Effect of a nutrient-enriched drink on dietary intake and nutritional status in institutionalised elderly

Objective: (1) To determine whether nutritional supplementation (energy and micronutrients) in institutionalised elderly has a positive effect on dietary intake and nutritional status. (2) To investigate whether individuals tend to compensate for the energy content of the intervention product by decreasing their habitual food consumption. Methods: A 24-week, randomised, double-blind, placebo-controlled, intervention trial in homes for the elderly (n = 3), in nursing homes (n = 3) and 'mixed' homes (n = 3) in The Netherlands. Institutionalised elderly people (n = 176) older than 60 years of age, with a body mass index <= 30 kg/m(2) and a Mini-Mental State Examination score of 10 points or higher, randomly received a nutrient-enriched drink or a placebo drink twice a day during 24 weeks in addition to their usual diet. Allocation to treatment took into account of sex, the Mini-Mental State Examination score and the plasma homocysteine level. Body weight and several nutrition-related analyses in fasting blood samples were measured in all participants. Data on dietary intake were collected in a subsample (n = 66). Results: A significantly favourable effect (P < 0.001) of the intervention drink was observed on vitamin intake, mineral intake and vitamin status in blood (for example, homocysteine decreased from 14.7 to 9.5 mu mol/l in the intervention group as compared with that in the placebo group (17.2-15.9)). The difference in change in total energy intake between the two treatment groups was 0.8 MJ/day (P = 0.166). Energy intake from food decreased in both groups to the same extent (-0.5 MJ/day). Therefore, this decrease cannot be considered as compensation for the energy content of the product. Conclusions: This group of institutionalised elderly people does not compensate for the energy content of a concentrated nutritional supplement. Therefore, this supplement is effective for counteracting the development of malnutrition in this population. European Journal of Clinical Nutrition (2009) 63, 1241-1250; doi:10.1038/ejcn.2009.28; published online 20 May 2009