22 Jan Reduced Mortality With Specialized Oral Nutrition In Malnourished Older Adults

Dr. Refaat Hegazi

MedicalResearch.com Interview with:
Dr. Refaat Hegazi, MD, PhD MS MPH
Abbott medical director and study author

MedicalResearch: What is the background for this study? What are the main findings?

Dr. Hegazi: The NOURISH study that was recently published in Clinical Nutrition showed that a specialized oral nutrition supplement (with high protein, HMB and Vitamin D) was associated with a 50 percent lower death rate in older, malnourished patients with a heart or lung disease, 90 days after leaving the hospital.

The study was conducted with the utmost scientific rigor and is one of the largest nutrition clinical studies of its kind. In the study, we evaluated the effects of this specialized nutrition supplement compared to a placebo supplement on the incidence of hospital readmission or death through 90-days after leaving the hospital. The population studied has never been evaluated before in this way.

Results showed no significant differences between the two groups for the primary composite (i.e. combined) endpoint of hospital readmissions or death. However, the study individual components and additional analyses showed:

• A significantly lower (50 percent) death rate for those who received the specialized nutrition supplement. This lower incidence of death began at 30 days after participants left the hospital, and continued for 90 days.
• Similar rates of hospital readmissions between the two groups.
• Improvements in other health outcomes including body weight, nutritional status and Vitamin D levels at 30 and 60 days after leaving the hospital, and continued body weight and nutritional status improvements at 90 days for the group taking the specialized nutrition supplement. 

MedicalResearch: What is the connection between malnutrition and recovering from an illness?

Dr. Hegazi: Surprisingly, disease-associated malnutrition in hospitalized older adults is very common – and it’s a condition that is having a rippling effect on our health and health system. Up to 1 in 2 older adults are already malnourished when they’re admitted to the hospital. When a person has a health issue, like heart failure or pneumonia, malnutrition can worsen their health outcomes including higher chances of complications, readmissions and death.

Even short hospitalizations in older adults can cause loss of muscle and strength, and they may continue to lose body weight and muscle after leaving the hospital, keeping them from getting back to their quality of daily lives. For the patients in the NOURISH study who were ill and malnourished, nutrition is critical, in addition to proper medical care of their primary diseases, because it helps keep the body, especially the muscles, functioning properly.

MedicalResearch: What should clinicians take away from your report?

Dr. Hegazi: One of the biggest study takeaways from the NOURISH study is the power of nutrition impacting health outcomes in malnourished patients, in addition to their medical treatment plan. We understand the importance of preventative measures like flu shots and aspirin — the NOURISH study is more proof that we need to incorporate nutrition as part of our standard medical care to help older adults – who already have or are at risk for malnutrition and chronic illness – live longer, better lives. Disease-associated malnutrition should be optimally addressed both by treating the primary disease and by managing its associated malnutrition.

MedicalResearch: Is there anything else you would like to add?

Dr. Hegazi: As medicine has advanced, so has the science of nutrition. We know proper nutrition is foundational for good health, particularly during times of illness or injury, but the medical community and patients don’t always turn to it as one of the tools they use when recovering from a health issue. 

The study estimated that within this population studied, one life could be saved for every 21 malnourished patients who received the specialized nutrition supplement. The NOURISH study is more proof that nutrition needs to be an integral part of the conversation about a patient’s overall treatment plan.

Citation:

Readmission and mortality in malnourished, older, hospitalized adults treated with a specialized oral nutritional supplement: A randomized clinical trial

Deutz, Nicolaas E. et al. January 18, 2016

Clinical Nutrition , Volume 0 , Issue 0 ,

DOI: http://dx.doi.org/10.1016/j.clnu.2015.12.010

Dr. Refaat Hegazi, MD, PhD MS MPH (2016). Reduced Mortality and Readmissions With Specialized Oral Nutrition In Malnourished Older Adults 

Last Updated on January 22, 2016 by Marie Benz MD FAAD