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Factors Affecting Adherence, Intake, and Perceived Palatability of Oral Nutritional Supplements: A Literature Review

Lester, S.; Kleijn, M.; Cornacchia, L.; Hewson, L.; Taylor, M. A.; Fisk, Ian


S. Lester

M. Kleijn

L. Cornacchia

Associate Professor in Sensory and Consumer Science


Oral nutritional supplements (ONS) are a clinically effective and relatively inexpensive way to supplement the diet of patients with, or at risk of, undernutrition. Good adherence is a primary determinant of the effectiveness of ONS. However adherence can be problematic for those with the greatest clinical need, such as undernourished older adults. This review aimed to appraise the available literature for the factors (contextual, personal and product related) affecting patient adherence and perceived palatability of ONS, identify areas requiring improvement and uncover gaps in the evidence to guide the focus of future research. Contextual factors identified were healthcare staff and the timing of administration. Personal factors included sensory changes and motivation which alter experience of and desire to consume ONS. The product’s sensory characteristics determined palatability and intake, but undesirable attributes, such as off-flavours, can stem from nutritional ingredients. The contribution made by aroma to older adults’ experience of ONS was a comparatively under-researched area. Further research should address this evidence gap to optimise the flavour, aroma profile and palatability for undernourished older consumers, thereby optimising intake. A combined multidisciplinary effort involving strategic expansion of research, industry development and clinical practice should simultaneously address the factors identified, to provide the best approach to improve adherence.


Lester, S., Kleijn, M., Cornacchia, L., Hewson, L., Taylor, M. A., & Fisk, I. (2022). Factors Affecting Adherence, Intake, and Perceived Palatability of Oral Nutritional Supplements: A Literature Review. Journal of Nutrition, Health and Aging, 26, 663-674.

Journal Article Type Article
Acceptance Date May 3, 2022
Online Publication Date Jun 27, 2022
Publication Date 2022-07
Deposit Date Jul 4, 2022
Publicly Available Date Jul 5, 2022
Journal Journal of Nutrition, Health and Aging
Print ISSN 1279-7707
Electronic ISSN 1760-4788
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 26
Pages 663-674
Public URL
Publisher URL


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