Interesting and Innovative Ways to use Oral Nutritional Supplements

Oral Nutritional Supplements (ONS) offer a convenient way to support patients to meet their nutritional requirements, but their effectiveness relies on patient compliance. A 2012 systematic review found that mean ONS compliance is 78%, although it varies considerably in different care settings (67% in hospitals and 81% in community settings) (1). This blog post offers top tips to help improve ONS compliance and includes some of our tastiest and refreshing recipes to offer inspiration and variety to your patients.

A Food First Approach

Food First is a simple way of providing enhanced nutrition to those who have malnutrition or are at risk of becoming malnourished. It can be useful for patients who still have a good appetite. This method increases the nutritional density of the diet without increasing the volume of food being offered. A food first approach may include:

• Fortifying foods with additional high energy and/or high protein ingredients
• Providing nourishing drinks
• Encouraging patients to eat additional snacks and puddings

AYMES are keen to complement the food first approach, which is why our ONS come in a wide range of flavours, including sweet, savoury and neutral flavours, all of which can be used to fortify food or be added to homemade nourishing drinks.

Nourishing Drinks

Homemade nourishing drinks can be an effective strategy to improve nutritional intake, but when food first strategies are not appropriate or ineffective a prescribable oral nutritional supplement may be indicated.

ONS products can be added to other foods and fluids according to individual patient preference. Here are some ideas to help improve your patient’s compliance with their ONS prescription:

• Experiment with flavours. Adding ingredients such as whipped cream, cocoa powder or syrups/cordials makes for fun and flavoursome ONS with a twist.
• Replicate favourite drinks. ONS can be incorporated into simple drinks recipes to add additional nourishment to favourite drinks. Our favourites include hot chocolate, refreshing carbonated drinks, and Pina Colada mocktails.
• For those who enjoy milky drinks, you can add ONS products into milkshakes, milky coffeesand malted milk drinks.
• For those who enjoy fruit-based drinks, smoothie-style ONS productscan be added into fruit juice and cordials.

Tasty Recipes

Reduced appetite is a common symptom among people with or at risk of malnutrition (2). You may be interested to learn that ONS products can be incorporated in meals and snacks as well as nourishing drinks. Fortifying meals and snacks with ONS products is a convenient way to increase the energy and protein content without greatly increasing the volume of food consumed, making it ideal for patients with reduced appetite or those struggling to comply with simply drinking the prescribed amount.

AYMES ActaSolve Savoury* comes in vegetable and chicken flavours to provide patients with added variety and choice. They can be consumed alone as a nutritionally-balanced soup-style supplement and can also be incorporated into classic dishes such as curries, casseroles, pies, soups and pasta bakes to enhance their nutritional content. Here are some of our favourite recipe ideasusing AYMES ActaSolve Savoury*.

Ways to increase ONS compliance

Compliance with ONS is dependent on the palatability and tolerance of the ONS product (3). Palatability is influenced by a number of factors, including appearance, convenience, temperature, taste, and volume (4). Here are some top tips to increase ONS compliance:

• Temperature: Anecdotally speaking, patients report preferring chilled ONS as opposed to room temperature ONS. Encourage patients and healthcare professionals to store ONS in the fridge. In hot weather, you could add ice cubes or even freeze ONS products into ice cubes or ice lollies.
• Appearance: Visual stimuli is known to influence our perception of taste, smell and flavour (5). Consider serving the ONS product in the patient’s favourite cup or mug. Cordials and syrups can be added or the ONS product can be blended with fruit, ice cream or cocoa powder. We like to serve our Pina Colada mocktailin a tall glass with a straw, wedge of pineapple and a sprig of fresh mint.
• Volume: Large portions may be overwhelming for patients with reduced appetite. A high-energy, low volume ONS product may be preferable for patients with reduced appetite. Suggest serving the ONS product in a suitably sized glass or mug or consider splitting the dose into smaller manageable amounts.
• Convenience: Keep the ONS within easy reach of the patient, and consider any mobility issues they may have – for example, does the patient require a specific cup or do they require assistance with eating and drinking.
• Taste: Experiment with different flavours of ONS to avoid taste fatigue. New and innovative flavours such as AYMES Shake Ginger offers patients more variety and choice to help overcome taste fatigue.
• Patient-Centred Approach: A key component of patient-centred care is involving the patient in making decisions about their treatment and care. If there are ONS compliance issues, it can be useful to explore and address the reasons for non-compliance with the patient.