ESPEN 2021: The Impact of Nutrition on Patient Care
04 Oct 2021
Each year, the European Society for Clinical Nutrition and Metabolism (ESPEN) runs a congress, which allows healthcare practitioners, researchers, industry organisations and other key opinion leaders to gather, share learnings and discuss how to further knowledge in the medical nutrition space.
Despite COVID-19 restrictions requiring this year’s ESPEN conference to remain as a virtual event, this year’s theme “Nutrition Matters” was brought to life by a diverse and interesting programme.
The present global nutrition community was treated to educational and scientific sessions, in-depth case studies, poster presentations, the latest scientific findings, presentations of the latest guidelines including Q&As with the guideline experts as well as sessions showing examples of collaborative efforts that will increase public and political support for nutrition in patient care.
Why does NZMP care about clinical research and patient care?
NZMP is a key supplier to both global and local medical nutrition companies. We collaborate closely with customers to develop novel solutions for medical foods.
This means we believe it is important to be involved in the latest developments in clinical nutrition and patient care. Growing this body of knowledge leads to improved outcomes for patients, and in turn, the development of specialised nutrition solutions to address unmet needs.
These nutrition solutions increasingly require sophisticated technical knowledge to combine the right ingredients, and application expertise to deliver solutions for the future. This is a combination of strengths that NZMP can provide.
NZMP dairy ingredients for patient nutrition
NZMP has attended or sponsored the ESPEN congress for a few years now, so was pleased to again participate in the ESPEN 2021 conference, including exhibiting at a virtual booth that attendees were invited to.
The role of dairy ingredients in patients’ nutrition and new application information was shared. Two unique solutions were presented in more detail:
- Unique heat stable NZMP whey protein concentrate for use in UHT treated beverages (like Oral Nutrition Supplements) allows the use of high-quality whey without the need to hydrolyse while providing whey protein’s special digestive benefits.
- Modular protein solutions which allow for easy increase of protein intake without impacting the dietary habits of patients.
These modular protein solutions can be simply added to foods already eaten, rather than requiring drastic changes to the diet.
Summarised below are key takeaways from this year's ESPEN Congress
1. The role of nutrition in COVID-19
COVID-19 is still affecting daily live, but even more so hospital logistics. There was a lot of new data presented on the COVID-19 patient population. Initially the focus had been on ICU care as well as the impact of nutritional status on the acute phase of the infection.
Currently data is starting to become available on the long-COVID patients. More research results are expected on this topic in the coming year, which will provide insights for treatment of the chronic expression of the viral infection.
The tremendous amount of insights in ICU Covid-patients is also of relevance for nutrition in wider ICU care. It was seen in many studies that the standard calculation methods often don’t line up with the energy requirements found with indirect calorimetry and that inter- and intra-person intake and tolerability can vary widely.
This also allows us to consider how future nutritional solutions for this setting could be personalised, e.g. through adapted macro-compositions of tube feed, or applications for modular protein in tube flushes or fortified foods in the diet.
Definition: Indirect Calorimetry
- A traditional way of calculating energy needs by assessing the heat that a person produces, compared to the oxygen consumed and the carbon dioxide released by the body.
2. Inclusion of nutrition in multimodal treatment
The positive impact nutrition can make in patient outcomes is becoming clearer everyday. As a result, there is increasing attention on the inclusion of nutrition care in the multi-modal treatment models.
Multi-modal treatment looks beyond just pharmaceutical and medical care, to combine these approaches with nutrition optimisation, exercise and psychological care. The incremental value of combining disciplines is evident and makes it accessible for broader support.
The joint policy seminar by ESPEN, Optimal Nutritional Care for All (ONCA) and Medical Nutrition International Industry (MNI) on optimal nutrition care in cancer, included presentations by various dedicated research, patients and policy groups which showed the effect of combining efforts by all parties involved.
Thanks to such collaborations, the ‘Europe’s Beating Cancer’ plan recognizes the role of nutrition not only in cancer prevention, but also in driving better patient outcomes and improved quality of life in treatment.
Regardless of policy impact continuous research is still needed and for this purpose MNI has provided a grant to AuSPEN for a project under the lead of Professor. Nicole Kiss at Deakin University to develop a predictive model for malnutrition-related adverse outcomes in oncology.
3. Impact of nutrition during patient transitions
Transition of the patient from hospital to home, and the associated issues in continuation of nutrition care are a fairly new topic of interest but are highly relevant knowing that good nutrition management is a significant aspect in recovery.
Fonterra is involved in consortium research to improve the nutritional follow-up from patients after hospital release. The goal is to ensure that people are well supported to continue to focus on good energy and protein intake when finishing their recovery at home. In the hospital setting a similar challenge exists when people are transferred from the ICU to the ward and a new team is assigned to the patients’ care.
An example given during the sessions was the often-seen focus in the ward to remove the gastric tube and returning patients to a normal diet as quickly as possible. This may however not always be in the interest of the patient, who may still suffer from lack of appetite or difficulty in swallowing.
In such cases nutritional risks can arise if patients are not well supported in the process of returning to oral food intake. More research is needed to optimise nutritional strategies for this transition phase.
4. Probiotics in medical nutrition
The microbiome and the way it can affect the body, from simple digestive comfort to influencing the gut-brain interaction, is a very complex topic, but also an interesting one for nutritionists.
The diet can impact the composition of the gut microbiome, specific probiotic species can change the composition in a more direct way and faecal transplants are even more impactful and could provide a more direct effect in chronic conditions. We intend to closely follow how this area develops to understand which patient groups could benefit from any of these strategies.
There are already some promising findings emerging, on the relationship of microbiome specificities in certain conditions and some promising results on supplementation of probiotic strains, e.g. in diabetes.
The results however are very often varied and possibly impacted by other factors. An element of personalisation is likely to be accounted for, but the opportunity is worthwhile to further explore when the goal is to develop nutritional solutions for specific conditions.
Jacqueline van Schaik
Global Lead Nutritionist - Active Living Team
Jacqueline has a MSc in Human Nutrition, Marketing and Consumer Science. She is the Nutritionist for the Active Living Functional Nutrition Unit focused on the Medical Nutrition category.