Range of Prescribed Nutritional Supplements
Table 1 shows the range of nutritional supplements available.
UHT milk-based supplements: Suitable as a sole source of nutrition. These supplements are recommended for patients who are able to take only a limited range of foods.
Fruit juice-based supplements: Not intended as a sole source of nutrition. Recommended for patients taking food, although can also be used in late palliative setting for patients unable to manage diet / UHT milk-based supplements. Useful for patients who do not like milk-based drinks. Not all are milk protein free. Refer to manufacturer details or seek advice from a dietitian.
Fresh milk-based supplements: In this range, only Complan® Shake is suitable as a sole source of nutrition for patients who are only able to take a limited range of foods. The other fresh milk-based supplements are not intended as a sole source of nutrition and are recommended in patients taking food, although they can also be used in a late palliative setting for patients unable to manage diet / UHT milk-based supplements. Patients may prefer fresh milk-based supplements.
Nutritional supplement starter packs: Useful particularly for finding out the patient’s taste preferences. Contain an assortment of UHT milk-based and fruit juice-based supplements. The packs include information on recipes and serving suggestions.
EPA-enriched UHT milk-based supplements: These products are indicated for use by patients with pancreatic cancer. They should be used only under close medical supervision. They can be used as a sole source of nutrition or as a supplement to the patient’s diet. Research has been done to assess the effectiveness of the omega-3 fatty acid eicosapentaneoic acid (EPA) and to see if it slows down the metabolic processes that lead to cachexia. Results to date have been mixed. If the decision is to trial these products it should be under the close supervision of a dietitian who is able to assess the appropriateness of the supplement, instruct on its use, and monitor and review the patient’s nutritional status.
Other protein and energy nutritional supplements
These products should be prescribed only under the guidance of a dietitian, and include:
•fat supplements: Calogen® (SHS Ltd), Liquigen® (SHS Ltd)
•carbohydrate supplements: Super Soluble Maxijul® (SHS Ltd), Liquid Maxijul® (SHS Ltd), Polycal Powder® (Nutricia), Polycal Liquid® (Nutricia), Vitajoule® (Vitaflo)
•protein supplements: Promod® (Abbott), Protifar® (Nutricia), Vitapro® (Vitaflo)
•powdered soups: Vitasavoury® 200 and Vitasavoury® 300 (Vitaflo) high energy savoury supplement.
The dietitian will advise the patient on how to take these supplements mixed in certain
foods and / or added to certain drinks.
Date of Preparation: September 2007 Macmillan Durham Cachexia Pack