faculty of Medicine, University of Southampton, and University Hospital Southampton NHS Foundation Trust, Southampton, England, UK; Mailpoint 113, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK.
authors: Abbie L
authors: AL
authors: Cawood
authors: University Hospitals Southampton NHS Foundation Trust, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK.
authors: Trevor R
authors: TR
authors: Smith
authors: Institute of Human Nutrition & Faculty of Medicine, University of Southampton, and University Hospital Southampton NHS Foundation Trust, Southampton, England, UK; Mailpoint 113, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK. Electronic address: m.elia@soton.ac.uk.
authors: Marinos
authors: M
authors: Elia
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003376:Counseling; D004032:Diet; D004044:Dietary Proteins / Q000008:administration & dosage; D019587:Dietary Supplements; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000188:drug therapy*; D011939:Mental Recall; D018977:Micronutrients / Q000008:administration & dosage; D015596:Nutrition Assessment; D009752:Nutritional Status; D011788:Quality of Life; D012307:Risk Factors; D015431:Weight Loss
chemical_list: D004044:Dietary Proteins; D018977:Micronutrients
keywords: Care home; Elderly; Malnutrition; Quality of life; Supplement