Table 7.
Characteristics of the nutritional intervention and composition of the nutritional supplementation used in the included studies.
| Author Year Origin |
Type of Supplement Administration Method |
kcal | Nutritional Composition | Treatment Duration Adherence Rate (%) |
Control Group |
|---|---|---|---|---|---|
| Schürch [50] 1998 Switzerland |
Oral liquid supplement; single oral dose of vit D3 200.000 UI Ca: 550 mg/day |
250 kcal/day | 20 g protein, 3.1 g lipid, 35.7 g carbohydrates, 90% milk proteins |
5 days a week for 6 months AR: IG 73% CG 80% |
Placebo: 54.5 g carbohydrates Single oral dose of vitamin D 200.000 UI Calcium: 550 mg/day |
| Espaulella [36] 2000 Spain |
Oral liquid supplement 200 mL |
149 kcal | 20 g protein, 800 mg calcium, 25 IU vitamin D3 | 60 days AR: IG 94.1% CG 94.2% |
Placebo 200 mL, 155 kcal; mainly carbohydrates |
| Bruce [51] 2003 Australia |
Oral liquid supplement (235 mL/day) | 352 kcal | 17.6 g protein, 11.8 g fat, 44.2 g carbohydrate, vitamins and minerals | 28 days after surgery | Hospital diet only |
| Houwing [56] 2003 The Netherlands |
Oral liquid supplement (400 mL/day) | 500 kcal | 40 g protein | Immediately postoperatively during 4 weeks or until discharge AR: 75% of patients consumed >75% of daily dose |
Non-caloric placebo supplement |
| Sullivan [48] 2004 USA |
Standard care + post-operative nightly via enteral feeding tube: 1375 mL (125 mL/h) over 11 h |
1031 kcal | 85.8 g protein | When volitional intake exceeded 90% of estimated requirements for 3 consecutive days or was discharged: mean 15.8 ± 16.4 days AR: 83.3% |
Standard care |
| Tidermark [53] 2004 Sweden |
PR: protein-rich liquid supplement (200 mL/day) PR-N: PR + nandrolone decanoate injections (every third week) 1 g of calcium + 400 IE vitamin D3 |
200 kcal/day nandrolone: 25 mg intramuscular injection |
20 g protein | 6 months | Standard treatment 1 g of calcium + 400 IE vitamin D3 |
| Eneroth [16] 2005 Sweden |
Hospital diet + intravenous nutrition (1 l/day) followed by 400 mL/day oral supplement |
Oral supplement 400 kcal/day | IV: amino acids, fat, carbohydrate, and electrolytes | 3 days → IV 7 days → oral |
Hospital diet only |
| Duncan [49] 2006 UK |
NA | Mean supplement: 409 kcal/day | NA | NA | Mean standard supplement: 123 kcal/day |
| Hommel [39] 2007 Sweden |
Oral nutritional supplement twice a day | 125 kcal/100 mL enriched with arginine, zinc, vitamins A, B, C, and E, selenium, and carotenoids | NA | From post-surgery to discharge | NA |
| Botella-Carretero [24] 2010 Spain |
Oral nutritional supplement intake (2 × 200 mL/day) | 400 kcal/day | 40 g protein/day | From admission until discharge AR 52.2 ± 12.1% |
Control group: no supplement |
| Fabian [23] 2011 Austria |
Oral liquid supplement | Supplements were administered when intake of energy < 20 kcal and/or protein < 1 g/kg body weight/day | 40% protein, 41% carbohydrate, 19% fat, vitamins and minerals | From post-surgery to discharge | Standard medical treatment |
| Hoekstra [25] 2011 The Netherlands |
Nurse and doctor encouraged and motivated patients to eat and drink; if MNA < 24, dietician consulted with the patient | NA | NA | NA | Standard nutritional care |
| Wyers [29] 2013 The Netherlands |
Oral liquid nutritional supplement (500 mL/day) Dietetic counseling |
500 kcal | 40 g protein | Started during hospital admission and continued until 3 months after surgery | Usual care ONS on demand: 13% received ONS and 23% received dietetic counseling |
| Myint [52] 2013 Hong Kong |
Oral liquid nutritional supplement (240 mL twice daily) 1.2 g of calcium + 800–1000 IU vitamin D |
500 kcal | 18–24 g protein | Started within 3 days after admission until discharge or 28 days AR = 77.7% |
NA 1.2 g of calcium + 800–1000 IU vitamin D |
| Anbar [17] 2014 Israel |
Standard ONS (237 mL) or diabetic ONS (237 mL) Patients received the difference between intake and measured energy expenditure |
355 kcal 237 kcal |
13.5 g protein 9.9 g protein |
Started 24 h after surgery AR = 100% |
Usual hospital diet = 1800 kcal, 80 g protein |
| Ekinci [55] 2016Turkey |
Oral liquid nutritional supplement (220 mL twice daily) | NA | 36 g protein 3 g CaHMB 1000 IU vitamin D |
30 days | Usual hospital diet: 1900 kcal, 76 g protein, 63 g fat |
| Malafarina [54] 2017 Spain |
Oral liquid nutritional supplement (220 mL twice daily) | 660 kcal | 60 g protein 4.6 g CaHMB 1500 IU vitamin D |
During hospital admission, until discharge Mean treatment duration: 42.3 ± 20.9 days AR = all of the subjects took more than 80% |
Usual hospital diet: 1500 kcal, 87 g protein, 59 g fat |