The purpose of this study was to compare the effects of nutritional supplement drinks (NSDs) and nutritional education (NE) on the nutritional status and physical performance of older nursing home residents who were at risk of malnutrition. This study was a clustered, randomized, parallel, multi-center clinical trial, with 107 participants more than 65 years old and at risk of malnutrition recruited from several nursing homes in this study. Participants were divided into two groups: an NE group (n = 50) and an NSD group (n = 57). The NE group was given NE by a dietitian, while the NSD group was provided with two packs of NSD except receiving NE (Mei Balance, Meiji Holdings, Tokyo, Japan) per day as a snack between meals and before bed. Anthropometric data, blood pressure, nutritional status, blood biochemical biomarkers, and physical performance were measured before and after 12-week interventions. After 12 weeks of NE combined with NSD intervention, body weight, body-mass index, the mini nutritional assessment-short form (MNA-SF) score, walking speed, and SF-36 questionnaire score were improved in older nursing home residents at risk of malnutrition.

This study aims to investigate the Vit D status, physical function parameters and analyze their correlation in older nursing home residents with malnutrition risk and malnutrition. Methods: This study was a cross-sectional study and recruited 152 older residents from multiple nursing homes and divided into well-nourished (n=34), malnutrition risk (n=102) and malnutrition (n=16) groups. The nutrition status was evaluated by mini nutritional assessment short form (MNA-SF), then anthropometric data, biochemical blood test and physical function parameters were evaluated and compared among groups. Compared with well-nourished group, BW (body weight), BMI (body mass index), ASMI (appendicular skeletal muscle index) and calf circumference were significantly lower in the malnutrition risk and malnutrition groups. The malnutrition risk and malnutrition groups also represented the significantly higher SOF (study of osteoporotic fractures) score than that of well-nourished group. Three groups showed the Vit D insufficiency that means blood 25(OH)D level is less than 30ng/dL, although there is no difference among three groups. In addition, The MNA-SF was negatively correlated with BMI, ASMI and calf circumference, whereas positively correlated with SOF score. Regarding the odd ratios, when the score of MNA-SF was low, the odds ratios of low ASMI, low calf circumference, and high SOF score were significantly increased. The institutionalized older adults with malnutrition risk or malnutrition had lower ASMI and calf circumference. However, regardless of nutritional status, occurrence of Vit D insufficiency was observed, and Vit D showed no significant correlation with physical function parameters among the older adults in the nursing home.