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Observational Study
. 2024 Sep 17;16(18):3136.
doi: 10.3390/nu16183136.

Effectiveness of High-Protein Energy-Dense Oral Supplements on Patients with Malnutrition Using Morphofunctional Assessment with AI-Assisted Muscle Ultrasonography: A Real-World One-Arm Study

Juan José López-Gómez  1   2 , David Primo-Martín  1   2 , Angela Cebria  3   4 , Olatz Izaola-Jauregui  1   2 , Eduardo Jorge Godoy  3   4 , Paloma Pérez-López  1   2 , Rebeca Jiménez Sahagún  1   2 , Beatriz Ramos Bachiller  1   2 , Jaime González Gutiérrez  1   2 , Daniel A De Luis Román  1   2
Affiliations
Observational Study

Effectiveness of High-Protein Energy-Dense Oral Supplements on Patients with Malnutrition Using Morphofunctional Assessment with AI-Assisted Muscle Ultrasonography: A Real-World One-Arm Study

Juan José López-Gómez et al. Nutrients. .

Abstract

Background: User-friendly tools for assessing nutrition status and interventions in malnourished patients are crucial. This study evaluated the effectiveness of a personalised nutrition intervention using a novel oral nutritional supplement and AI-supported morphofunctional assessment to monitor clinical outcomes in patients with disease-related malnutrition (DRM). Methods: This prospective observational study involved patients receiving concentrated high-protein, high-calorie ONS (cHPHC-ONS), per usual clinical practice. Comprehensive assessments were performed at baseline (B0) and three months (M3) post-intervention. Results: 65 patients participated in the study. Significant decreases were observed in the percentage weight loss from B0 (-6.75 ± 7.5%) to M3 (0.5 ± 3.48%) (p < 0.01), in the prevalence of malnutrition (B0: 93.4%; M3: 78.9%; p < 0.01), severe malnutrition (B0: 60.7%; M3: 40.3%; p < 0.01), and sarcopenia (B0: 19.4%; M3: 15.5%; p < 0.04). Muscle area increased (p = 0.03), and there were changes in the echogenicity of the rectus femoris muscle (p = 0.03) from B0 to M3. In patients aged ≥60, an increase in muscle thickness (p = 0.04), pennation angle (p = 0.02), and handgrip strength (p = 0.04) was observed. There was a significant reduction in the prevalence of malnutrition (B0: 93.4%; M3: 78.9%; p < 0.01) and severe malnutrition (B0: 60.7%; M3: 40.3%; p < 0.01). Conclusions: In patients with DRM, a personalised intervention with cHPHC-ONS significantly reduces the prevalence of malnutrition, severe malnutrition, and sarcopenia and improves muscle mass and function.

Keywords: artificial intelligence; malnutrition; nutritional support; sarcopenia.

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Conflict of interest statement

J.J.L. has received support for the development of the present manuscript by Nestlé Healthcare. J.J.L. has received payment or honoraria for lectures, presentations, participation in speakers’ bureaus, manuscript writing, or educational events from Nestlé Healthcare, Vegenat Healthcare, Abbott Nutrition, Persan Pharma, Adventia Pharma, and Nutricia. Additionally, J.J.L. has been supported for attending meetings and/or travel by Adventia Pharma, Nutricia, and Persan Pharma. Furthermore, J.J.L. has participated on Data Safety Monitoring Boards or Advisory Boards for Abbott Nutrition, Nutricia, Persan Pharma, Vegenat Healthcare, and Nestlé Healthcare. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Differences between ultrasonographic variables determined by AI-based ultrasound imaging system PIIXMEDTM.
Figure 2
Figure 2
Prevalence of the underlying pathologies in the whole sample and according to the age of the patients.
Figure 3
Figure 3
Flow chart of the included patients.
Figure 4
Figure 4
Differences in malnutrition and sarcopenia prevalence before and after the intervention. * denotes a statistically significant difference between baseline and follow-up period.
Figure 5
Figure 5
Differences in malnutrition and sarcopenia prevalence before and after the intervention in patients aged above and below 60 years. * p-value < 0.05.
Figure 6
Figure 6
Differences in quality index measured in muscular ultrasonography between patients concerning oral nutritional supplement amount. Mi: muscle; FATi: fat; NMNFi: collagen, connective tissue, and fibrosis. * p-value < 0.05.
Figure 7
Figure 7
Rate of compliance to the prescribed dose.
See this image and copyright information in PMC

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