Hit Refresh: Innovative Ways to Use Juice-Style ONS During Summer Months

Introduction

Oral Nutritional Supplements (ONS) are a useful strategy in the management of disease-related malnutrition, but they are only effective if consumed.¹ ² ³ A recent study found that 64% of patients didn’t comply with their ONS prescription.⁴ Poor compliance to ONS can be attributed to a variety of factors including ONS specific features such as flavour, palatability, texture, variety, volume, and energy density.⁵ ⁶ ⁷ Individual patient factors such as reduced taste or smell function, dysphagia, and gastrointestinal symptoms also influence compliance.⁸⁻¹¹ Additionally, prolonged and repeated consumption of ONS, is known to cause taste fatigue; contributing to lower compliance rates.¹²⁻¹⁵

Patient preference plays an important role in ONS compliance.¹⁶ ¹⁷ For example, some studies have reported poor compliance to standard (milkshake style) ONS due to patients’ dislike of milky drinks, the thickness, mouth-feel, and available flavours. ¹⁸⁻²⁰

Offering a variety of forms and styles of ONS, such as juice-style ONS, in different flavours, may help to combat personal dislike, boredom and taste fatigue, ultimately improving ONS compliance. This article introduces our new high energy juice-style ONS and suggests a number of innovative ways to offer this fresh alternative to patients, especially in the summer months.

Switching without compromise

A recent survey examining ONS prescribing experiences of thirteen Dietitians revealed that the Dietitians thought that switching to a juice-style ONS compromised the nutritional value of an ONS regimen.²¹

It is important to correct this misimpression. Choosing a juice-style ONS can offer a useful and refreshing alternative to milkshake style ONS with minimal nutritional compromise. AYMES’ Actagain Juce has comparable nutritional profiles for protein and energy; when compared with standard milkshake style ready-to-drink (RTD) ONS (see figure 1).

Introducing Actagain Juce

AYMES Actagain Juce is a refreshing new, high-energy juice-style ONS, designed especially for patients who dislike milky drinks or prefer a more refreshing taste. ActagainJuce is available in5flavours (Juicy Apple, Zesty Orange, Berry Medley, Exotic Fruit)and Juicy Peach.ActagainJuceis also a useful choice for patients experiencing taste fatigue, taste changes, (due to medication and/or treatment), and for those who would benefit from a fat-free ONS. Patients can switch from a standard ready-to-drink (RTD) milkshake style ONS product to AYMES Actagain Juce with minimal impact on their protein intake – this is not always the case for other RTD juice-style ONS (see figure 1).

Key facts about AYMES Actagain Juce:

• Contains the highest amount of protein (11g/200ml bottle) when compared with other available juice-style ONS – meaning minimal impact on protein intake when switching from standard RTD milkshake style ONS (see figure 1).²²
• Is the most cost-effective juice-style ONS (per gram of protein) at just £1.80 per 200ml serving (see figure 2). ²³
• Provides the 10μg daily Vitamin D requirements just 2 servings (DoH recommendations for adults and children over 4 years of age). ²4
• Scores high withtaste; in a recent study,93% of participants ratedActagainJuce as acceptable for palatability (e.g., taste,consistency andappearance).²5
• Our Tetra Pak cartonscontain63% plant-based material and use 4x less plastic. ²6, ²7 

Figure 1: ONS Nutrient Composition Comparison (200ml)

Figure 2: AYMES Actagain Juce: summary features (200ml carton)

Innovative ways to use Actagain Juce during summer months

There are plenty of interesting and innovative ways to serve Actagain Juce. Summer is a particularly good time to enjoy Actagain Juce and to experiment with different serving options. Serving drinks at different temperatures can be a simple way to mix things up and improve compliance. Patients often report preferring chilled ONS to room temperature ONS.²⁴

Innovative ways to enjoy AYMES Actagain juce include:

Conclusion

ONS are an effective way of managing disease-related malnutrition when taken as prescribed. ONS compliance can be poor due to a number of factors such as patient preference, sensory experiences, and taste fatigue.

Strategies to improve ONS compliance include offering a variety of different types of ONS (formats and flavours). Choosing a juice-style ONS can offer a useful and refreshing alternative to RTD milkshake style ONS with minimal nutritional compromise. AYMES Actagain Juce contains the highest amount of protein (11g/ 200ml bottle) when compared with other available juice-style ONS products and can be served in a variety of interesting and innovative ways, to help improve compliance.

◄References:

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22. Comparison based on MIMS data (accessed Jan 2024):ActagainJuce; 5g protein/100ml, Ensure PlusJuce; 4.8g protein/100ml,FresubinJucy; 4g protein/100ml,Fortijuce; 3.9g protein/100ml,Altrajuce; 3.9g protein/100ml.
23. (MIMS;February,2024) 
24. Provides 10μg in 2 servings which meetsDoH recommendations for adults and children over 4 years of age. The Scientific AdvisoryCommittee on Nutrition (SACN) recommendations on vitamin D;December, 2023.
25. AYMES Data on File - AYMESActagainJuce Acceptability and tolerance study.February, 2024. 
26. Data on file; Tetra Pak Packaging for AYMES presentation;October, 2023.
27. Comparison based on AYMES data on file; Tetra Pak. Tetra Pak Packaging for AYMES presentation (accessed January 2024):Compared to HDPE bottle weighing 20g 
28. Methven, L, et al. (2009). Can changing the serving temperature improve the palatability of oral nutritional supplements in older consumers? Proceedings of the Nutrition Society, 68(OCE1), E37. doi:10.1017/S0029665109001785