Personalized approaches to the prescription of protein-based oral nutritional supplements in older adults: A scoping review

Background and aims

Oral nutritional supplements (ONS) are prescribed for older adults with malnutrition and sarcopenia to prevent nutritional and functional deterioration. Studies investigating ONS effectiveness commonly provide the same ONS prescription for participants. This scoping review aimed to provide an overview of studies that have personalized ONS prescription in older adults with malnutrition or sarcopenia.

Methods

In July 2023, PubMed, CINAHL, SCOPUS and EMBASE were searched for studies wherein older adults with malnutrition, risk of malnutrition or sarcopenia received personalized ONS. Data extracted were synthesized into tables and descriptively summarized.

Results

Fifteen studies met the inclusion criteria, all in developed countries: 10 randomized controlled, 3 cross-over, 1 non-randomized and 1 single-arm trials. Fourteen studies included older adults at risk of malnutrition/malnourished. One study included older adults with sarcopenia. Studies included between 34 and 671 participants aged 70–88 years. Dietitians (10 studies) or trained nutritionists (5 studies) personalized the ONS prescription. Personalization included: (i) providing ONS for protein requirements based on weight (11 studies) or (ii) current dietary intake (2 studies), or (iii) offering ONS flavors based on personal preference (2 studies). Outcome measures included nutritional status, change in body weight/composition and quality of life. Definition and methods of assessing adherence varied. Seven studies showed a significant improvement in primary outcomes when personalized ONS were prescribed.

Conclusion

15 studies which personalized ONS for older adults with malnutrition/sarcopenia were identified. Further research on optimizing personalized approaches with standardized outcome measures is warranted.