Efficacy of a Special Oral Nutritional Supplement on Nutritional Status of Malnourished Elderly Patients

NCT ID: NCT00877578

Last Updated: 2013-10-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-04-30

Study Completion Date

2011-07-31

Brief Summary

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The aim of this study is to evaluate in malnourished elderly patients the nutritional efficacy of a new nutritional supplement enriched in different specific pharmaco nutrients (leucine, micronutrients, omega-3) appearing in the form of a cake of high caloric density and palatability.

The primary endpoint is the outcome of fat-free mass measured by multiple frequence bio-impedance analysis.

Detailed Description

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Ageing of the population and loss of autonomy expose to major consequences in terms of treatment charges and need for hospitalisation. Malnutrition has a key prognostic value, that worsen the prognosis of the primary disease; the length of hospital stay and the incidence of complications are related to nutritional status (Correia 2003, Pichard 2004, Schneider 2004). Several large scale studies at Rouen University Hospital, in 1998 and 2001, have revealed on more than 1000 patients (mid age 71 years) that malnutrition prevalence ranged of 35 to 38%, one third of which is severe (Jusserand 2000, Delaire 2002). Malnutrition increases the risk of complications (Naber 1997, Correia 2003), including muscle mass depletion, decrease of immune function and delayed wound healing. The main consequence of malnutrition is increased infectious morbidity and post operative mortality for the weakest patients. Increased length of hospital stay and rehabilitation duration also results in increased medicals and social burden, in particular in the elderly patients.

Recent studies have shown that usual hospital food intake was insufficient to cover patient's needs (Hébuterne 2001, Dupertuis 2003, Petit 2004) and that systematic nutritional screening was mandatory in hospitalised patients, using validated criteria and scales (e.g. NutriSteps®, MNA®).

The strategy for nutritional support includes as a first step enriched diets and the use of oral supplements, then enteral nutrition or even parenteral nutrition in the most severe cases (HAS guidelines 2007). The efficacy of oral supplementation has been proven (Stratton 2007). Yet, their composition still need to be optimised to better match specific nutritional needs and to ameliorate palatability and favour compliance.

The provision of specifics nutrients with anabolic, anti-oxidants or anti-inflammatory effects can optimise oral nutritional supplements, to achieve a true pharmaco-nutritional therapy. Accordingly, leucine enrichment has inhibitory effects on proteasome-mediated muscular proteolysis in aged rats (Combaret 2005). Trace elements deficiency (zinc, selenium, chromium, iron) is common in the elderly patients and increase the risk of infectious or wound complications (HAS 2007), and the level of trace elements provision in standard supplements may be insufficient to compensate this deficiency. Finally, omega-3 fatty acids enrichment enables to limit the inflammatory response and hypercatabolism (Delarue 2005).

The aim of this study is to evaluate in malnourished elderly patients the nutritional efficacy of a new nutritional supplement enriched in different specific pharmaco nutrients (leucine, micronutrients, omega-3) appearing in the form of a cake of high caloric density and palatability.

Conditions

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Malnutrition

Keywords

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elderly patient malnutrition new nutritional support micronutrients elderly patient malnutrition

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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1

Nutri-Energie ®, a cake of high caloric density and palatability, twice a day for 4 weeks, in addition to an enriched diet.

Group Type EXPERIMENTAL

Nutri-Energie ®, Aliscience society

Intervention Type DIETARY_SUPPLEMENT

Nutri-Energie ® is a new cake of high caloric density and palatability, enriched in different specific pharmaco nutrients.

2

Clinutren 1.5 ® standard isocaloric commercially available supplement, twice a day for 4 weeks, in addition to an enriched diet.

Group Type ACTIVE_COMPARATOR

Clinutren 1.5 ®, Nestlé Clinical Nutrition

Intervention Type DIETARY_SUPPLEMENT

Clinutren 1.5 ®, isocaloric commercially available supplement, twice a day for 4 weeks, in addition to an enriched diet

Interventions

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Nutri-Energie ®, Aliscience society

Nutri-Energie ® is a new cake of high caloric density and palatability, enriched in different specific pharmaco nutrients.

Intervention Type DIETARY_SUPPLEMENT

Clinutren 1.5 ®, Nestlé Clinical Nutrition

Clinutren 1.5 ®, isocaloric commercially available supplement, twice a day for 4 weeks, in addition to an enriched diet

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Both male and female participants
* Moderately malnourished defined by whether:

18 \< BMI \< 21

5 to 10% body weight loss in the last past 6 months.

Buzby index between 83.5 and 97.5 (calculated with weight loss and albumin)

* With or without any factors increasing malnutrition (insufficient caloric intakes, long term treatment)
* Justifying hospitalisation in rehabilitation unit

Exclusion Criteria

* Age \< 70 years old or \> 90 years old
* Surgical affection involving a surgery in the next 10 days
* Contraindicated oral intakes due to digestive injury
* Total parenteral nutrition
* Ulcer or infection existing
* Malignant hemopathy
* Hepatic insufficiency (TP \< 30%)
* Swallowing difficulties limiting solid oral intakes
* Kidney failure (renal dialysis)
* Expected survival \> 3 months
* Impossibility to give an informed consent
Minimum Eligible Age

60 Years

Maximum Eligible Age

95 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Rouen

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Pierre DECHELOTTE, PR

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Rouen

Locations

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Centre Hospitalier de Dieppe

Dieppe, , France

Site Status

UHRouen

Rouen, , France

Site Status

Countries

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France

Other Identifiers

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2007/023/HP

Identifier Type: -

Identifier Source: org_study_id