P039 NUTRITIONAL STATUS OF NURSING HOME RESIDENTS

Rationale: Limited information exists on the efficacy of high energy density (>2 kcal/ml) oral nutritional supplements (ONS). This pilot study investigated elderly patients’ compliance with a novel, low volume, energy dense (2.4 kcal/ml) ONS and its effects on food and total energy intakes, appetite and anthropometry. Methods: Thirty one community-based patients identified at risk of malnutrition (using “MUST”, www.bapen.org.uk) were recruited (mean age: 82±12years, mean body mass index (BMI) 20.3±2.4 kg/m2, 52% medium risk, 48% high risk). Patients were offered two 125ml, 2.4 kcal/ml oral nutritional supplements (Fortisip Compact, Nutricia; total provision 600 kcal, 24 g protein in 250ml) daily in addition to the diet for 4 weeks. Compliance, palatability and tolerance of the supplement and its effects on food and total energy intake, hunger (100mm visual analogue scale) and anthropometry (body weight, mid upper arm circumference, MUAC) were assessed. Results are presented as mean±SD. Results: Compliance with supplementation was 97% with mean wastage per bottle of 4ml (3% of bottle volume). There were no significant gastro-intestinal side effects with supplementation and > 80% of patients rated the supplement pleasant and convenient. Patients’ mean total daily energy intake significantly increased (from 1430±599 kcal to 1965±596 kcal, p = 0.0001) with supplementation, with no significant reduction in voluntary food intake and a significant increase in hunger score (from 24±24mm to 36±24mm, p = 0.018). A small but significant increase in body weight (+0.9 kg, p = 0.009) and mid upper arm circumference (+0.3 cm, p = 0.025) were observed. Conclusion: This pilot study in community patients shows that compliance with a high energy density (2.4 kcal/ml), low volume supplement is excellent, leading to significant improvements in total energy intakes and anthropometry. Further controlled study is required to ascertain the clinical benefits of using such an energy dense supplement in the management of patients with malnutrition.