Fatima S, Gerasimidis K, Wright C, Malkova D. Impact of high energy oral nutritional supplements consumed in the late afternoon on appetite, energy intake and cardio-metabolic risk factors in females with lower BMI. European Journal of Clinical Nutrition, 2021.


  • A randomised, crossover study with two experimental trials investigated the effectiveness of oral nutritional supplement (ONS) intake in the late afternoon and for long duration in terms of appetite, energy intake and cardio-metabolic risk factors for females with low BMI. 
  • Over the 5-day period, they found that in the ONS trial intake from evening meals was lower but averaged total daily energy intake was higher. On day six, energy intake, appetite scores, plasma GLP-1 and PYY, and energy expenditure were not significantly different between the two trials but fasting insulin concentration and insulin resistance (HOMAIR) were higher (p<0.05) and insulin sensitivity score based on fasting insulin and TAG lower (p<0.05) in ONS trail.
  • They concluded that late afternoon consumption of ONS for five days has only a partial and short-lived energy intake suppression, and thus increases daily energy intake but reduces insulin sensitivity.


  • This study focuses on the participants without clinical problems, therefore these results may not be applicable for patients with various disease-related malnutrition.
  • Usually, ONS treatment is provided through multiple doses (by splitting the single dose). However, this study was done based on a single dose of ONS treatment. Therefore, the health influences of a single dose ONS intake may vary compared to multiple doses.

Question to members

What impact will frequent small doses of ONS have on insulin sensitivity?

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