Talking Nutrition Editors
Personalized nutrition is a growing market, thanks to advances in diagnostics and an increasing awareness amongst consumers of the benefits of a customized combination of nutritional ingredients at effective and safe doses. It allows for a tailored diet and supplement plan based on an individual’s unique status, including information such as genotype, blood measures and personal and/or family health history. However, the role of personalized nutrition in medical nutrition is still relatively unexplored.
In patients, malnutrition is thought to increase the rate of complications and the risk of prolonged hospital stays3-4. This is alongside other adverse clinical outcomes, such as a higher likelihood of admission to intensive care or major complications. While guidelines recommend nutritional support for patients, the recommendations have little supporting research, and are based mainly on observation3.
A new study by Schuetz et al., published in The Lancet, has investigated the use of personalized nutrition strategies to reach protein and caloric goals and reduce the risk of adverse clinical outcomes among inpatients with the potential to have a poor nutritional status.
To determine if a personalized medical nutritional plan reduces the risk of adverse clinical outcomes, The Effect of early nutritional support on Frailty, Functional Outcomes, and Recovery of malnourished medical inpatients Trial (EFFORT) included the results of 2,028 patients in the final analysis. These patients were randomly assigned to the control or intervention group. The control group received standard hospital food, while the intervention group started a personalized nutritional plan developed by a registered dietitian as soon as possible after randomization and no later than 48 hours after hospital admission.
All patients in the study were identified as at nutritional risk on initial assessment. The participants included individuals from both sexes, with a range of ages as well as morbidities and illnesses.
The intervention group were part of a phased strategy to meeting nutritional targets. Dietary interventions, often supported by Oral Nutritional Supplements as well as micronutrient supplements, were the starting point. If patients did not achieve >75% of caloric and protein targets, oral intake was supported with enteral nutrition. Then for those still not achieving >75% of caloric and protein targets, parenteral was used alongside oral and enteral.
The study reported an adverse clinical outcome in 23% of the intervention group and 27% of the control group. In comparison, patients in the control group had a significantly higher risk for adverse clinical outcomes Additionally, no specific adverse side effects of the intervention were observed.
The study results also demonstrated that personalized nutrition increased energy and protein levels, and improved functional status and quality of life. The study therefore concluded that this tailored nutritional support was superior to standard hospital food.
Nate Matusheski, Ph.D., Lead Scientist, Personalized Nutrition, at dsm-firmenich, explains why the findings of the study are so important and what further research is needed.
Why are the findings of this study so significant?
The study by Schuetz et al. again demonstrates that nutrition screening of hospitalized patients, and the development of individualized nutrition care plans, provide important improvements on clinical outcomes, including mortality. Based on this and other recent research, it has become clear that an increased focus on the implementation of such approaches can provide patient benefits and has the potential to reduce the growing burden of healthcare costs.
Are there any challenges involved in delivering personalized nutrition for hospital patients?
One practical concern about the approach described in this study is the amount of resources required to deliver such complex individualized interventions leveraging trained dietitians. However, digital tools and the provision of personalized food products has the potential to increase the efficiency of such an approach, making its standardized implementation more accessible on a larger scale.
In what ways could personalized nutrition positively impact medical nutrition for hospital patients and is any further research needed?
This study ultimately backs the positive impact that personalized nutrition, often referred to as ‘precision nutrition’, can have in healthcare applications, delivering tangible benefits for patients. The findings show that the improvements in outcomes arose from the diligent application of well-accepted nutrition care guidelines for calorie and protein targets, compared to the provision of standard hospital food in the control group. Because many individuals begin hospitalization with existing nutrient deficiencies, a deeper level of nutritional assessment, including micronutrient sufficiency information, may have the potential to deliver further benefits.
01 July 2019
6 min read
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