According to Gram Research analysis, hospitalized older adults consumed significantly more of a drink-based nutritional supplement (about 67% of what was offered) compared to a new porridge supplement (about 26%) in a 2026 randomized controlled trial of 27 patients. The porridge’s thick texture was the main reason for lower consumption, even though taste was rated similarly. The study found that hospital staff attitudes, patient appetite, and supplement variety also strongly influence whether patients actually eat prescribed supplements.
When older hospital patients need extra nutrition, doctors often give them special drinks. But a new study found that patients actually eat less of these drinks than they do of a newer porridge-style supplement—even though they didn’t like the porridge’s texture as much. Researchers at a hospital tested both types with 27 older adults and found that how much patients actually consume depends on taste, thickness, and how hospital staff present the food. The study suggests hospitals should offer more variety in nutritional supplements and better train staff on helping patients eat well.
Key Statistics
A 2026 randomized controlled trial of 27 hospitalized older adults found that patients consumed a median of 66.8% of drink-based nutritional supplements compared to only 26.31% of porridge supplements over 4 days.
In the same study, patients significantly disliked the texture of the porridge supplement compared to the drink supplement, rating it lower on a 7-point palatability scale, despite similar taste ratings between products.
Hospital staff attitudes and institutional culture significantly influenced patient acceptance of nutritional supplements, with 9 interviewed patients and 5 staff members identifying staff support as a key factor in supplement adherence.
Neither the porridge nor drink supplement replaced patients’ regular meals in the 2026 study, indicating they functioned as true nutritional additions rather than meal substitutes for hospitalized older adults.
The Quick Take
- What they studied: Whether older hospital patients would eat more of a new porridge-style nutritional supplement or a traditional drink-based supplement, and which one they preferred.
- Who participated: 27 older adults (average age 80 years, mostly women) staying in a hospital who were at risk of not getting enough nutrition.
- Key finding: Patients consumed significantly more of the drink supplement (about 67% of what was given) compared to the porridge supplement (about 26% of what was given), even though the porridge had slightly less calories and protein.
- What it means for you: If you’re an older adult in the hospital needing nutritional support, the type of supplement offered matters—but it’s not just about taste. Hospital staff attitudes, how the food looks and feels, and your appetite all play a role in whether you’ll actually eat it.
The Research Details
Researchers conducted what’s called a ‘crossover study,’ which means each patient tried both types of supplements. For 4 days, patients received the porridge supplement twice daily, then after a break, they received the drink supplement twice daily for another 4 days (or vice versa for some patients). This design lets researchers compare how the same person responds to each product.
The researchers weighed leftover food to measure exactly how much each patient actually consumed. They also asked patients to rate how much they liked each supplement on a scale of 1 to 7. To understand why patients made their choices, the team interviewed 9 patients and 5 hospital staff members about what they thought of the supplements.
This multi-method approach—combining measurements, ratings, and interviews—gives a complete picture of not just what patients ate, but why they ate it.
This research design is important because it shows that simply creating a ‘better’ supplement isn’t enough. Real-world factors like how food feels in your mouth, hospital culture, and staff support matter just as much as nutrition facts. By combining numbers with patient stories, the study reveals practical barriers that hospitals can actually fix.
This was a well-designed study with good controls—each patient served as their own comparison, which reduces bias. The sample size of 27 is moderate but reasonable for this type of detailed research. The inclusion of staff interviews strengthens the findings by showing institutional factors. However, the study was conducted at only one hospital, so results may not apply everywhere. The researchers were transparent about what they measured and how.
What the Results Show
The most striking finding was the difference in how much patients actually consumed. When given the drink supplement, patients consumed a median of about 67% of what was offered to them. When given the porridge supplement, they consumed only about 26%—less than half as much. This difference was statistically significant, meaning it wasn’t due to chance.
Interestingly, when researchers looked at the actual volume of liquid or food consumed (rather than percentage), there was no significant difference between the two supplements. This suggests patients weren’t necessarily eating more total food—they were just choosing to consume more of the drink when given a choice.
When asked to rate how much they liked each product on a 7-point scale, patients significantly disliked the texture of the porridge supplement compared to the drink. Many described the porridge as too thick or having an unpleasant mouthfeel. However, taste ratings were similar between the two products, suggesting texture was the main issue.
The interviews revealed several important factors beyond the supplement itself. Patients’ changing physical abilities and appetite levels influenced whether they ate the supplements at all. Hospital culture—including how staff presented the food and their attitudes toward nutrition—significantly affected patient choices. Some staff members seemed more supportive of nutritional care than others, and patients noticed this. Patients also expressed wanting more variety in food-based supplements with natural ingredients rather than processed drinks or unfamiliar textures. Importantly, neither supplement replaced patients’ regular meals, suggesting they served as true additions to diet rather than substitutes.
Previous research has shown that oral nutritional supplements are important for preventing malnutrition in hospitalized older adults. However, most studies focused on whether supplements work nutritionally, not whether patients actually consume them. This study fills an important gap by showing that ‘adherence’—actually eating what’s prescribed—is a major challenge. The finding that texture matters more than taste aligns with some earlier research on food preferences in older adults, but this is one of the first studies to directly compare different supplement formats in a hospital setting.
The study was conducted at only one hospital, so results may not apply to all hospitals or all older adults. The sample of 27 patients is relatively small, though appropriate for this detailed type of research. The study lasted only 4 days per supplement, which is a short timeframe—patients might have adapted to the porridge if they’d tried it longer. The researchers didn’t measure whether patients’ overall nutrition improved with either supplement. Additionally, the study didn’t explore whether cost, ease of preparation, or other practical factors influenced hospital choices about which supplements to offer.
The Bottom Line
Hospitals should offer multiple types of nutritional supplements rather than a one-size-fits-all approach. Staff should receive training on how to present supplements in appealing ways and how to support patients in eating them. When possible, food-based supplements with natural ingredients may be more acceptable than unfamiliar textures. However, this single-hospital study suggests caution before making major changes—more research across different hospitals is needed. Confidence level: Moderate—the findings are clear but from one location.
Hospital administrators and nutritionists should care most about these findings, as they can change what supplements are offered and how staff present them. Older adults at risk of malnutrition and their families should know that speaking up about supplement preferences matters. Healthcare workers should understand that patient acceptance is just as important as nutritional content. This research is less relevant to healthy people eating at home.
Changes in supplement consumption could happen immediately if hospitals switch products or improve how staff present them. However, improvements in overall nutrition and health outcomes would take weeks to months to become apparent.
Frequently Asked Questions
Why do hospitalized older adults not eat nutritional supplements even when they need them?
Texture and thickness matter more than taste—patients disliked the porridge supplement’s mouthfeel despite similar taste ratings. Hospital staff attitudes, patient appetite changes, and how supplements are presented also significantly influence whether older adults actually consume them.
What type of nutritional supplement do hospital patients prefer?
A 2026 study of 27 hospitalized older adults found patients consumed more than twice as much of a drink-based supplement (67%) compared to a porridge supplement (26%). Patients requested more variety with natural ingredients and better staff support in choosing supplements.
Do nutritional supplements replace regular meals in hospitals?
No. In this study, neither the porridge nor drink supplements replaced patients’ regular meals, meaning they functioned as true additions to their diet rather than meal substitutes for hospitalized older adults at risk of malnutrition.
How can hospitals improve whether patients eat nutritional supplements?
Offer multiple supplement types rather than one option, train staff on supportive presentation techniques, and consider food-based supplements with natural ingredients. Patient preferences for texture and thickness matter as much as nutritional content for actual consumption.
Does the amount of protein or calories in a supplement affect whether patients eat it?
Not directly. The drink supplement had more calories (306 vs. 249) and protein (18g vs. 16g), but patients’ actual consumption was driven by texture preference and staff support rather than nutritional content differences.
Want to Apply This Research?
- Track the percentage of prescribed nutritional supplements actually consumed each day (e.g., ‘Consumed 60% of morning supplement’). This helps identify patterns in acceptance and shows whether changes in presentation or product type improve adherence.
- If using a nutrition app in a hospital setting, users could rate each supplement on texture, taste, and thickness immediately after consuming it. This real-time feedback helps hospital staff understand preferences and adjust offerings. Users could also note how hungry they felt before the supplement and whether staff support affected their willingness to eat it.
- Over weeks, track which supplement types and presentations result in the highest consumption percentages. Monitor whether changes in staff approach (more encouragement, better timing, different presentation) correlate with higher adherence. Share this data with hospital nutritionists to continuously improve the supplement program.
This research describes findings from a single-hospital study of 27 older adults and should not replace medical advice from your healthcare provider. Nutritional supplement recommendations should be individualized based on your specific health needs, medications, and medical conditions. If you’re hospitalized or at risk of malnutrition, discuss supplement options with your doctor or registered dietitian. This article is for educational purposes and does not constitute medical advice.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.