Effects of Oral Nutritional Supplement with HMB on Biochemical and Haematological Indices in Community-Dwelling Older Adults at Risk of Malnutrition ^†

Abstract

Malnutrition is associated with abnormal biochemical and haematological indices in older adults. There are few studies examining the impact of nutrition intervention on the above indices in community-dwelling older adults at risk of malnutrition. The objective of this study was to investigate the effects of an oral nutritional supplement (ONS) containing beta-hydroxy-beta-methylbutyrate (HMB) on biochemical and haematological indices in community-dwelling older adults at risk of malnutrition. A total of 811 older adults aged 65 years and above took part in the Strengthening Health in ELDerly through nutrition (SHIELD) study. This was a randomised, double-blind, placebo-controlled, multi-centre study across four sites in Singapore. The participants were randomly allocated to one of the two treatments: ONSs containing either HMB or a placebo. Both groups received dietary counselling and consumed the study products twice a day for 180 days. The data were collected at baseline, on day 90, and on day 180. We previously reported that ONSs containing HMB significantly improved nutritional outcomes and muscle health. The current analyses showed that pre-albumin, urea, globulin, corrected calcium, potassium, and vitamin B12 levels were significantly greater in the intervention group compared to the placebo group over 180 days (all p ≤ 0.032). The mean platelet volume, reticulocyte absolute, and reticulocyte percentage were also significantly higher in the intervention group (all p ≤ 0.003). In addition, there were tendencies of significant improvement in the total protein, monocyte absolute, monocyte percentage, and eosinophil percentage (all p ≤ 0.095). These improvements are attributable to the consumption of the ONS containing HMB in the intervention group. In conclusion, daily consumption of ONS containing HMB for six months significantly improved biochemical and haematological indices in community-dwelling older adults at risk of malnutrition. Early intervention after the identification of malnutrition is essential to optimise the nutritional status and markers of haemopoiesis.