Guiding framework for clinical nutrition research

Experience and lessons learned consolidated into a research framework

Carliene van Dronkelaar conducted the ProIntens study: a large-scale clinical trial investigating the effectiveness of a combined nutrition and physical activity intervention, carried out in five hospitals in Amsterdam. During the implementation of this study, several barriers were encountered, including the outbreak of the COVID-19 pandemic. These challenges were not unique to ProIntens but are recognizable across many large-scale clinical nutrition studies.

Therefore, as the final chapter of her PhD thesis, she co-authored a perspective paper together with international experts experienced in large-scale clinical nutrition research. In this paper, the lessons learned were translated into a framework for future clinical nutrition research. This framework aims to improve the development, implementation, and evaluation of interventions, and to facilitate their translation into clinical practice.

The framework is based on insights from a range of large and smaller studies. Key lessons include:

• Multidisciplinary, personalized nutrition care improves outcomes, but implementation is challenging.
• Early and structured involvement of all stakeholders is essential.
• Flexible study designs and digital tools can enhance feasibility and relevance.
• Long-term follow-up is needed to assess sustainable effects.

Future directions, recommendations, and conclusion

The authors advocate an integrated, interdisciplinary approach to malnutrition in older adults, with attention to both effectiveness and real-world feasibility. The proposed framework provides practical guidance for future research and has the potential to contribute to improved care and outcomes for vulnerable patients.

By applying this framework, researchers, healthcare professionals, and policymakers can work together to develop more effective and more easily implementable nutrition interventions for older adults and other vulnerable populations. This may lead to improved quality of life, greater independence, and lower healthcare costs.

Authors of this article

Studies underpinning this framework

The development of this framework is based on multiple studies and on the research experience of the authors involved in these studies. The table below provides an overview of the main characteristics and findings that underpin the framework. A detailed description of the contribution of each study can be found in the appendix of the article.

Taken together, these studies illustrate the opportunities and challenges of nutrition research, particularly in clinically vulnerable patients and older adults, and highlight why a structured yet flexible approach is necessary.