A multi-center prospective study of plant-based nutritional support in adult community-based patients at risk of disease-related malnutrition.

Introduction: There is an emerging need for plant-based, vegan options for patients requiring nutritional support. Methods: Twenty-four adults at risk of malnutrition (age: 59 years (SD 18); Sex: 18 female, 6 male; BMI: 19.0 kg/m2 (SD 3.3); multiple diagnoses) requiring plant-based nutritional support participated in a multi-center, prospective study of a (vegan suitable) multi-nutrient, ready-to-drink, oral nutritional supplement (ONS) [1.5 kcal/mL; 300 kcal, 12 g protein/200 mL bottle, mean prescription 275 mL/day (SD 115)] alongside dietary advice for 28 days. Compliance, anthropometry, malnutrition risk, dietary intake, appetite, acceptability, gastrointestinal (GI) tolerance, nutritional goal(s), and safety were assessed. Results: Patients required a plant-based ONS due to personal preference/variety (33%), religious/cultural reasons (28%), veganism/reduce animal-derived consumption (17%), environmental/sustainability reasons (17%), and health reasons (5%). Compliance was 94% (SD 16). High risk of malnutrition ('MUST' score ≥ 2) reduced from 20 to 16 patients (p = 0.046). Body weight (+0.6 kg (SD 1.2), p = 0.02), BMI (+0.2 kg/m2 (SD 0.5), p = 0.03), total mean energy (+387 kcal/day (SD 416), p < 0.0001) and protein intake (+14 g/day (SD 39), p = 0.03), and the number of micronutrients meeting the UK reference nutrient intake (RNI) (7 vs. 14, p = 0.008) significantly increased. Appetite (Simplified Nutritional Appetite Questionnaire (SNAQ) score; p = 0.13) was maintained. Most GI symptoms were stable throughout the study (p > 0.06) with no serious adverse events related. Discussion: This study highlights that plant-based nutrition support using a vegan-suitable plant-based ONS is highly complied with, improving the nutritional outcomes of patients at risk of malnutrition.

Iodine status in Melbourne adults in the early 1990s and 2007-08.

OBJECTIVE: To investigate the iodine status of Melbourne adults in 1992-94 and 2007-08, and to assess dietary iodine intake to enable comparison with recommended Nutrient Reference Values. METHOD: A cross-sectional study utilising 24-hr urine samples collected at two time points in a random sample of the Melbourne Collaborative Cohort Study. Two hundred and fifty seven adults (128 males, 129 females) in 1992-94, with a mean age of 56 years, and 265 adults (132 males, 133 females) in 2007-08, with a mean age of 68 years, were assessed, all being Melbourne residents. Urinary iodine concentration (UIC) was determined and daily urinary iodine excretion and daily iodine intake were assessed. RESULTS: In 1992-94, the median UIC was 27 µg/L and 84% had UIC <50 µg/L. The median daily iodine intake was 51 µg/d, and 83% of participants had dietary iodine intakes below the Estimated Average Requirement of 100 µg/d. In 2007-08, the median UIC was 49 µg/L, 51% had UIC <50 µg/L and the median daily iodine intake was 98 µg/d, with 52% of intakes below the EAR. CONCLUSION: Melbourne adults were moderately iodine deficient in 1992-94, and borderline moderately deficient in 2007-08. IMPLICATIONS: While iodine status appears to have improved, it remains below an adequate level for much of the adult population of Victoria. Adequate monitoring is fundamental to assess whether the mandatory use of iodised salt in bread is effective in reducing iodine deficiency across all population groups.