Malnutrition Awareness Week: Spotlight on Danone’s targeted medical nutrition

International organizations and companies bring malnutrition and optimal nutritional care to the forefront of political discussions during Malnutrition Awareness Week (November 11–15). WHO highlights that disease-related malnutrition affects 30–50% of hospitalized patients in Europe, weakening their ability to fight infection and recover from illness.

The often overlooked condition poses significant risks to vulnerable groups, such as older adults and people with non-communicable diseases like cancer or diabetes.

Nutrition Insight meets Katrien van Laere, Danone’s chief scientific and medical officer, to learn the causes, impacts and nutritional solutions to disease-related malnutrition.

“Disease-related malnutrition is not really on people’s minds. Still, it’s commonplace, and it has a significant impact on the outcomes of the patients and health care costs. To address it and treat this is essential,” says Van Laere.

She points to research from the UK finding “around 50% of hospitalized patients have disease-related malnutrition, and about half of that is being treated.”

Patients with disease-related malnutrition often have less strength, more complications and infections and even higher mortality rates. Usually, these patients require an extended hospital stay. “Medical nutrition can help reduce those complications,” highlights Van Laere. “It’s clear that if you treat disease-related malnutrition, you can get better patient outcomes.”

Disease-related malnutrition causes

WHO Europe explains that disease-related malnutrition can be caused by any acute or chronic disease, affecting hospitalized patients (inpatients), cancer patients, inpatients with cardiovascular or pulmonary disease and elderly patients. It results from inflammation in most diseases and reduced food intake and assimilation commonly associated with disease.

Van Laere explains that patients often have less appetite and that people suffering from a disease may need more energy because their body burns more calories in fighting their illness.

“Typical patient groups where you have disease-related malnutrition are in oncology. In cancer patients, losing weight is a key issue and the first red flag that something is wrong,” she explains. “But also because of therapy, the condition often worsens. 

Tube feeding can support patients who often have less appetite while needing more energy to fight off diseases.“Oncologists need to treat the tumor, so all the therapies focus on the tumor. But what we see more and more is that to treat the tumor, you need to take nutritional care of the patient, making sure they have the strength to be at the next visit for the chemotherapy. And that is where medical nutrition should become a more integrated part of the therapy.”

According to the WHO, effective nutritional care requires medical nutrition treatment, which can be administered orally or artificially through tube feeding.

“If patients take medical nutrition, they have more strength and energy, they feel better and can fight diseases better,” adds Van Laere. “If you address disease-related malnutrition in frail, elderly people, these patients also achieve a better quality of life.”

Economic impacts

Van Laere points to a study on the economic impact of untreated malnutrition in the Netherlands. The research by health economist Dr. Mark Nuijten reveals that treating malnutrition with oral nutritional supplements contributes substantially to cost savings within the Dutch healthcare system. 

“In the Netherlands, the direct cost of disease-related malnutrition is around €3 billion (US$3.2 billion), which is around 3.4% of the healthcare costs,” highlights Van Laere. When considering indirect costs, such as lost productivity, the country’s untreated malnutrition costs amount to €5.4 billion (US$5.7 billion).

“Just by using medical nutrition, the net cost benefit is around €749 million (US$795 million).”

The study further highlights that treating malnutrition is very cost-effective at an estimated €15,552 (US$16,514) per gained healthy life year (QALY) compared to no treatment, as the Netherlands is willing to spend €20,000 (US$21,237) to €80,000 (US$84,943) per QALY.

“Medical nutrition is proven to have an effect leading to fewer complications,” underscores Van Laere. “But people need to know that, especially with the pressure on healthcare costs. Sometimes people think it adds costs, but it reduces costs because one day in the hospital costs much more than a bottle of medical nutrition.”

The reformulated Nutrison tube feeding range improves patients’ health and has a lower CO2 footprint (Image credit: Danone).Nutrison reformulation

Recently, Danone reformulated its Nutricia tube feeding range, Nutrison, designed to address disease-related malnutrition. The medical nutrition product complies with the latest ESPEN (European Society for Clinical Nutrition and Metabolism) guidelines — evidence-based recommendations on hospital nutrition.

The executive says the product now contains 78% vegetable protein, resulting in an average 17% reduction in its CO2 footprint and increased patient benefits. Danone has determined this reduction by comparing the new and old formulations in Germany. All products are certified for a CO2 reduction between 14% and 22%. 

“Tube feed patients are often lying down, which means that it is crucial that the tube feed is well tolerated and that it passes easily through the stomach,” she explains. “It’s essential that we give the right nutritional quality, which is why we developed this mixture of four different proteins.”

“In our in vitro models, when we compare a casein-based formula with a hybrid, a mixture of casein and plant-based proteins, there is no coagulation or ‘cheese-making’ process, which does occur with pure casein-based formulas. This means that the hybrid is very well tolerated.”

In addition to plant-based proteins, Nutrison also contains dairy [proteins] to ensure the amino acid profile is aligned with patient needs.

“Because it addresses health and sustainability, and we have shown in clinical studies that it’s well tolerated, we aim to bring it to as many patients as possible,” believes Van Laere. She notes that Danone aims to roll it out globally.