The Role of Protein in Malnourished Older Adults

Malnutrition in older adults is often linked with frailty and may develop when a person's nutritional intake does not provide them the right amount of energy (calories), protein and other nutrients. Clinical evidence and guidelines support higher protein intake in this cohort1 .

High Protein 85 percent study

Why is protein important?

When protein intake is insufficient, the body breaks down muscle tissue3 , increasing the risk of frailty. The primary protein reservoir is skeletal muscle4 , unlike carbohydrates and fats which have non-tissue storage forms.

Older adults tend to consume less protein than younger individuals1 . This issue is compounded by age-related metabolic changes5 , and the need to counteract the elevated metabolism from inflammatory diseases1.

Evidence supports higher protein intake in older adults for health, recovery from illness and to maintain function3.

ESPEN guidelines highlight the increased protein requirement for malnourished older adults1

HIGH-PROTEIN-WEBPAGE-ESPEN

85% of older adults do not meet the ESPEN recommended protein intake of 1.2g/kg/day2.

High protein ONSᶱ improve patients' outcomes and quality of life6

High protein intakes are associated with improved clinical and economic outcomes6. High protein ONSᶱ increases nutritional intake without suppressing individuals' appetite or voluntary food intake#.

HIGH-PROTEIN-WEBPAGE-OUTCOMES

In a meta-analysis with mean energy density (1.5kcal/ml), high protein ONS significantly reduce complications7. These included: infections, falls and post-operative complications.

complications-in-community-frailty

Fortisip Extra: optimal nutrition for malnourished older adults

Guidelines support ONS to help meet the nutritional needs of malnourished patients8-10.

Fortisip Extra: Optimal nutrition for malnourished older adults. It is also the best value high protein 200ml liquid ONS available in the community##, described as easy to drink by ≥ 84% of individuals who tasted it###.

fortisip-extra-features

  1. Deutz, et al. Clin Nutr. 2014;33(6);929-36 
  2. Morris, et al. Geriatrics (Basel). 2020;5(1):6 
  3. Bauer, et al. J Am Med Dir Assoc. 2013;14(8):542-59 
  4. Severin, et al. Topics Geriatric Med. 2019;35(1)79-87 
  5. Grootswagers, et al. Proc Nutr Soc. 2021;80(3):339-43 
  6. Cawood, et al. Ageing Res. Rev 2012;11:278-96 
  7. Cawood, et al. Ageing Res Rev, 2023, 88(101953)
  8. NICE Clinical Guideline 32, August 2017. Available at: www.nice.org.uk/guidance/cg32. Accessed on: 8th January 2025. 
  9. Volkert, et al. Clin Nutr. 2022;41(1):958-89 
  10. Stratton, et al. Managing malnutrition to improve lives and save money, October 2018. Available at: www.bapen.org.uk/pdfs/reports/mag/managing-malnutrition.pdf. Accessed on: 8th January 2025.
  11. Roberts, et al. Nutrients. 2019;11(4):808

ᶱ Oral Nutritional Supplements with ≥20% of energy from protein
# Based on meta-analysis compared to control.
## Based on NHS dm+d data taken in December 2024 comparing Fortisip Extra 200ml to Altraplen Protein 200ml and Fresubin Protein Energy 200ml.
### Home Usage study with N=100 patients diagnosed with Disease Related Malnutrition (2023, UK)
* p<0.001
** Control: Standard diet, +/- placebo depending on the study
*** Mean energy density of 1.5 kcal/ml and mean energy from protein 22%
^ Product can be provided to patients upon the request of a Healthcare Professional. They are intended for the purpose of professional evaluation only.

Fortisip Extra is a Food for Special Medical Purposes for the dietary management of disease related malnutrition and must be used under medical supervision.

This information is intended for healthcare professionals only. 

Date of publication: January 2025. 

ONS = Oral Nutritional Supplement

ESPEN = The European Society for Clinical Nutrition and Metabolism

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