The RELISH Study: Compliance and Palatability of Oral Nutritional Supplements in Hospitalised Older Adults

The RELISH study will investigate a new oral nutritional supplement (fortified porridge) for older adults in hospital who are undernourished (i.e., have malnutrition). Malnutrition is a lack of nutritional intake that can lead to poor recovery from illness, increasing hospital length of stay, and elevating healthcare costs. 22% of hospitalised older adults are estimated to have malnutrition. Oral nutritional supplementation (ONS) is key in the management of malnutrition. ONS are energy and nutrient dense products designed to increase dietary intake when diet alone is insufficient to meet daily nutritional requirements. However, for the ONS to be effective they need to be palatable (i.e., taste good), so that patients consume them (i.e., have good compliance) to reap the benefits of extra calories and protein. Normally, hospital patients are offered liquid based ONS (sip feeds). However, previous research has pinpointed that 56% of older adults on geriatric wards did not like sip feeds. Hence, exploration of compliance to different ONS formats is an important research direction to maximise malnourished older adult's nutritional intake. Therefore, the current study aimed to investigate the compliance and palatability of novel fortified porridge compared to traditional sip-feeds in malnourished older adults in hospital.

Inclusion Criteria:Older adults ≥65 yearsPatients on University Hospital Southampton (UHS) acute medical wardsMedium-high risk of malnutrition (MUST score 1-4)Able to provide written consentExclusion Criteria:Patients that have used ONS in previous monthReceiving enteral or parental nutritionPatients with a MUST score >4 (severely malnourished)Patients with a BMI ≤15Patients with chronic liver disease, renal failure, dysphagiaPatients who have had major surgery within the preceding monthPatients with a terminal illnessPatients receiving end of life carePatients unable to eat by mouth (Nil By Mouth [NBM])Patients who require alternative ONS as advised by dietetic support