Should You Add Salt to Nutritional Supplements for Elderly Patients?

Issues with Enteral Nutrition Products

Hello, nutritionist.
My elderly family member, who is nearly ninety years old, has chronic obstructive pulmonary disease (COPD).
They were hospitalized in June, and the hospital arranged for daily enteral feeding with Abbott Ensure Plus, adding 5 grams of salt.
After being discharged in mid-July and placed in a long-term care facility, we continued to add salt to the enteral feeding as done during hospitalization.
In early September, they were readmitted due to pneumonia and treated with antibiotics.
During this hospital stay, the nutrition provided was adjusted around dialysis.
Now that they have been discharged, we are still administering Abbott Ensure Plus, but I would like to know if it is still necessary to add salt to it.
Thank you.

Miss Hsu, 40~49 year old female. Ask Date: 2023/09/26

Dr. Cai Xiuwen reply Nutrition

Hello, I recommend that you return to the original treatment hospital for a follow-up.
During your discussion with the physician, consider whether to monitor relevant indices, or ask the physician for a referral to a dietitian's clinic to provide recommendations based on the elder's actual condition.
Wishing you safety and good health.

Reply Date: 2023/09/26

More Info

When considering whether to add salt to nutritional supplements for elderly patients, especially those with chronic conditions such as Chronic Obstructive Pulmonary Disease (COPD), several factors must be taken into account.
First, it is crucial to understand the role of sodium in the diet. Sodium is an essential mineral that helps maintain fluid balance, nerve function, and muscle contraction. However, excessive sodium intake can lead to health complications, particularly in elderly patients who may have underlying health issues such as hypertension, heart disease, or kidney problems. In the case of your elderly relative, who has COPD and has experienced pneumonia, careful management of sodium intake is particularly important.

In the hospital setting, the addition of salt to nutritional supplements may have been justified based on the patient's specific needs, including their overall health status, dietary restrictions, and the presence of any electrolyte imbalances. However, once the patient is discharged and under different care circumstances, such as in a long-term care facility, the dietary approach may need to be reassessed.
Here are some considerations regarding the addition of salt to nutritional supplements for elderly patients:
1. Fluid Retention and Blood Pressure: For patients with COPD, fluid retention can exacerbate breathing difficulties. High sodium intake can lead to increased blood pressure and fluid retention, which may worsen respiratory symptoms. Therefore, if your relative has a history of fluid retention or hypertension, it may be advisable to limit or avoid adding salt to their nutritional supplements.

2. Kidney Function: If the patient has any kidney issues, the intake of sodium must be monitored closely. The kidneys play a crucial role in regulating sodium levels in the body, and impaired kidney function can lead to sodium retention and further complications.

3. Dietary Needs: The nutritional needs of elderly patients can vary significantly. If the patient is receiving a well-balanced nutritional supplement like Abbott's Ensure or similar products, these typically contain adequate sodium levels for most patients. It is essential to consult with a healthcare provider or a registered dietitian to determine if additional sodium is necessary based on the patient's overall diet and health status.

4. Taste and Acceptance: Sometimes, adding a small amount of salt can enhance the flavor of nutritional supplements, making them more palatable for the patient. However, this should be balanced against the potential health risks associated with increased sodium intake.

5. Monitoring and Adjustment: After any changes in dietary practices, it is vital to monitor the patient's health closely. This includes watching for any signs of fluid retention, changes in blood pressure, or other health issues. Regular follow-ups with healthcare providers can help ensure that the dietary approach remains appropriate.

In conclusion, while adding salt to nutritional supplements for elderly patients can be beneficial in certain contexts, it is essential to consider the individual patient's health status, dietary restrictions, and overall nutritional needs. Consulting with a healthcare professional or a registered dietitian is the best course of action to ensure that the dietary practices align with the patient's health goals and conditions. If there are any concerns about the patient's sodium intake or overall nutrition, these should be addressed promptly to optimize their health and well-being.

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