New ESPEN expert guidance: how to tailor nutritional management for patients at risk of COVID-19

By: Talking Nutrition Editors

Reducing the risk of malnutrition in patients

  • Preserving nutritional status and preventing or treating malnutrition amongst patients can help to fight against infections and improve clinical outcomes for those infected, or at risk of severe infections.
  • New guidelines have been issued by the European Society for Clinical Nutrition and Metabolism (ESPEN) to provide practical steps for preserving nutritional status in patients who are at risk of SARS-CoV-2 infection. Published in Clinical Nutrition, the paper outlines the latest guidance for tailoring nutritional management to meet the requirements of patients who have, or are at risk, of infection.
  • Discover how dsm-firmenich can support you with in-depth patient insights to develop innovative medical nutrition solutions that meet the needs of patients as well as medical compliance requirements. 

Malnutrition: what is the risk for COVID-19 patients? 

The COVID-19 pandemic poses an unprecedented global health risk – both to patients and healthcare systems. Global data has consistently shown that patients with the worst outcomes and higher mortality rates include immunocompromised people, such as the elderly and polymorbid individuals. These population groups are also more susceptible to malnutrition, making it especially important to prevent or treat malnutrition in the event of them becoming infected.  In addition, COVID-19 patients often have prolonged ICU stays, which can worsen or cause malnutrition, impacting quality of life in the longer term and potentially leading to additional complications that require further hospitalization.

Given the importance of the prevention, diagnosis and treatment of malnutrition, the European Society for Clinical Nutrition and Metabolism (ESPEN) has recently issued guidance on the nutritional management of COVID-19 patients and those at risk of infection. The document outlines 10 practical recommendations for nutritional management before and during an infection with SARS-CoV-19. It provides guidance on the identification of those at risk of malnutrition and means to ensure adequate nutritional intake for these people using diet, oral nutritional supplements, enteral and where needed parenteral nutrition.

Meeting patient needs with science-led nutritional guidelines 

The ESPEN guidelines are designed to support individuals in reaching nutritional targets in a pragmatic way. They acknowledge that while food should provide the basis of nutritional management, it is well understood that for individuals at a higher risk of infection, as well as patients in the ICU, it may also be necessary to consider methods such as oral nutritional supplements, enteral nutrition and parenteral nutrition. 

Using knowledge to gain in-depth patient and consumer insights also opens opportunities to develop personalized medical nutrition solutions, in line with the updated ESPEN guidelines. Since each patient has different and complex nutritional and clinical needs, taking a more human-centric approach is important in the design of targeted medical nutrition concepts and novel delivery formats. For example, research by dsm-firmenich found that individuals in care homes do not always consume the oral nutritional supplements they are offered.  As elderly people often have mental or physical barriers to eating, they can feel pressured at meal times or uninspired by limited and unappealing options. The report found that reduced appetite is the biggest challenge when it comes to fulfilling nutritional needs in older populations. The views of the elderly are also often misrepresented to those tasked with developing medical nutrition solutions or those making decisions regarding their care. 

To appeal to senior adults, medical nutrition solutions should ideally be an integral part of normal meals or available in a range of dosage sizes, delivery formats, flavors and textures. The creation of more appealing and palatable delivery formats in a range of dosage sizes can therefore help to support patient compliance, as well as ultimately improve the nutritional status of patients. 

Keeping the world’s population healthy 

The new ESPEN guidelines present a viable opportunity to tailor medical nutrition solutions to support growing needs – through fortified foods, oral nutritional supplements, enteral nutrition and parenteral nutrition products.

We understand that it takes more than ingredients to succeed in today’s rapidly changing marketplace. With a range of science-backed health and nutrition solutions, as well as expert services, dsm-firmenich is your end-to-end partner for medical nutrition solutions that meet the needs of target population groups at risk of malnutrition while meeting medical compliance requirements. At the pulse of policy making, we work with key decision makers in care homes and healthcare settings to identify the factors preventing a good standard of nutritional care and provide optimal nutrition to support the health of the elderly population and critically ill patients.

For a successful go-to-market, the understanding and acceptance of the medical community is key. We support those who want to make a difference in the medical community with in-depth patient and consumer insights to open up opportunities to develop medical nutrition solutions.

Our medical nutrition brochure outlines how to support optimal patient care and improve quality of life through insight-led innovation. Discover how together, we can raise the profile of vital nutrients supporting the health of those that need it most.

Published on

05 June 2020


  • Medical Nutrition
  • Health & Nutrition
  • Innovation Services
  • Senior Management


6 min read

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[2] ASCEND Study Collaborative Group. Effects of n−3 Fatty Acid Supplements in Diabetes Mellitus. New England Journal of Medicine, vol. 379, pg. 1540-1550, 2018.

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[10] Ibid.

[11] Dangardt F et al. Omega-3 fatty acid supplementation improves vascular function and reduces inflammation in obese adolescents. Atherosclerosis, vol. 212, pg. 580-585, 2010.

[12] Tribulova N et al. Omega-3 index and anti-arrhythmic potential of omega-3 PUFAs. Nutrients, vol. 9, pg. 1191, 2017.

[13] Gerber M. Omega-3 fatty acids and cancers: a systematic update review of epidemiological studies. Br J Nutr., vol. 107(suppl. 2):S228-39, 2012.

[14] Mozaffarian D et al. Omega-3 fatty acids and cardiovascular disease: effects on risk factors, molecular pathways and clinical events. J Am Coll Cardiol., vol. 58, pg. 2047-2067, 2011.

[15] P.P. Ritz et al. Dietary and Biological Assessment of the Omega-3 Status of Collegiate Athletes: A Cross-Sectional Analysis, PLoS One 2020, 10.1371/journal.pone.0228834

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