An Innovative Solid Oral Nutritional Supplement to Fight Weight Loss and Anorexia: Open, Randomised Controlled Trial of Efficacy in Institutionalised, Malnourished Older Adults.

BACKGROUND AND OBJECTIVE:To evaluate the impact of a solid nutritional supplement on the weight gain of institutionalised older adults>70 years with protein-energy malnutrition. The innovation of these high-protein and high-energy cookies was the texture adapted to edentulous patients (Protibis®, Solidages, France).DESIGN:An open, multicentre, randomised controlled trial.SETTING:Seven nursing homes.PARTICIPANTS:One hundred and seventy-five malnourished older adults, aged 86±8 years.INTERVENTION:All participants received the standard institutional diet. In addition, Intervention group participants received eight cookies daily (11.5 g protein; 244 kcal) for 6 weeks (w0-w6).MEASUREMENTS:Five visits (w-4, w0, w6, w10 and w18).MAIN OUTCOME:Percentage of weight gain from w0 to w6 (body mass in kg).SECONDARY OUTCOMES:Appetite, rated using a numerical scale (0: no appetite to 10: extremely good appetite); current episodes of pressure ulcers and diarrhea.RESULTS:Average weight increased in Intervention group (n=88) compared with Control group (n=87) without cookies supplementation (+1.6 versus -0.7%, P=0.038). Weight gain persisted 1 month (+3.0 versus -0.2%, P=0.025) and 3 months after the end of cookies consumption (+3.9 versus -0.9%, P=0.003), with diarrhea reduction (P=0.027). There was a synergistic effect with liquid/creamy dietary supplements. Subgroup analysis confirmed the positive impact of cookies supplementation alone on weight increase (P=0.024), appetite increase (P=0.009) and pressure ulcers reduction (P=0.031).CONCLUSION:The trial suggested that, to fight against anorexia, the stimulation of touch (finger food; chewing, even on edentulous gums) and hearing (intra-oral sounds) could be valuable alternatives to sight, smell and taste alterations.