Oral nutrition improves protein, calcium, vitamin B12 levels among Singapore elderly – Abbott study
Findings of the clinical trial, known as the SHIELD study, were published on Nutrients.
The oral nutrition supplement used in the trial is marketed as Ensure Life HMB. Each serving contains 10.5g protein, 8.5g fats, 34.2g carbohydrates, 7.75mcg vitamin D3, and 0.74g calcium HMB.
A total of 811 seniors took part in this 180-day trial where they were randomised to take two servings of Ensure Life HMB daily or the placebo.
Latest findings from the study showed that there were significant improvements in biochemical and haematological or blood-related indices.
In terms of biochemical indices, there were significant improvements in indicators related to protein intake and protein levels seen in the intervention group.
For instance, prealbumin, urea, and urea-to-creatinine ratio were significantly higher in the intervention group as compared to the placebo group at day 90 and 180 of the trial.
Urea is produced in the liver from breakdown of protein and amino acid, and it is often used as an indicator of protein intake.
Throughout the study, urea levels were 6.0 ± 0.1 mmol/L in the intervention group, significantly higher than the 5.4 ± 0.1 mmol/L reported in the placebo group.
Urea to creatinine ratio, on the other hand, is said to be a useful estimate of dietary protein intake, and higher urea and urea to creatinine ratio have been associated with higher protein intake.
In this study, urea-to-creatinine ratio was 4.39 ± 0.01 in the intervention group, significantly higher than the 4.26 ± 0.02 seen in the placebo group.
However, total protein levels were only significantly higher in the intervention group at day 90 of the study – at 71.7 ± 0.2 g/L in the intervention group and 71.1 ± 0.2 g/L in the placebo group.
Overall, total protein levels were higher in the intervention group at 71.7 ± 0.2 g/L versus 71.3 ± 0.2 g/L seen in the placebo group. However, the differences were not statistically significant.
Aside from protein, the study also reported improvements in corrected calcium and vitamin B12 levels.
Throughout the study, corrected calcium levels were 2.24 ± 0.004 mmol/L in the intervention group, significantly higher than 2.23 ± 0.005 in the placebo group.
Vitamin B12 was similarly significantly higher at 480.0 ± 8.9 pmol/L in the intervention group and 420.1 ± 9.0 pmol/L in the placebo group.
The improvements in vitamin B12 could be because the dosage given was equivalent to 76 per cent of the Recommended Dietary Allowance.
“The present study showed a significant increase in vitamin B12 levels at day 90 and day 180.
“This increase was likely due to the fact that two servings of the specialised ONS (oral nutrition supplement) provide 1.82 µg of vitamin B12, which is 76 per cent of the Recommended Dietary Allowance for vitamin B12 in adults aged 51 and above,” said the researchers, adding that vitamin B12 was essential for proper functioning of nerve cells.
Improvements in haematological indices
The researchers also reported improvements in blood-related indices, such as a significantly higher absolute reticulocyte count and mean platelet volume.
At day 180 of the trial, absolute reticulocyte count was 62.6 ± 0.9 103/µL in the intervention group, significantly higher than 59.1 ± 0.9 103/µL reported in the placebo group.
Reticulocytes are immature red blood cells made in bone marrow and continue to mature in the spleen or bloodstream to form red blood cells.
In normal conditions, most red cells exist as mature red blood cells, with only a very small proportion of reticulocytes.
“Absolute reticulocyte count and reticulocyte percentage are rarely measured in clinical studies of ONS use.
“In the present study, the significantly higher absolute reticulocyte count and reticulocyte percentage could be indicative of heightened erythropoiesis (referring to red blood cell production), as a result of better nutrition with ONS intervention,” said the researchers.
The researchers said that the findings complemented their earlier reports of improved nutritional and functional outcomes in elderly taking the supplement.
However, the improvements are attributed to the entire supplement product as opposed to any single nutrient.
“The results of our present analysis of SHIELD study data show that daily consumption of specialised ONS for six months led to significant improvements in biochemical and haematological indices.
“Due to the nature of the study design, the improvements are attributed to the intervention product as a whole rather than to any single ingredient or nutrient.
“Such findings complement our earlier findings of improvements in nutritional and functional outcomes, as evidenced by better nutritional intake and status and beneficial increases in body weight, mid upper-arm circumference, serum 25-hydroxyvitamin D levels, and handgrip and leg strength,” they said.
Source: Nutrients
Effects of Oral Nutritional Supplement with β-Hydroxy-β-methylbutyrate (HMB) on Biochemical and Hematological Indices in Community-Dwelling Older Adults at Risk of Malnutrition: Findings from the SHIELD Study.
https://doi.org/10.3390/nu16152495
Authors: Tey, S.L et al.
