2. Medical nutrition

2.1 ABOUT MEDICAL NUTRITION

Summary

Good nutrition is an essential part of care, and it includes ensuring that the right people receive the right nutritional support at the right time during their care, regardless of whether that care is delivered in hospital, in an institution or in the person’s own home. Good nutritional care also includes ensuring that people who are malnourished or at risk of malnutrition are identified through screening programmes, and that action is taken to ensure that they receive appropriate and timely nutritional support. Nutritional support may take many forms, e.g. dietary counselling, food fortification, oral nutritional supplements (ONS), enteral tube feeding (ETF) and parenteral nutrition (PN).

Medical nutrition products are specific nutritional compositions for disease intervention that effectively contribute to the therapeutic regimen by improving a patient’s general condition. In circumstances where patients are unable to consume enough food to meet their nutritional needs to sustain life or optimize health, medical nutrition (ONS, ETF and/or PN) is used.

Medical nutrition helps to sustain life by providing either all or some of the patient’s energy, protein, vitamin, mineral, trace element and fluid requirements depending on whether the patient is able or willing to consume some food. The aim may be to improve, maintain or minimise deterioration in nutritional status depending on the underlying health issue and prognosis. Medical nutrition may be required from birth or at any stage during infancy, childhood, adulthood or in old age. It may be required for a short period of time to support a patient through recovery from injury or through a course of medical or surgical treatment. In the case of chronic disease it may be needed for a prolonged period of time, for example weeks, months or years.

Medical nutrition products (ETF and ONS) are manufactured by specialist medical food companies. PN products are classed as prescription only medicines (POM) and are therefore only produced by companies with a pharmaceutical licence.

As progress in nutrition and medical research has advanced to meet the complex needs of patients, the manufacturers of medical nutrition products have responded to these needs by developing an increasingly diverse range of products specifically designed to meet the needs of different age groups and different medical conditions.

In subsequent sections of this document the evidence base for ONS, ETF and PN will be outlined to demonstrate the nutritional, functional, clinical and economic benefits of medical nutrition. As the needs of patients and healthcare providers have evolved over time, so too has the science behind medical nutrition. Research continues to drive innovation to achieve the optimal outcome for patients by identifying potential improvements in the formulation, timing, duration and route of nutrition support.

Conclusion

Medical nutrition products are specific nutritional compositions for disease intervention that effectively contribute to the therapeutic regimen by improving a patient’s general condition. They are an essential part of the clinicians toolkit in delivering high quality, and in many cases, life-saving nutritional care.

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