The effect of 12-weeks Nutritional supplementation on Nutritional Intake and Status among Indonesian Older Outpatients with Malnutrition Risk, the Prolansia study: a randomized controlled trial
Background: Standard care for older outpatients who are at risk of malnutrition in Indonesia is still based on the 2017’s recommendations of the Indonesian Geriatrics Society. and does not provide nutritional supplementation as recommended by ESPEN guidelines 2019/2022. Objective: We compared the ef...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-06-01
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| Series: | The Journal of Nutrition, Health and Aging |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1279770725000727 |
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| author | Esthika Dewiasty Sjors Verlaan Rahmi Istanti Fariza Rahmah Eugene Satryo Lisette CPGM de Groot Siti Setiati |
| author_facet | Esthika Dewiasty Sjors Verlaan Rahmi Istanti Fariza Rahmah Eugene Satryo Lisette CPGM de Groot Siti Setiati |
| author_sort | Esthika Dewiasty |
| collection | DOAJ |
| description | Background: Standard care for older outpatients who are at risk of malnutrition in Indonesia is still based on the 2017’s recommendations of the Indonesian Geriatrics Society. and does not provide nutritional supplementation as recommended by ESPEN guidelines 2019/2022. Objective: We compared the effects of supplementation of at least 400 kcal/day including 30 g or more of protein/day as nutritional intervention as recommended by the ESPEN Guideline with standard care recommended by The Indonesian Geriatrics Society, in Indonesian older adults who are at risk of malnutrition. Methods: Older outpatients (60 years or older) at a geriatric clinic of the national referral hospital with or at risk of malnutrition were recruited. They were randomly allocated to 12 weeks of supplementation with a nutrient dense drink twice a day on top of standard care compared to standard care only. We assessed energy and nutrient intake at baseline, after 6 and 12 weeks and nutritional status, physical performance, and vitamin D level at baseline and after 12 weeks. Data analyses were blinded. Results: As many as 105 older outpatients (65 % women, mean age 72.5 years, SD = 6.3) were randomly assigned to the intervention (n = 54) and the control group (n = 51). One hundred and one participants completed the intervention, with an average compliance of 90% to the nutritional intervention. Nutritional supplementation significantly increased daily intake of energy, protein, total fat, vitamin D, vitamin B12, calcium (all p values <0.001) and carbohydrate (p = 0.002) in both men and women after 12 weeks. The intervention group showed an increase in vitamin D levels (p = 0.008). Furthermore, the intervention group gained more body weight than the control group did (p = 0.021)), especially in women (p = 0.017). Women in the intervention group also showed more increase in skeletal muscle mass (p = 0.023). Improvements in muscle strength and physical performance were not statistically different between the groups. No significant adverse effects were noted. Conclusion: Nutritional supplementation is effective in improving nutritional intake and status among Indonesian outpatients with malnutrition risk, which has the potential to support and enhance the standard of care. |
| format | Article |
| id | doaj-art-d8101762c97141e2b31fc68e978bc3b6 |
| institution | DOAJ |
| issn | 1760-4788 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Journal of Nutrition, Health and Aging |
| spelling | doaj-art-d8101762c97141e2b31fc68e978bc3b62025-08-20T02:54:33ZengElsevierThe Journal of Nutrition, Health and Aging1760-47882025-06-0129610054810.1016/j.jnha.2025.100548The effect of 12-weeks Nutritional supplementation on Nutritional Intake and Status among Indonesian Older Outpatients with Malnutrition Risk, the Prolansia study: a randomized controlled trialEsthika Dewiasty0Sjors Verlaan1Rahmi Istanti2Fariza Rahmah3Eugene Satryo4Lisette CPGM de Groot5Siti Setiati6Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands; Division of Geriatric Medicine, Department of Internal Medicine – Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia; Universitas Indonesia Hospital (RSUI), Depok, Indonesia; Corresponding author.Department of Nutrition and Dietetics, Faculty of Health, Sport and Physical Activity, Amsterdam University of Applied Sciences, The Netherlands; Department of Operating Rooms, Radboud University Medical Center, Nijmegen, The NetherlandsCenter of Clinical Epidemiology and Evidence-Based Medicine, Cipto Mangunkusumo Hospital – Faculty of Medicine, Universitas Indonesia, Jakarta, IndonesiaFaculty of Health Sciences, Universitas Muhammadiyah Prof. Dr. Hamka, Jakarta, IndonesiaFaculty of Medicine, Universitas Indonesia, Jakarta, IndonesiaDivision of Human Nutrition and Health, Wageningen University, Wageningen, The NetherlandsDivision of Geriatric Medicine, Department of Internal Medicine – Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia; Center of Clinical Epidemiology and Evidence-Based Medicine, Cipto Mangunkusumo Hospital – Faculty of Medicine, Universitas Indonesia, Jakarta, IndonesiaBackground: Standard care for older outpatients who are at risk of malnutrition in Indonesia is still based on the 2017’s recommendations of the Indonesian Geriatrics Society. and does not provide nutritional supplementation as recommended by ESPEN guidelines 2019/2022. Objective: We compared the effects of supplementation of at least 400 kcal/day including 30 g or more of protein/day as nutritional intervention as recommended by the ESPEN Guideline with standard care recommended by The Indonesian Geriatrics Society, in Indonesian older adults who are at risk of malnutrition. Methods: Older outpatients (60 years or older) at a geriatric clinic of the national referral hospital with or at risk of malnutrition were recruited. They were randomly allocated to 12 weeks of supplementation with a nutrient dense drink twice a day on top of standard care compared to standard care only. We assessed energy and nutrient intake at baseline, after 6 and 12 weeks and nutritional status, physical performance, and vitamin D level at baseline and after 12 weeks. Data analyses were blinded. Results: As many as 105 older outpatients (65 % women, mean age 72.5 years, SD = 6.3) were randomly assigned to the intervention (n = 54) and the control group (n = 51). One hundred and one participants completed the intervention, with an average compliance of 90% to the nutritional intervention. Nutritional supplementation significantly increased daily intake of energy, protein, total fat, vitamin D, vitamin B12, calcium (all p values <0.001) and carbohydrate (p = 0.002) in both men and women after 12 weeks. The intervention group showed an increase in vitamin D levels (p = 0.008). Furthermore, the intervention group gained more body weight than the control group did (p = 0.021)), especially in women (p = 0.017). Women in the intervention group also showed more increase in skeletal muscle mass (p = 0.023). Improvements in muscle strength and physical performance were not statistically different between the groups. No significant adverse effects were noted. Conclusion: Nutritional supplementation is effective in improving nutritional intake and status among Indonesian outpatients with malnutrition risk, which has the potential to support and enhance the standard of care.http://www.sciencedirect.com/science/article/pii/S1279770725000727Oral nutrition supplementationMalnutritionNutrient intakesOlder outpatientsIndonesia |
| spellingShingle | Esthika Dewiasty Sjors Verlaan Rahmi Istanti Fariza Rahmah Eugene Satryo Lisette CPGM de Groot Siti Setiati The effect of 12-weeks Nutritional supplementation on Nutritional Intake and Status among Indonesian Older Outpatients with Malnutrition Risk, the Prolansia study: a randomized controlled trial The Journal of Nutrition, Health and Aging Oral nutrition supplementation Malnutrition Nutrient intakes Older outpatients Indonesia |
| title | The effect of 12-weeks Nutritional supplementation on Nutritional Intake and Status among Indonesian Older Outpatients with Malnutrition Risk, the Prolansia study: a randomized controlled trial |
| title_full | The effect of 12-weeks Nutritional supplementation on Nutritional Intake and Status among Indonesian Older Outpatients with Malnutrition Risk, the Prolansia study: a randomized controlled trial |
| title_fullStr | The effect of 12-weeks Nutritional supplementation on Nutritional Intake and Status among Indonesian Older Outpatients with Malnutrition Risk, the Prolansia study: a randomized controlled trial |
| title_full_unstemmed | The effect of 12-weeks Nutritional supplementation on Nutritional Intake and Status among Indonesian Older Outpatients with Malnutrition Risk, the Prolansia study: a randomized controlled trial |
| title_short | The effect of 12-weeks Nutritional supplementation on Nutritional Intake and Status among Indonesian Older Outpatients with Malnutrition Risk, the Prolansia study: a randomized controlled trial |
| title_sort | effect of 12 weeks nutritional supplementation on nutritional intake and status among indonesian older outpatients with malnutrition risk the prolansia study a randomized controlled trial |
| topic | Oral nutrition supplementation Malnutrition Nutrient intakes Older outpatients Indonesia |
| url | http://www.sciencedirect.com/science/article/pii/S1279770725000727 |
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