RESEARCH EXAMINED EFFECTS OF A SPECIALIZED ORAL NUTRITION
SUPPLEMENT ON HOSPITAL READMISSIONS AND MORTALITY RATES IN
MALNOURISHED ADULTS AGED 65 OR OLDER(1)
ABBOTT PARK, Illinois, Jan. 19,
2016 /PRNewswire/ -- Results from a new clinical trial
show that a specialized oral nutrition supplement was associated
with a 50 percent lower death rate in older malnourished patients
with a heart or lung disease 90 days following hospitalization. The
study, published online today in Clinical Nutrition and
supported by Abbott, estimated that within this population one life
could be saved for every 21 patients who received the specialized
nutrition supplement, demonstrating it as a highly effective
therapy.
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The NOURISH (Nutrition effect On Unplanned ReadmIssions and
Survival in Hospitalized patients) study – one of the largest
nutrition clinical studies of its kind – was a prospective,
randomized, double-blind, placebo-controlled trial. The study was
designed to build upon the body of evidence demonstrating that oral
nutrition supplements may reduce complications, mortality and
hospital readmissions in malnourished patients. Participants
in the NOURISH study included 652 malnourished adults, aged 65 or
older, who were admitted to the hospital and suffered from heart or
lung disease. Researchers compared the effects of a specialized
nutrition supplement with high protein (20 grams), HMB* (a
muscle-preserving ingredient) and Vitamin D to a placebo supplement
on rates of readmissions or death 90-days after leaving the
hospital.
Results showed no significant differences between the two groups
for the primary composite (i.e. combined) endpoint of hospital
readmissions or death. However, the study individual components and
additional analyses showed:
- A significantly lower (50 percent) death rate for those
patients who received the specialized nutrition supplement. This
lower incidence of death began at 30 days and continued for 90 days
after participants left the hospital.
- Similar rates of hospital readmissions between the two
groups.
- Improvements in other health outcomes including body weight,
nutritional status and Vitamin D levels at 30 and 60 days after
leaving the hospital, and continued body weight and nutritional
status improvements at 90 days for the group taking the specialized
nutrition supplement.
"The NOURISH study clearly reinforces the power of nutrition in
impacting health outcomes. For the people in this study who were
ill and malnourished, nutrition was critical to survival because it
helps keep your body, especially your muscles, functioning
properly," said Nicolaas E. Deutz,
MD, PhD, Center for Translational Research in Aging &
Longevity, Department of Health and Kinesiology, Texas A&M University, and lead study author.
"This is more proof that we need to change the standard and include
nutrition as an integral part of care, much like flu shots or
aspirin, to help older adults who already have or are at risk for
malnutrition and chronic illness."
MALNUTRITION: A COMMON CONDITION IN OLDER ADULTS
Up to 1 in 2 older adults are malnourished when they are
admitted to the
hospital.2–4 Many
adults may not even realize they are malnourished – they can be of
normal weight, or overweight, but have low levels of muscle or lean
body mass. The loss of muscle, strength and energy can intensify in
malnourished patients and those with a health issue like a heart
attack or pneumonia. Other studies have shown that malnutrition can
worsen their health outcomes including higher chances of
complications, readmissions and even
death.5–7
"Surprisingly, malnutrition in older adults is very common – and
it's a condition that is having a rippling effect on our health and
health system," said Alfonso
Cruz-Jentoft, MD, PhD, head of the Geriatrics Department,
Hospital Ramón y Cajal, Spain, and
past president of the European Union Geriatric Medicine Society. He
was not involved in the study. "People underestimate how critical
strength and muscle health are to recovery from hospitalization and
illness. Proper nourishment is a key component and cannot be left
out of the conversation."
The NOURISH study builds upon existing research that shows the
role nutrition plays in a patient's health, ranging from rebuilding
muscle mass to helping with recovery from disease and time in the
hospital. The nutrients in the specialized nutrition supplement
used in the study – protein, HMB and Vitamin D – are all important
components in repairing and rebuilding muscle while recovering from
hospitalization and illness.
"As medicine has advanced, so has the science of nutrition. We
know proper nutrition is foundational for good health, but the
medical community and patients don't always turn to it when
recovering from a health issue like pneumonia," said Refaat Hegazi, MD, PhD, Abbott medical director
and study author. "While the prevalence of malnutrition is high,
research shows that less than two percent of malnourished patients
in the hospital receive an oral nutrition supplement. Nutrition
must be one of our critical tools to help adults live longer,
better lives."
The commercially available versions of the specialized nutrition
supplement evaluated in the study are Ensure® Plus
Advance in Europe, and it will be
available this year as Ensure® Enlive® in
the United States. The specialized
nutrition supplement is also expected to be available in other
countries around the world in the next couple of years.
*HMB (β-hydroxy β-methylbutyrate) has been
demonstrated in older adults to help maintain their muscle health
as they age or when ill – even helping minimize muscle loss during
bedrest.8
About the Study:
The NOURISH study was a prospective, randomized, double-blind,
placebo-controlled trial conducted in the
United States between May 2012
and October 2014 across 78 different
U.S. hospitals and sites. Researchers evaluated the impact of
Abbott's specialized nutrition supplement with high protein, HMB
and Vitamin D compared to a placebo supplement on rates of death or
readmissions 90 days after hospitalization.
Researchers from institutions including Texas A&M University, Medical University of South Carolina, East Carolina University, University of Illinois at Urbana-Champaign, and
Emory University School of Medicine
evaluated 652 malnourished adults aged 65 or older admitted to the
hospital with conditions that have previously been shown to result
in a high risk of readmission: congestive heart failure, acute
myocardial infarction (AMI/heart attack), pneumonia or chronic
obstructive pulmonary disease (COPD). Study participants were
randomly assigned to receive the specialized nutrition supplement
or placebo supplement, twice a day within 72 hours of
hospitalization and continued for 90 days after leaving the
hospital. Both groups also received standard nutrition care and
medical care prescribed by their physician.
The study's primary composite endpoint evaluated the incidence
of death or non-elective hospital readmissions 90-days after a
patient left the hospital. Other endpoints included 30- and 60-day
incidence of death or readmission, hospital length of stay (LOS),
activities of daily living, body weight, Vitamin D levels and
nutritional status using the Subjective Global Assessment (SGA), a
validated tool that is considered the gold standard for assessment
of malnutrition in hospitalized patients.
About Abbott:
At Abbott, we're committed to helping
you live your best possible life through the power of health. For
more than 125 years, we've brought new products and technologies to
the world -- in nutrition, diagnostics, medical devices and branded
generic pharmaceuticals -- that create more possibilities for more
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References
- Deutz N et al. Clin. Nutr. 2016; published online
18 January 2016.
http://dx.doi.org/10.1016/j.clnu.2015.12.010
- Coats KG et al. J Am Diet Assoc. 1993; 93: 27-33.
- Giner M et al. Nutrition. 1996; 12: 23-29.
- Thomas DR et al. Am J Clin Nutr. 2002; 75: 308-313
- Norman K et al. Clin. Nutr. 2008; 27: 5-15.
- Lim SL, et al. Clin. Nutr. 2012;31(3):345-50.
- Gariballa Set al. Clin. Nutr. 2013;32(5):772-776.
- Deutz N et al. Clin. Nutr. 2013; 32: 704-712.