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The role of Oral Nutritional Supplements

Oral Nutritional Supplements (ONS) are multi-nutrient liquid, semi-solid or powder products that provide macronutrients and micronutrients with the aim of increasing oral nutritional intake[17].

Several systematic reviews have demonstrated that, as part of the management of disease related malnutrition, ONS improve dietary intake and weight, as well as benefiting the clinical outcome of underlying diseases.

Beneficial outcomes of an oral nutritional supplement management

Trials, systematic reviews and meta-analyses indicate that appropriate consumption of ONS in patients’ disease-related malnutrition has the following significant beneficial outcomes[3,18,19,20]:

  • Reduced infections
  • Less time spent in hospital and fewer re-admissions
  • Improved well-being and activities of daily living
  • Lower mortality in the acutely ill elderly
  • Fewer pressure ulcers, poorly healing wounds and other complications

Cost saving

The clinical benefits of the malnutrition management can be translated into significant cost saving in both the hospital and community settings.  The lower duration of hospital stays or rate of re-admission with an ONS treatment may represent up to 8% cost saving per patient [21]. An appropriate nutritional support given to disease-related patients could save millions and is confirmed by meta-analysis studies[22].


  1. Stratton R, Green C, Elia M. Disease-related malnutrition: an evidence based approach to treatment. Wallingford: CABI Publishing; 2003.
  1. Loch H. et al. Introductory to the ESPEN Guidelines on Enteral Nutrition: Terminology, Definitions and General Topics.  Clin Nutr 2006; 25:180–186.
  2. National Institute for Health and Clinical Excellence (NICE). Nutrition support in adults: oral nutrition support, enteral tube feeding and parenteral nutrition (clinical guideline 32). London: National Institute for Health and Clinical Excellence (NICE). 2006.
  3. Stratton R, Ek A, Engfer M, Moore Z, Rigby P, Wolfe R, Elia M. Enteral nutritional support in prevention and treatment of pressure ulcers: a systematic review and meta-analysis. Ageing Res Rev 2005; 4(3):422-450.
  4. Stratton R, Elia M. A review of reviews: A new look at the evidence for oral nutritional supplements in clinical practice. Clinical Nutritional Supplements 2007; 2:5-23.
  5. Freijer K., Nuijten M. Analysis of the health economic impact of medical nutrition in Netherland. European Journal of Clinical Nutrition (2010) 64, 1229–1234
  6. Cawood A, Elia M, Stratton R. Meta-analysis shows reduced health care use and costs with Oral Nutritional Supplements. Clin Nutr Suppl 2010; 5(2).