Oral nutritional supplements (ONS) are medically designed, nutrient-dense formulas that provide extra energy, protein, vitamins, and minerals for individuals who cannot meet their nutritional needs through food alone. They are commonly prescribed for patients recovering from illness or surgery, those with chronic diseases, or individuals with a poor appetite or difficulty eating. To use them effectively, it is crucial to understand the proper techniques for consumption, storage, and flavor management, as advised by a healthcare professional.
The Role of Professional Guidance
Before beginning any ONS regimen, consulting with a doctor or dietitian is the most important step. A healthcare professional can accurately assess your nutritional needs, determine if ONS is appropriate, and recommend the specific type and quantity for your condition. They will also monitor your progress, checking your weight and appetite, to ensure you are receiving the maximum benefit from the supplements. Relying on professional advice ensures that the supplements are tailored to your specific health requirements and are used for the correct duration.
Types of Oral Nutritional Supplements
ONS come in a variety of forms, flavors, and nutritional compositions to suit different patient needs and preferences. Understanding the distinctions can help with adherence and tolerance.
Common Formats:
- Liquid: Ready-to-drink shakes are the most common format, available in milk-based or juice-based varieties. They are convenient and require no preparation.
- Powder: These supplements are mixed with water or milk and can be added to fortified drinks or foods, offering more flexibility.
- Semi-Solid: Puddings, custards, and soups are options for those who find liquid drinks difficult to tolerate or who have swallowing difficulties (dysphagia).
- Pre-thickened: Specially formulated supplements with a thickened consistency are available for individuals with dysphagia, but should only be used under the guidance of a Speech and Language Therapist.
Nutritional Variations:
- Standard: Provides balanced calories, protein, and micronutrients for general malnutrition.
- High-Protein: Contains an increased protein content to support wound healing and muscle preservation, often used for post-operative patients or the elderly.
- High-Energy (Small Volume): Concentrated supplements that deliver a high number of calories in a smaller volume, ideal for patients with poor appetite or fluid restriction.
- Fiber-Containing: Includes added fiber, which can help manage constipation.
How to Take Your Supplements
Consistency and proper timing are key to making ONS effective. Here are some guidelines for optimal use:
- Timing: For most people, taking ONS between meals is recommended. This prevents the supplement from filling you up and reducing your appetite for normal food at mealtimes. Your dietitian will provide specific instructions based on your treatment goals.
- Dosage: Always follow the exact dosage and frequency prescribed by your healthcare provider. Prescribing less than the clinically effective dose may not yield the desired nutritional benefits.
- Preparation: If using a powder, always follow the mixing instructions carefully. Use the provided scoop to ensure the correct concentration.
- Palatability: The taste of supplements can be a barrier for some. To make them more enjoyable:
- Serve them at your preferred temperature—chilled or slightly warmed.
- Add ingredients like fruit to make a milkshake or smoothie.
- Mix powders into foods like oatmeal, yogurt, or custard.
- Freeze liquid supplements into ice pops for a refreshing treat.
Storage and Safety Guidelines
Proper storage and handling of ONS are essential for maintaining their quality and safety.
- Unopened: Store unopened oral nutritional supplements in a cool, dry place, away from direct sunlight. Always check the best-before date before opening.
- Opened: Once a liquid supplement is opened, cover it and store it in the refrigerator. Any unused portion must be thrown away within 24 hours.
- Temperature: Never boil or microwave ONS, as this can degrade or destroy some of the nutrients.
- Labeling: ONS should be treated like a medication. Ensure they are clearly labeled with the patient's name, especially in shared living spaces.
- Expiration: Adhere to the expiration or best-before date on the packaging. Do not use expired products.
Potential Side Effects and When to See a Doctor
While generally well-tolerated, some individuals may experience mild side effects, particularly when first starting ONS.
- Common Side Effects: Nausea, bloating, and changes in bowel habits (e.g., diarrhea or constipation) are possible. These often diminish as your body adjusts. If they persist, discuss them with your dietitian.
- Reporting Adverse Events: In case of a serious or life-threatening adverse event, such as a severe allergic reaction, stop taking the supplement and seek immediate medical attention. You should also report the event to the appropriate health authorities.
- Consulting Your Doctor: If side effects are severe or persistent, if you notice no improvement in your nutritional status after several weeks, or if you have concerns about the suitability of your ONS, contact your healthcare provider or dietitian.
Comparison of Different Supplement Types
| Feature | Standard Liquid ONS | High-Protein ONS | Powder-Based ONS |
|---|---|---|---|
| Convenience | High (ready-to-drink) | High (ready-to-drink) | Medium (requires mixing) |
| Nutrient Profile | Balanced energy, protein, vitamins, minerals | Higher protein content, often with specific micronutrients for healing | Flexible, allows for fortification of different foods and drinks |
| Target Audience | General malnutrition, poor appetite | Post-op recovery, wound healing, elderly | Patients needing flexible energy/protein boosts in various foods |
| Preparation | None | None | Needs to be correctly mixed with water or milk |
| Storage | Unopened: cool, dry place. Opened: refrigerated, discard after 24 hrs | Unopened: cool, dry place. Opened: refrigerated, discard after 24 hrs | Unopened: cool, dry place. Opened: reseal bag or container tightly |
Conclusion
Oral nutritional supplements are a powerful tool for combating malnutrition and supporting recovery, but their effectiveness depends on proper use. By working closely with a healthcare team, including a doctor and a dietitian, you can ensure the right type of supplement is chosen, the correct dosage is administered, and it is taken appropriately to avoid spoiling your appetite for regular meals. Following proper storage and safety procedures is also critical for your health. Remember, ONS are designed to supplement your diet, not replace it. Regular monitoring by a healthcare professional ensures you achieve your nutritional goals and use the supplements only for as long as they are needed. For additional information on nutritional guidelines, you can consult reliable sources such as the British Association for Parenteral and Enteral Nutrition (BAPEN) ONS information from BAPEN.
