Nutritional products can be a vital source of calories for patients who are getting insufficient amounts through their regular diets. Unintentional weight loss can occur in patients who are ill, especially those undergoing chemotherapy; patients who have difficulty swallowing; pregnant women experiencing nausea; and elderly patients who have appetite loss. ?There are times when patients need to supplement their intakes with nutritional products if they can?t eat adequate amounts of food,? said Wendy Albovias, clinical dietitian with St. Francis Memorial Hospital in San Francisco, CA.
Sharlea Leatherwood, PD, owner of North Oak Pharmacy in Kansas City, Mo, said that she often recommends nutritional beverages or bars to patients who need to boost their nutritional intakes. ?Patients aren?t generally diagnosing and treating themselves with an OTC product in this category,? she said. ?Most times, patients have received a referral from their physician,? she added.
Dr. Leatherwood also recommends nutritionals to patients on chemotherapy who are experiencing unintentional weight loss or elderly patients who are living alone and not eating properly. Occasionally, she will make a recommendation for an underweight teen who wishes to ?bulk up? for athletics.
Dr. Leatherwood said that, although the available brands are similar, pharmacists should recommend a product that best suits the patient?s needs. ?There are specific brands that are designed for patients with diabetes,? said Dr. Leatherwood, ?and for people who can?t handle a lot of protein.? Ensure, for example, markets special formulations for patients with specific conditions. High-calcium, high-protein, and high-fiber versions are all available.
Many products are lactose-free and gluten- free, so they are easy to digest. Some products do contain milk, however, so pharmacists should help patients with milk allergies select a product that is appropriate for them.
Products are formulated to deliver protein as well as essential vitamins and minerals in a single serving. Boost and Ensure, the top 2 brands of nutritionals designed specifically for weight gain, deliver between 240 and 250 calories in an 8-oz serving. The Choice brand?s nutritional drink delivers 100 calories.
Products are available in a variety of flavors in ready-to-drink liquids or in powders that can be mixed into milk or food. The makers of Ensure, Abbott Laboratories Ross Products Division, recommend mixing the liquid into cooked or cold cereal or even into coffee. Nutritional products can be heated in the microwave oven, but they should not be allowed to boil, because boiling can cause the product to clump and may result in a loss of nutrients. Some patients find nutritional drinks too sweet. Manufacturers suggest serving the liquids over ice to blunt the sweetness.
Other nutritional products are used for weight reduction in patients with diabetes. Ross Products Division?s Glucerna is designed specifically to aid weigh loss in people with diabetes and have a unique blend of carbohydrates that have been clinically proven to help manage blood sugar levels.
?It?s very hard for people to achieve the meaningful weight loss [goal] they need to meet to control their diabetes while eating traditional foods,? said Anne Daly, a registered dietitian and past president of American Diabetes Association?s Health Care and Education. ?There are no calorie mysteries when a patient uses a meal replacement drink or bar. They offer patients a very controlled way of consuming food and calculating calories. We?re realizing how effective these products can be in helping patients achieve weight loss.?
Daly called meal replacements ?one of the tools in the toolbox? recommended by the American Diabetes Association?s diabetes prevention program. ?Since these products offer a balanced amount of vitamins and minerals and a controlled calorie intake, they can satisfy the need for a quick, easy meal and are a good alternative to fast food,? said Daly.
Daly stressed that, while these products should only be used under the supervision of a diabetes care team, pharmacists can play a vital role in helping patients stick with their meal replacement program.
?Pharmacists can help patients use these products at a time of day when they are likely to be snacking on unhealthy foods and taking in too many calories,? she said.