Revista Espanola de Geriatria y Gerontologia · Nov 2, 2026

Physical exercise and oral nutritional supplementation on hospitalized malnourished or at-risk older adults: protocol for a randomized controlled trial

By Chenhuichen C, Cedeño Veloz BA, Zugasti Murillo A et al.

Background and aims Hospitalization in older adults is frequently associated with malnutrition, functional decline, and adverse health outcomes. Up to 50% of hospitalized older adults are malnourished or at risk of malnutrition, conditions further exacerbated by immobilization and metabolic stress. Although oral nutritional supplements (ONS) and structured physical exercise have independently shown positive effects, their combined effect during hospitalization remains insufficiently studied. This protocol describes a randomized controlled trial designed to evaluate the combined impact of ONS and a multicomponent physical exercise program in older inpatients. Methods The present trial will be conducted at a tertiary hospital in Spain and will include 102 participants aged ≥ 75 years, hospitalized for at least four days and identified as malnourished or at risk. Participants will be randomized into two groups (1:1): (1) control group, receiving standard care including ONS tailored to nutritional needs, and (2) intervention group, receiving standard care and a supervised multicomponent physical exercise program, including strength, balance, and aerobic exercises. Results The primary outcome is the change in physical performance, measured through the Short Physical Performance Battery (SPPB). Secondary outcomes include body composition, nutritional biomarkers, functional status, frailty, cognitive and affective status, quality of life, and other clinical endpoints such as length of hospital stay, and readmissions at 30 days. Conclusion This protocol provides a robust framework for evaluating the effects of oral nutrition supplementation combined with an individualized physical exercise programme in hospitalized older adults with malnutrition or at risk of malnutrition. The trial has been registered at ClinicalTrials.gov (NCT07067697).

doi.org/10.1016/j.regg.2026.101842PubMed 42971106Interventions