A healthy, nutritionally balanced diet is important throughout our lives, but as we get into old age or if we become ill it can be difficult to achieve the optimum nutrient levels we need. When the body doesn't get enough energy, protein and other nutrients it can become malnourished. Common consequences of malnutrition include a greater chance of infection, weakness/fatigue, decreased bone strength, slower wound healing and even impaired functioning of the heart, lungs and gastrointestinal (GI) system.
The role of nutrition in frailty
Disease related malnutrition can lead to loss of muscle mass, which reduces body strength and walking speed. This is a state known as 'frailty'. This in turn reduces a patient's overall activity and energy levels. The vicious circle of reduced energy leading to more restrictions of physical activity can eventually lead to a loss of independence. Frail patients need extra medical attention in order to reduce the risk of them becoming dependent on others and to stay as independent as possible for as long as possible. Patients typically enter a spiral of decline in which inadequate nutrition leads to muscle weakness, increasing frailty and risk of costly injury (falls, etc.) and disability.
Frailty is a medical condition that affects both the brain and the body, and that can leave elderly patients vulnerable, both immediately and in the future. With little strength left in reserve, frail patients often have a low resistance to even the most minor of illnesses, meaning something like a urinary tract infection can result in a greater risk of the onset of disability or even institutionalisation.
Providing healthy and balanced nutrition to patients is key for their overall care.
As mentioned, physical frailty can be induced by disease related malnutrition. We can split frail elderly patients in two groups: the first is the group that have involuntary weight loss and show physical frailty. The second is the group that do not show involuntary weight loss (yet) but do show signs of physical frailty.
Elderly patients with physical frailty may benefit from preventative interventions against disability.
In a consensus paper a group of geriatricians and gerontologists discuss screening and treatment for these elderly with physical frailty¹. Their recommendations consist of an exercise program, dietary management with high-energy/high-protein products, calcium and vitamin D supplementation.
¹ Morley JE, et al. Frailty Consensus: a call to action. JAMDA 14 (2013): 392-397.
The Fortimel range
The following products are foods for special medical purposes for the dietary management of disease related malnutrition and must be used under medical supervision.
Fortimel Compact Protein
A high protein, energy dense medical nutrition supplement for the dietary management of disease related malnutrition. It contains all essential minerals, vitamins and trace elements, providing 18 g of protein and 300 kcal in 125 ml. Available in the following flavours: Banana, Berries, Mocha, Peach, Mango, Strawberry and Vanilla. Fortimel Compact Protein must be used under medical supervision.
A high protein, energy dense medical nutrition supplement for the dietary management of disease related malnutrition. It contains all essential minerals, vitamins and trace elements and is available in 200ml bottles, with one serving providing 18g protein and 300kcal. Fortimel Extra must be used under medical supervision.
A high protein medical nutrition food containing whey protein, leucine and vitamin D. FortiFit Pro is for the dietary management disease related malnutrition and must be used under medical supervision. A 40g serving provides 21g protein and 150kcal.
Frailty: a public health issue?
Professor Olivier Guerin, University Professor and hospital practitioner discusses frailty as a healthcare issue, and the importance of maintaining nutritional status.
Nutricia products are intended for the nutritional management of diseases and related medical conditions and therefore should be used under medical supervision.