The Effect of Food and Beverage Based Nutritional Supplements in Recipients of Home Care Services at Risk of Malnutrition

Study Overview
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Brief Summary
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Malnutrition increases the risk of complications and predisposes ti infections through impaired immune response and wound healing. Healthcare costs related to the management of malnourished patients is estimated to be more than double the amount spent managing non- malnourished The objective of this study is to examine the effect of newly developed energy and nutrients-dense beverage product on the nutritional status among patients at risk of malnutrition.

Detailed Description
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Malnutrition is a complex state described as a deficiency of energy, protein and other nutrients causing measurable adverse effect on body tissue, function and clinical outcome. Oral nutritional supplementation has in multiple individual trials and meta-analyzes shown an increased total energy intake and protein intake in patients in hospital settings as well as in the community. The largest producer of dairy products in Norway, TINE AS released a new milk based energy- and nutrient dense product, called E+. The initiative behind this was Haukeland University Hospital and the municipality of Bergen. The product were developed to prevent malnutrition in the elderly and patients with a low food intake and high energy requirements. The overall contribution to this study will be to provide new insight on how to offer malnourished patients the best available treatment.

Official Title
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The Effect of Food and Beverage Based Nutritional Supplements in Recipients of Home Care Services at Risk of Malnutrition

Conditions
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Malnutrition

Intervention / Treatment
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* Dietary Supplement: E+


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Recipients of homecare services in the municipality of Bergen Recipients determined as at-risk of malnutrition based on screening with MNA (mini-nutritional assessment) Informed consent by participant Informed consent by participants and close relatives or guardian in case of dementia Exclusion Criteria: Terminal care patients with < 3 month life expectancy Patients using parenteral or enteral nutrition Patients prescribed oral nutritional supplementation before recruitment Pregnancy Diabetes Mellitus Lactose intolerance Patients without a norwegian personal identification number Psychiatric patients

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: E+ drink, enriched with energy and nutrients.<br>The intervention consists of 300 ml E+ per day for 35 days in addition to a normal food intake. This means 525 kcal, and 22.5 gram protein extra per day for five weeks. | Dietary Supplement: E+<br>* 300 ml E+ per day (525 kcal, 22.5 gram protein) for 35 days.<br>|
| No Intervention: Control<br>Subjects in the control group will be assessed in the same way and same time as the intervention group. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Hand grip strength | Hand grip strength will be measured in kg with a handgrip dynamometer. Subjects will be asked to perform a maximal contraction for a few seconds with the non-dominant hand three times with about 10-20 seconds between each trial. | Assessment at day 0, 35 and 70. | 
| Change in Body weight | Participants will be asked to remove shoes, socks, heavy clothing and jewelry for measurement of body weight to the nearest 100 g using portable digital scales. | At day 0, 35 and 70 | 
| Change in Body composition | A Bioelectric impedance analysis will be used to calculate change in body composition. Measurements will be conducted by a device sending weak electric signals through the participant's body. The method is non-invasive and is commonly used by medical, health and fitness professionals. | At day 0, 35 and 70 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Nutritional intake | Dietary intake will be assessed for each study participant using a twenty-four-hour recall method conducted by the investigator and two additional people employed to help with the data collection. All three data collectors will use a standardized interview. The data collected will be used to calculate daily calorie and protein intake by entering the food records into a computerized version of a food composition table, Dietist XP. | At day 0, 35 and 70 | 
| Change in Quality of life | Measurements of global subjective well-being and quality of life will be assessed using a simple visual analogue scale (VAS QL). | At day 0, 35 and 70 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Malnutrition