Recommending ultra-processed oral nutrition supplements for unintentional weight loss: Are there risks?
Daniela Rivero-MendozaCecelia L CaldwellHannah CooperJessica GoldbergMeagan LamotheSarah LoganElena B SmithElena TornaJamie A ZeldmanWendy J DahlPublished in: Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition (2022)
Oral nutrition supplements (ONS) are widely recommended for the management of unintentional weight loss in patient populations, long-term care residents, and community-dwelling older adults. Most marketed ONS are ultra-processed, with precision nutrition and aseptic composition, as well as convenience and availability, driving their selection. However, therapeutic effectiveness is mixed and the potential health risks of consuming ultra-processed ONS long-term in lieu of less-processed foods have received little attention. A diverse and balanced microbiota supporting immunity and wellness is maintained by a diet rich in plant-sourced foods. The implications of ultra-processed ONS displacing plant-sourced foods, and specifically the potential for undesirable impacts on the gut microbiota, require consideration. Most ONS are either devoid of fiber or are supplemented with isolated or purified fibers that may contribute to adverse gastrointestinal symptoms and appetite suppression. In contrast, the diversity of microbial-available, nondigestible carbohydrates, together with the array of phytochemicals found in plant-sourced foods, support microbial diversity and its resiliency. This review outlines the clinical dilemma of recommending commercial ultra-processed ONS vs nutritionally adequate (eg, high-energy/high-protein) foods and beverages that contribute to diet quality, maintenance of a diverse and stable gut microbiota composition, and support nutrition status and health. Ultra-processed ONS may fall short of expected health benefits, and overreliance may potentially contribute to the risk for patient and older adult populations because of the displacement of a variety of healthful foods.
Keyphrases
- weight loss
- physical activity
- high resolution
- bariatric surgery
- healthcare
- public health
- human health
- long term care
- roux en y gastric bypass
- randomized controlled trial
- case report
- gastric bypass
- systematic review
- magnetic resonance
- working memory
- health information
- emergency department
- mass spectrometry
- body mass index
- social media
- small molecule
- glycemic control
- type diabetes
- insulin resistance
- sleep quality
- young adults
- community dwelling
- computed tomography
- middle aged
- amino acid