Does nutritional supplementation influence the voluntary dietary intake in an acute geriatric hospitalized population?

Undernutrition is a significant problem in hospitalized elderly patients, and is associated with a higher morbidity and mortality. The aim of this study is to assess the effect of an oral nutritional supplementation on the total daily caloric intake in an acute geriatric hospitalized population. A dietary assessment and a total food intake were collected on admission and every other day (day 0, 2, 4, 6 …) during hospitalization (mean duration, 12.8 days±6) in 50 randomly chosen elderly patients (mean age 82.5±5.5 years, 18 men and 32 women). The mean daily caloric intake was calculated from 108 dietary assessments after receiving oral supplementation (Nutridrink-Nutricia, 300 kcal/200 mL), and 154 when a voluntary diet without supplementation was consumed. The mean voluntary energy intake (including parenteral fluid) was similar on days a nutritional supplementation was given or not (1546 kcal/d vs 1475 kcal/d, respectively, p=0.27), but the total caloric intake was significantly higher on days a nutritional supplementation was consumed (1825 kcal/d vs 1475 kcal/d, p=0.0006). This beneficial effect of a nutritional supplementation on the total caloric intake existed when patients were divided into well nourished (N=15) and those at risk or malnourished (N=35), according to the Mini-Nutritional Assessment. In conclusion, short-term nutritional supplementation has a beneficial effect on the total daily caloric intake in elderly hospitalized patients with and without malnutrition, but the wastage remains high.