a1 Department of Community and Geriatric Medicine, Fremantle Hospital, Fremantle, Western Australia
a2 School of Medicine & Pharmacology, University of Western Australia, Western Australia
Undernutrition contributes to poor clinical outcomes in hospitalised elderly patients but the potential impact of oral nutritional supplements may be reduced by suppressing subsequent food intake. We investigated this possibility in elderly female patients recovering mainly from hip fracture by studying the effect of oral supplements on subsequent food intake during an ad libitum buffet luncheon meal. We tested the effect in seven women by giving the supplement 90 min before the meal and compared energy and macronutrient intake with a control water pre-load condition. A similar study was carried out in another seven women with the supplement or water drink given 30 min beforehand. Both self-rated appetite and energy intake were low in these women. The nutritional supplement did not alter ratings of hunger, fullness or prospective consumption or subsequent energy and macronutrient consumption whether given 90 or 30 min before the meal. There were significant independent correlations between the lack of adequate compensation of energy intake at meals and chronic undernutrition (as assessed by skinfold thickness) and energy intake during the control meal. We conclude that elderly women during the recovery phase after major fractures have low appetites and energy intakes and markedly impaired adjustment of energy intake following liquid oral nutritional supplements. The reasons for this are unknown but are related to anorexia and undernutrition. The consumption of liquid oral supplements given up to 30 min before a meal does not suppress subsequent energy intake from meals.
(Received May 05 2004)
(Revised October 18 2004)
(Accepted October 25 2004)
c1 *Corresponding author: Associate Professor David G. Bruce, School of Medicine & Pharmacology, Fremantle Hospital, P.O. Box 480, Fremantle, Western Australia 6959, Australia, fax +61 618 9431 3229, email firstname.lastname@example.org