Oral nutritional supplements promote significant weight gain in cystic fibrosis patients

Abstract

Background: Malnutrition and poor growth are major problems for many patients with cystic fibrosis (CF), and nutritional supplements can enhance the success of dietary strategies. The purpose of this study was to assess Scandishake (Scandipharm Ltd, U.K.), an energy dense (2.0 kcal/ml) oral supplement. Methods: The study design included a 4‐week monitoring period, followed by 8 weeks of supplementation with Scandishake. The subjects had anthropometry assessed at weeks 0, 4 and 12, and their dietary intake assessed at weeks 0 and 12. Results: Data from 26 patients (16 male, 10 female; age range 9–34 years) showed a significant mean weight increase of 1.9 kg (range 1.6–4 kg) and a mean increase of 0.5 cm (range 1.1–2.7 cm) in mid‐arm muscle circumference. There was also an increase in energy intakes, rising from a mean of 11.15 MJ (2665 kcals) to a mean of 13.42 MJ (3208 kcals) ( P < 0.01), and the mean of individual percentages of estimated average requirement (EAR) for energy increased from 120% (73–182%) to 143% (67–221%). Conclusion: The energy dense formulation of Scandishake makes it a useful adjunct in the treatment of malnutrition and the promotion of normal growth in patients with CF.

Summary of a systematic review on oral nutritional supplement use in the community

“…The increase was evaluated to be statistically significant in only eighteen studies: surgery (Jensen & Hessov, 1997;Keele et al 1997); liver disease (Simko, 1983;Hirsch et al 1993); cancer (Evans et al 1987;Ovesen & Allingstrup, 1992); the elderly (Meredith et al 1992;Fiatarone et al 1994;Woo et al 1994); cystic fibrosis (Sondel et al 1987) and Crohn's disease (Harries et al 1983); COPD (Lewis et al 1987;Norregaard et al 1987;Efthimiou et al 1988;Knowles et al 1988;Fuenzalida et al 1990;Rogers et al 1992); other diseases (Kuhlmann et al 1997). Although fourteen of sixteen non-randomized trials that assessed total energy intake showed an increase, in only seven was this increase statistically significant (Lynch et al 1983;Parsons et al 1983;Stauffer et al 1986;Welch et al 1991;Gray-Donald et al 1994;Tolia, 1995;Skypala et al 1998). The extent to which the energy from the ONS replaced or added to that from food could be assessed in seventeen trials, the results of which are summarized graphically in Fig.…”

“…Functional changes (assessed in fifty-nine studies) following ONS varied according to the disease or condition of patients, and were typically observed more commonly in those patients with a BMI < 20 kg/m 2 than in those with BMI > 20 kg/m 2 . Functional benefits included improved muscle strength, walking distance and well-being in patients with COPD (Wilson et al 1986;Efthimiou et al 1988;Donahoe et al 1989;Rogers et al 1992), improved growth performance in children with cystic fibrosis (Allan et al 1973;Berry et al 1975;Yassa et al 1978;Kirschner et al 1981;Parsons et al 1983;Shepherd et al 1983;Skypala et al 1998), reduced falls (Gray-Donald et al 1995) and increased activities of daily living (Volkert et al 1996) in the elderly, and improvements in immune function in patients with human immunodeficiency virus (Hellerstein et al 1994). It is possible that detriments due to ONS may occur in some overweight patients with certain diseases (e.g.…”

Energy-dense, low-volume paediatric oral nutritional supplements improve total nutrient intake and increase growth in paediatric patients requiring nutritional support: results of a randomised controlled pilot trial

“…As this was a multi-centre pilot study, the results need to be interpreted with caution. Although the sample size was relatively low (indicative of difficult recruitment in this complicated and vulnerable patient group), it was comparable to or higher than other similar studies of nutritional support in paediatric patients with faltering growth [11,14,15,36,43,52] and large enough to show significant benefits between interventions, in favour of the cONS. This trial aimed to compare the two ONS interventions with the standard ONS as the control group, and both groups included appropriate nutritional support, which was left to the Dietitians discretion and could have included dietary advice and/or food fortification.…”

Nutritional intervention in patients with Cystic Fibrosis: A systematic review

“…Nutritional interventions were subdivided into behavioural intervention (n = 6) [11][12][13][14][15][16], oral supplementation (n = 4) [17][18][19][20] and enteral tube feeding (n = 7) [21][22][23][24][25][26][27]. The treatment length of the behavioural interventions ranged from 7 weeks [13-15] to one year [11] and the follow-up period from 1 year [11,12,16] to 2 years [13][14][15].…”