New Research Highlights Benefits of Personalized Nutrition For Patients

New Science 07/01/2019

6min read

Talking Nutrition Editors

Personalized nutritional support for medical
patients 

  • Personalized nutrition, offering a diet and supplement plan tailored to the specific needs of an individual, is growing in popularity thanks to advances in diagnostics and the rise of the increasingly health-conscious consumer. However, it is still relatively unexplored when it comes to medical nutrition.
  • In hospital settings, malnutrition is prevalent, and is thought to increase the rate of complications and the risk of prolonged hospital stays for patients1. While tailored nutritional plans are considered beneficial in these cases, most studies so far have been based on observation, rather than interventional research.
  • A recent study2 has investigated the impact of personalized nutritional support on clinical outcomes in medical inpatients at nutritional risk. Here, we discuss the findings and ask one of DSM’s personalized nutrition experts why the study is so significant.

Nutrition gets personal

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.

A study in reducing nutritional risk

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.

Benefits of tailored nutritional support

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.

Ask the Expert with Nate Matusheski, Ph.D.

Nate Matusheski, Ph.D., Lead Scientist, Personalized Nutrition, at DSM, 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.

DSM’s Medical Nutrition solutions

To find out more how DSM can support medical nutrition solutions, watch our video and get started.

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Tags: MEDICAL NUTRITIONNEW SCIENCEARTICLER&D
References
  1. Felder S, Lechtenboehmer C, Bally M, et al. Association of nutritional risk and adverse medical outcomes across different medical inpatient populations. Nutrition 2015; 31: 1385-93.
  2. Schuetz, P., et al. (2019). "Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial." Lancet.
  3. Felder S, Lechtenboehmer C, Bally M, et al. Association of nutritional risk and adverse medical outcomes across different medical inpatient populations. Nutrition 2015; 31: 1385-93.
  4. Imoberdof R, Meier R, Krebs P, et al. Prevalence of undernutrition on admission to Swiss hospitals. Cin Nutr 2010; 29: 38-41.

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