Barnes, Nicole and Illingworth, Sarah (2025) Mitigating oral and systemic health risks associated with oral nutritional supplements: the role of dietitians. Clinical Nutrition ESPEN, 68. p. 824. ISSN 2405-4577
Background:
Oral nutritional supplements (ONS) are commonly used to manage malnutrition, but their high sugar content poses potential risks to oral and systemic health (1). Existing literature highlights the relationship between poor oral health and systemic diseases such as cardiovascular and respiratory conditions (2,3). However, there is limited guidance among dietitians regarding these risks.
Aims:
The primary aim of this study was to investigate the knowledge, attitudes, and practices of dietitians regarding the oral and systemic health risks associated with cariogenic ONS in the treatment of malnutrition. Additionally, the study sought to identify whether dietitians are currently mitigating these risks in their practice.
Methods:
This mixed-methods study utilised an online survey through promotion on social media to collect quantitative and qualitative data from dietitians across the UK and the Republic of Ireland. The survey included questions about demographics, professional experience, knowledge of ONS risks, and current practices. Analysis methods involved descriptive statistics for quantitative data and thematic analysis for qualitative responses. Ethical approval was granted by London Metropolitan Ethics Committee.
Results:
The thematic analysis identified the following themes: awareness; education and training; clinical guidelines; collaborative working; scope of practice; and strategies for risk mitigation. The answers revealed limited risk perception; education and training deficits; lack of recognized standards; and lack of confidence in collaborating with experts and giving advice on oral health. Very few dietitians who completed the survey gave general dental hygiene advice (20%, n¼6).
Conclusions:
The study revealed significant gaps in dietitians' awareness and practice regarding the oral and systemic health risks of ONS. Many dietitians prioritised treating malnutrition without sufficient consideration of associated risks to oral health, highlighting the need for enhanced education and training. There is a lack of standardised guidelines and effective communication of best practices. Collaborative efforts between dietitians and oral health professionals are limited but show positive potential when implemented (1).
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