Dietetics - Using Oral Nutritional Supplements

There are several types of oral nutritional supplements (ONS) available ‘over the counter’ or on prescription. Use of these will depend on individual nutritional needs and taste preferences.

Prescription supplements are only recommended by dietitians based on assessment or prescribed by doctors and non-medical prescribers based on local prescribing guidelines and clinical judgement.

‘Over the Counter’ Nutritional Supplements

Nutritional supplements are available ‘over the counter’ from various chemists/shops (for example, Meritene, Aymes or Complan). These are available to purchase for those who are malnourished or at risk of malnutrition as a first option. These products should be tried prior to referral to a Dietitian. If half or less of a meal is consumed, 1 sachet/bottle is recommended.

Nutritional Supplements on Prescription

Nutritional supplements are often prescribed when an individual needs extra nourishment and cannot achieve this through diet and ‘over the counter’ nutritional supplements alone.

Individuals should have conducted a trial of nourishing diet and fluids, food fortification and ‘over the counter’ supplements for a minimum of 4 weeks as well as be screened at high risk of malnutrition before oral nutritional supplements are prescribed.

Nutritional supplements available on prescription include varieties such as: milkshake style, yogurt style, juice style, dessert style, smoothies, and savoury soups. These come in a selection of flavours. In addition, there are concentrated liquid and powder varieties of nutritional supplements for adding to food and fluids.

Appropriate use of Nutritional Supplements

• Check best before date
• Best served at appropriate temperature i.e., chilled, frozen, or warmed
• Decant into an appropriate container for drinking i.e., bottle, cup, or beaker.
• If volume is a concern, try serving small doses frequently.
• Serve at correct consistency if advised by a Speech and Language Therapist
• Discard after 4 hours of opening/preparing unless refrigerated in which case discard after 24 hours.
• Consider alternative ways of using the supplement to aid compliance

Please note: Prescribed nutritional supplements should be treated like any medication. They should only be given to the individual for whom they are prescribed. Always double check the product provided against the prescription, ensuring correct type and dose are given.

If you have any concerns, please contact your local Dietetic Service

Sweet flavours

• Best served cold and can be frozen as ice lollies or added to ice cream to make a nutritious milkshake
• Can be served warm, for example as hot chocolate, coffee or malted drink
• Can be used to make Angel Delight/Instant Whip, milk jelly and mousses Chocolate, vanilla, banana, or neutral flavours can be poured over cereal
• Can be added to yoghurt, desserts and milky drinks

Savoury flavours

• Best served warm
• Use as a base to make sauces
• Add salt, pepper and herbs to enhance flavour
• Add pasta, dried or condensed soup
• Available in various flavours such as tomato, mushroom or chicken

Juice based

• Can be frozen to make ice lollies or ice cubes (ideal for summertime)
• Can be served warmed and served as an undiluted cordial (ideal for wintertime)
• Can be added to other drinks, such as fruit juices, smoothies, non-diet drinks, lemonade and milkshakes
• Can be used to poach fruit such as pear/apples for a tasty dessert
• Can be used to make jelly and Angel Delight/Instant Whip
• Available in a variety of flavours such as orange, cola, apple, lemon and lime, blackcurrant

Neutral Flavours

• Can be added to condensed soups or to make up packet soups
• Can be added to mashed potato or scrambled egg
• Can be used to make up sauces or provide a base for them such as cheese or bechamel sauce
• Can be used to make milk puddings such as rice pudding or custard
• Can be poured over cereal or used to make porridge
• Shot and powdered types can be added to various food/drinks such as yoghurt, milk, cereals, casseroles, stews, soups, milky puddings