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Background: Poor nutritional intake is well-recognised in hip fracture patients. Supplements are often prescribed but compliance is variable. To test whether we could improve intake, we conducted a prospective study comparing the consumption of supplement presented in three different forms but of the same calorific value (300kcal): (1) fortisip compact; (2) fortisip compact blancmange; (3) cake.Method: For each patient, over a three week period, we weighed the daily fortisip compact before and after consumption to determine how much had been taken. This was used as the study reference. For the same ward over another three week study period, we replaced fortisip compact with fortisip compact blancmange and weighed the containers in the same way. Finally for the subsequent three week period, all ward patients received a portion of cake and consumption was calculated by its remaining weight. Comparisons were then made between the three forms of supplement.Evaluation Fortisip compact: 172 episodes from 43 patients. 37% had AMTS < 7. 36% needed assistance with eating. Mean consumption was 38.6% (116kcal).Fortisip compact blancmange: 164 episodes from 31 patients. 54% had AMTS < 7, 52% needed assistance. Mean consumption was 27.5% (83kcal).Cake: 174 episodes from 30 patients. 44% had AMTS < 7, 33% needed assistance. Mean consumption was 48.2% (145kcal).Patients consumed significantly less blancmange than fortisip (p < 0.01) and significantly more cake than fortisip (p < 0.01).Conclusion: Mean consumption of fortisip compact, a commonly prescribed supplement, was low. We were able to significantly improve consumption by presenting the supplement in a more palatable form as cake. Whilst there are cost implications (cake costs 60p, fortisip 1p), a range of supplements should be offered to patients in order to improve compliance with supplements and improve nutritional status.

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