A multi-center prospective study of plant-based nutritional support in adult community-based patients at risk of disease-related malnutrition
Marta Delsoglio, Corbin Griffen, Rakshan Syed, Tobias Cookson, H. Saliba, A. Vowles, S. T. Davies, N. Willey, J. Hywel Thomas, N. Millen, Nour Odeh, Jayne Longstaff, N. Westran, Lindsey Allan, H. Offer, C. Howell, M. Sanders, Kirsty Gaffigan, K. Garrett, Sally Foster, Agnes Salt, Emily Carter, Sarah F. Moore, Nick Bergin, J. Roper, Joe Alvarez, Christine Voss, Teresa Connolly, Clare Macdonald, T. Thrower, D. Sills, J. Baxter, Rhonda Manning, Lynsey Gray, K. Voas, Scot Richardson, A.-M. Hurren, Daniel J. Murphy, Susan Blake, Paul McArdle, Sinead M. Walsh, Lucy H. Booth, Louise Albrich, S. Ashley-Maguire, Joanna Allison, Sarah Brook, R. Capener, Gary P. Hubbard, R.J. Stratton
Abstract
Introduction There is an emerging need for plant-based, vegan options for patients requiring nutritional support. Methods Twenty-four adults at risk of malnutrition (age: 59 years (SD 18); Sex: 18 female, 6 male; BMI: 19.0 kg/m 2 (SD 3.3); multiple diagnoses) requiring plant-based nutritional support participated in a multi-center, prospective study of a (vegan suitable) multi-nutrient, ready-to-drink, oral nutritional supplement (ONS) [1.5 kcal/mL; 300 kcal, 12 g protein/200 mL bottle, mean prescription 275 mL/day (SD 115)] alongside dietary advice for 28 days. Compliance, anthropometry, malnutrition risk, dietary intake, appetite, acceptability, gastrointestinal (GI) tolerance, nutritional goal(s), and safety were assessed. Results Patients required a plant-based ONS due to personal preference/variety (33%), religious/cultural reasons (28%), veganism/reduce animal-derived consumption (17%), environmental/sustainability reasons (17%), and health reasons (5%). Compliance was 94% (SD 16). High risk of malnutrition (‘MUST’ score ≥ 2) reduced from 20 to 16 patients ( p = 0.046). Body weight (+0.6 kg (SD 1.2), p = 0.02), BMI (+0.2 kg/m 2 (SD 0.5), p = 0.03), total mean energy (+387 kcal/day (SD 416), p < 0.0001) and protein intake (+14 g/day (SD 39), p = 0.03), and the number of micronutrients meeting the UK reference nutrient intake (RNI) (7 vs. 14, p = 0.008) significantly increased. Appetite (Simplified Nutritional Appetite Questionnaire (SNAQ) score; p = 0.13) was maintained. Most GI symptoms were stable throughout the study ( p > 0.06) with no serious adverse events related. Discussion This study highlights that plant-based nutrition support using a vegan-suitable plant-based ONS is highly complied with, improving the nutritional outcomes of patients at risk of malnutrition.