A group of experts published a review paper emphasizing how healthcare professionals could take the learnings of the Covid 19 pandemic and apply it more broadly by using an assertive, multi-modal nutrition support approach. The publication emphasizes the need for continued medical nutrition therapy through different settings and particularly at hospital discharge, where break points in care are often found.
The publication ‘Recovery Focused Nutritional Therapy across the Continuum of Care: Learning from COVID-19’ has now been published. This review paper is of relevance to doctors and other HCPs in acute care and primary care worldwide since it addresses early, multi-modal individualized nutrition intervention across the continuum of care to improve patient outcomes in COVID-19 with learnings to extend to the care of vulnerable, hospitalized patient groups.
The paper looks at the value of nutritional intervention along the entire continuum of care. Inadequate nutrition can have an impact on body weight, muscle mass and physical performance across the patient journey. Table shows symptoms, metabolic, nutritional status and nutritional intake factors contributing to malnutrition and impaired/delayed recovery across the continuum of care. It is well characterized that many patients that have extended ICU stays never return to their original level of ability, with it often taking years to fully recover.
This feeding decision tree provides a concrete, credible, and guideline supported visual to enable HCPs to ensure patient’s nutritional needs are being actively addressed.
At Nutricia we value the ability to provide nutritional solutions for patients at every step towards their recovery. Alongside the feeding decision tree, we have placed key products to support healthcare professionals select products based on the patient’s clinical need.
Multiple nutritional challenges highlight the need for early individualized nutrition intervention.1
Learn more on enabling individualized nutritional care during hospitalization, including in the ICU on page 5 and 6 of the publication1.
“Need for early, assertive nutrition intervention in critically ill and non-critically ill hospitalised patients to mitigate (..) malnutrition, loss of lean body mass and function that in turn impair and delay recovery”
“Practical guidelines for the nutritional management of acutely unwell inpatients with COVID-19 recommend enteral nutrition (EN) in patients unable to meet their nutritional requirements orally with food-based strategies and oral nutritional supplements (ONS)”
COVID-19 patients show progressive hypermetabolism and considerable variation in REE throughout ICU stay
“Nutrient deficits accumulate during hospital stay”
Learn more on enabling individualized nutritional care during hospitalization, at the ward as well as ICU on page 5 and 6 of the publication.
“Need for early, assertive nutrition intervention in critically ill and non-critically ill hospitalised patients to mitigate (..) malnutrition, loss of lean body mass and function that in turn impair and delay recovery”
“Practical guidelines for the nutritional management of acutely unwell inpatients with COVID-19 recommend enteral nutrition (EN) in patients unable to meet their nutritional requirements orally with food-based strategies and oral nutritional supplements (ONS)”
“Patients with oropharyngeal dysphagia must be prospectively identified. Compensatory treatments, including a texture-modified diet, fluid thickening and specific rehabilitation procedures, should be provided, with EN continued until oral intake is sufficient to meet the energy and protein needs”
“Ongoing nutritional needs frequently not addressed at discharge”
Key challenges in nutritional care at hospital discharge include:
“Low physical functioning, reduced functional capacity and impaired performance of activities of daily life after hospitalization for COVID-19, is suggestive of low muscle strength”
“Knowledge from a range of disease states and chronic conditions illustrate that low muscle mass is associated with higher rates of infections, poorer tolerance to chemotherapy, hospitalisation, fractures, reduced quality of life, and reduced survival with implications for patient outcomes and healthcare utilisation”
“Recommended treatment to target muscle mass and function requires a multi-modal approach with a focus on optimal protein intake, vitamin D supplementation and resistance training”
“A recent study showed benefits of a muscle-targeted ONS (20g whey protein, 2.8g leucine, 800 IU Vitamin D, 500mg calcium) compared to iso-caloric placebo in sarcopenic patients during a rehabilitation program.”
The muscle-targeted ONS led to a reduction in rehab duration (-27%), shorter length of stay (-10 days), more patients discharged home (+24%)2
World Sarcopenia Day is the perfect opportunity to increase awareness and knowledge for the prevalent disease, sarcopenia. Sarcopenia is a muscle disease that can drastically impede upon individuals physical function, independence, and overall quality of life. It is therefore vital that attention is given to appropriately diagnosing and managing this disease in order to maintain and promote overall well-being. Join us in celebration of this important day!
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