Managing Adult Malnutrition

Including a pathway for the appropriate use of
oral nutritional supplements (ONS)


Oral Nutritional Supplements (ONS)

Oral nutritional supplements to optimise oral intake
• ONS are typically used in addition to the normal diet, and not as a food replacement, when diet alone is insufficient to meet daily nutritional requirements
• An individual should be encouraged to take ONS when they most feel like taking them, this may be between meals, like a snack, first thing in the morning or before bed. ONS can also be incorporated into everyday foods e.g. in jellies and sauces
• ONS not only increase total energy and protein intake, but also the intake of micronutrients 14,22

• Evidence shows that ONS do not reduce intake of normal food over a 12 week period 22,23
• Evidence from systematic reviews including work by NICE demonstrate that ONS are a clinically and cost effective way to manage malnutrition particularly amongst those with a low BMI (BMI<20kg/m2) 14,24-26. Two recent studies demonstrated cost effectiveness specifically in the community setting 27,28
• ONS increase energy and protein intakes, can improve weight and have functional benefits (e.g. improved hand grip strength and quality of life) 14,22-25,27
• Clinical benefits of ONS include reductions in complications (e.g. pressure ulcers, poor wound healing, infections) 21,24, mortality (in acutely ill older people)14,22, hospital admissions and readmissions 24-28
• Clinical benefits of ONS are often seen with 300-900kcal/day (e.g. 1-3 ONS servings per day) with benefits seen in the community typically with 2-3 month’s supplementation 14,22,25, however supplementation periods may be shorter, or longer (up to 1 year) according to clinical need

PATHWAY FOR USING ONS


Management of malnutrition according to risk category

A screening and management pathway using 'MUST' that can be used across care settings to identify adults who are malnourished or at risk of malnutrition.

DOWNLOAD PATHWAY


A Guide to Managing Adult Malnutrition in the Community: the complete document is available.

DOWNLOAD COMPLETE DOCUMENT


Resources

A selection of publications for use by healthcare professionals, patients and carers are available in the resources section of the website.

RESOURCES AREA

Support for Patients & Carers

A number of resources are available that have been developed to support patients and carers.

PATIENTS & CARERS

Specific support for common conditions

A number of resources are available that have been developed to assist healthcare professionals supporting patients at risk of malnutrition as a result of a specific condition. These include:

COPD LUNG CANCER (external site)

Further Information

We can be contacted regarding the malnutrition pathway materials and website

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BMI calculator

Weight loss calculator

If you have a combined BMI and weight loss calculator score of 1 or more please go to malnutritionselfscreening.org
for further information

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