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. 2023 Nov 10:10:1297624.
doi: 10.3389/fnut.2023.1297624. eCollection 2023.

A multi-center prospective study of plant-based nutritional support in adult community-based patients at risk of disease-related malnutrition

Marta Delsoglio #  1 , Corbin Griffen #  1 , Rakshan Syed  2 , Tobias Cookson  3 , Hanorah Saliba  3 , Amanda Vowles  3 , Samuel Davies  4 , Nicola Willey  4 , Jennifer Thomas  4 , Nicola Millen  5 , Nour Odeh  5 , Jayne Longstaff  5 , Naomi Westran  6 , Lindsey Allan  6 , Hannah Offer  7 , Chloe Howell  7 , Meg Sanders  7 , Kirsty Gaffigan  7 , Kirby Garrett  7 , Sally Foster  8 , Agnes Salt  8 , Emily Carter  8 , Sarah Moore  8 , Nick Bergin  9 , Jane Roper  10 , Joe Alvarez  10 , Christine Voss  11 , Teresa Connolly  11 , Clare MacDonald  11 , Tracey Thrower  11 , Darren Sills  12 , Janet Baxter  13 , Rhonda Manning  13 , Lynsey Gray  14 , Karen Voas  15 , Scot Richardson  16 , Anne-Marie Hurren  16 , Daniel Murphy  17 , Susan Blake  17 , Paul McArdle  18 , Sinead Walsh  18 , Lucy Booth  18 , Louise Albrich  19 , Sarah Ashley-Maguire  19 , Joanna Allison  19 , Sarah Brook  20 , Rebecca Capener  1 , Gary P Hubbard  1 , Rebecca J Stratton  1   21
Affiliations

A multi-center prospective study of plant-based nutritional support in adult community-based patients at risk of disease-related malnutrition

Marta Delsoglio et al. Front Nutr. .

Abstract

Introduction: There is an emerging need for plant-based, vegan options for patients requiring nutritional support.

Methods: Twenty-four adults at risk of malnutrition (age: 59 years (SD 18); Sex: 18 female, 6 male; BMI: 19.0 kg/m2 (SD 3.3); multiple diagnoses) requiring plant-based nutritional support participated in a multi-center, prospective study of a (vegan suitable) multi-nutrient, ready-to-drink, oral nutritional supplement (ONS) [1.5 kcal/mL; 300 kcal, 12 g protein/200 mL bottle, mean prescription 275 mL/day (SD 115)] alongside dietary advice for 28 days. Compliance, anthropometry, malnutrition risk, dietary intake, appetite, acceptability, gastrointestinal (GI) tolerance, nutritional goal(s), and safety were assessed.

Results: Patients required a plant-based ONS due to personal preference/variety (33%), religious/cultural reasons (28%), veganism/reduce animal-derived consumption (17%), environmental/sustainability reasons (17%), and health reasons (5%). Compliance was 94% (SD 16). High risk of malnutrition ('MUST' score ≥ 2) reduced from 20 to 16 patients (p = 0.046). Body weight (+0.6 kg (SD 1.2), p = 0.02), BMI (+0.2 kg/m2 (SD 0.5), p = 0.03), total mean energy (+387 kcal/day (SD 416), p < 0.0001) and protein intake (+14 g/day (SD 39), p = 0.03), and the number of micronutrients meeting the UK reference nutrient intake (RNI) (7 vs. 14, p = 0.008) significantly increased. Appetite (Simplified Nutritional Appetite Questionnaire (SNAQ) score; p = 0.13) was maintained. Most GI symptoms were stable throughout the study (p > 0.06) with no serious adverse events related.

Discussion: This study highlights that plant-based nutrition support using a vegan-suitable plant-based ONS is highly complied with, improving the nutritional outcomes of patients at risk of malnutrition.

Keywords: disease-related malnutrition; oral nutritional supplement; plant-based diet; plant-based nutritional support; vegan ONS.

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Conflict of interest statement

MD, CG, RC, GPH and RJS were employed by Nutricia Ltd. The authors declare that this study received funding from Nutricia Ltd. The funder had the following involvement in the study: study design, data analysis, preparation of the manuscript and decision to publish. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Schematic of the trial design and schedule of assessments. P, outcome recorded by patient/carer; HCP, outcome recorded by patient’s healthcare professional; #, outcomes recorded on Day 29 for all patients unless patient terminated intervention period early, in which case outcomes were recorded on patient’s final intervention day; *, recorded for patients on ONS only; **, recorded every day during the intervention period. Standardized dietary advice was provided via a leaflet by the Malnutrition Pathway (13).
Figure 2
Figure 2
Flow chart of patient recruitment and study participation. ITT, intention-to-treat.
Figure 3
Figure 3
Reasons (%) why patients at risk of DRM required a plant-based ONS (n = 18).
Figure 4
Figure 4
Number (n) of patients identified as at high risk (‘MUST’ score = ≥2), medium risk (‘MUST’ score = 1) and low risk (‘MUST’ score = 0) of malnutrition at baseline and end of intervention by the Malnutrition Universal Screening Tool (MUST). Data were analyzed by Wilcoxon signed-rank test.
Figure 5
Figure 5
Total mean energy [(A), kcal/day] and protein intake [(B), g/day] from diet alone and with ONS at baseline and end of intervention [n = 23, means (SD)]. Data were analyzed by paired samples t-test.
Figure 6
Figure 6
Sensory outcomes (out of 10) for the plant-based ONS at end of intervention [n = 24, means (SD)].
See this image and copyright information in PMC

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