{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:07:16Z","timestamp":1792112836945,"version":"4.4.0"},"reference-count":51,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010886","name":"Nestl\u00e9 Health Science S.A.","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100010886","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/03y8jvk69","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Malnutrition in cancer adversely affects treatment outcomes and survival. Early intervention through oral nutritional supplements (ONSs) and dietary counseling can improve outcomes. This study evaluated the evolution of nutritional and morphofunctional parameters over three months in malnourished patients with cancer undergoing a comprehensive nutritional support program comprising dietary counseling, physical activity, and a novel concentrated high-protein, high-calorie ONS (cHPHC-ONS) with a high intrinsic leucine content. Methods: A prospective, observational, multicenter cohort study was conducted across 18 public hospitals in Spain. Two hundred thirty malnourished patients with cancer were enrolled: 147 na\u00efve (no ONS treatment in the last three months) and 83 non-na\u00efve (who transitioned to cHPHC-ONS after inadequate response to initial ONSs). Nutritional status was assessed using Global Leadership Initiative on Malnutrition (GLIM) criteria and morphofunctional parameters via bioelectrical impedance analysis, nutritional ultrasound, handgrip strength, the Timed Up and Go (TUG) test, and analysis of biochemical parameters. Results: After three months, 23.8% achieved normal GLIM nutritional status (p &lt; 0.0001), with a greater improvement seen in non-na\u00efve patients (28.4%, p &lt; 0.0001). Weight loss ceased in 42.6% (p &lt; 0.0001). and inflammation resolved for 10.3% (p = 0.0015). Non-na\u00efve patients experienced a significant increase in fat-free mass index (p = 0.0159), appendicular skeletal muscle index (p = 0.0248), and rectus femoris cross-sectional area (p = 0.0016). Muscle strength increased significantly by +1.7 kg (p = 0.0025), and TUG test time decreased by 1.13 s (p = 0.0003) overall. Conclusions: The comprehensive nutritional support program\u2014including a novel cHPHC-ONS, along with dietary and physical activity guidance\u2014significantly improved the nutritional and morphofunctional status of malnourished patients with cancer, with benefits particularly evident in non-na\u00efve individuals. Limitations: Observational design, no control group, short follow-up, and unadjusted non-multivariable comparisons, limiting causal inference.<\/jats:p>","DOI":"10.3390\/nu18091398","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:34:42Z","timestamp":1777458882000},"page":"1398","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effectiveness of a Comprehensive Program Including a Novel Concentrated High-Protein, High-Calorie Oral Nutritional Supplement to Enhance Nutritional and Morphofunctional Recovery in Malnourished Patients with Cancer: The ONAVIDA Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8570-184X","authenticated-orcid":false,"given":"Jos\u00e9 Manuel","family":"Garc\u00eda-Almeida","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Cl\u00ednico Universitario Virgen de la Victoria, 29010 M\u00e1laga, Spain"},{"name":"IBIMA BIONAND (Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga), 29590 M\u00e1laga, Spain"},{"name":"Department of Medicine and Dermatology, M\u00e1laga University, 29016 Malaga, Spain"},{"name":"Department of Endocrinology and Nutrition, Quironsalud M\u00e1laga Hospital, Av. Imperio Argentina, 29004 Malaga, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7469-5488","authenticated-orcid":false,"given":"Roc\u00edo","family":"Fern\u00e1ndez-Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Cl\u00ednico Universitario Virgen de la Victoria, 29010 M\u00e1laga, Spain"},{"name":"IBIMA BIONAND (Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga), 29590 M\u00e1laga, Spain"},{"name":"Department of Medicine and Dermatology, M\u00e1laga University, 29016 Malaga, Spain"},{"name":"Department of Endocrinology and Nutrition, Quironsalud M\u00e1laga Hospital, Av. Imperio Argentina, 29004 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Hern\u00e1ndez-Moreno","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitario de Navarra, C. de Irunlarrea, 3, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7646-2899","authenticated-orcid":false,"given":"Gabriel","family":"Olveira","sequence":"additional","affiliation":[{"name":"IBIMA BIONAND (Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga), 29590 M\u00e1laga, Spain"},{"name":"Department of Medicine and Dermatology, M\u00e1laga University, 29016 Malaga, Spain"},{"name":"Department of Endocrinology and Nutrition, Hospital Regional Universitario de M\u00e1laga, 29010 M\u00e1laga, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Diabetes y Enfermedades Metab\u00f3licas Asociadas (CIBERDEM), Instituto de Salud Carlos III, 29010 M\u00e1laga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercedes","family":"V\u00e1zquez-Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"UGC de Endocrinolog\u00eda, Nutrici\u00f3n y Riesgo Vascular, Hospital Torrec\u00e1rdenas, C. Hermandad de Donantes de Sangre, 04009 Almer\u00eda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Dassen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Health Research Institute Fundaci\u00f3n Jim\u00e9nez D\u00edaz, Av. de los Reyes Cat\u00f3licos, 2, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7460-5422","authenticated-orcid":false,"given":"Pedro Pablo","family":"Garc\u00eda-Luna","sequence":"additional","affiliation":[{"name":"Unidad de Gesti\u00f3n Cl\u00ednica de Endocrinolog\u00eda y Nutrici\u00f3n, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Roc\u00edo, Consejo Superior de Investigaciones Cient\u00edficas (CSIC), Universidad de Sevilla, 41013 Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amalia","family":"Gonz\u00e1lez-Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Unidad de Nutrici\u00f3n Cl\u00ednica y Diet\u00e9tica, Hospital Universitario San Cecilio, Av. del Conocimiento, 18007 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josefina","family":"Olivares","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Department, Hospital Universitario Son Ll\u00e0tzer, Health Research Institute of the Balearic Islands (IdISBa), Ctra Manacor km 4, 07198 Palma de Mallorca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Garc\u00eda-Duque","sequence":"additional","affiliation":[{"name":"Servicio de Endocrinolog\u00eda y Nutrici\u00f3n, Complejo Asistencial Universitario de Le\u00f3n, Gerencia de Salud de Castilla y Le\u00f3n (SACYL), Calle Altos de Nava, 24008 Le\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00aa Jos\u00e9","family":"Mart\u00ednez-Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Service, Jaen University Hospital, Avenida del Ej\u00e9rcito Espa\u00f1ol, 10, 23007 Ja\u00e9n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4413-9958","authenticated-orcid":false,"given":"Juan Manuel","family":"Guardia-Baena","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Virgen de las Nieves University Hospital, Av. de las Fuerzas Armadas, 2, Beiro, 18014 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2261-8210","authenticated-orcid":false,"given":"Mar\u00eda I.","family":"Rebollo-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Endocrinology and Nutrition Service, Hospital Juan Ram\u00f3n Jim\u00e9nez, Ronda Norte, 21005 Huelva, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8078-2054","authenticated-orcid":false,"given":"Miguel","family":"Civera","sequence":"additional","affiliation":[{"name":"Service of Endocrinology and Nutrition, Hospital Clinico Universitario of Valencia, Av. de Blasco Ib\u00e1\u00f1ez, 17, El Pla del Real, 46010 Valencia, Spain"},{"name":"Department of Medicine, University of Valencia, Av. de Blasco Ib\u00e1\u00f1ez, 17, El Pla del Real, 46010 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Visitaci\u00f3n","family":"\u00c1lvarez-de Frutos","sequence":"additional","affiliation":[{"name":"Service of Endocrinology and Nutrition, Hospital Universitario de Guadalajara, C. Donante de Sangre, 19002 Guadalajara, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicente","family":"Faus","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Hospital Costa del Sol, A-7, Km 187, 29603 Marbella, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc\u00eda","family":"D\u00edaz-Naya","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitario de Cabue\u00f1es, Los Prados, 395, 33394 Gij\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7620-3267","authenticated-orcid":false,"given":"Jos\u00e9 Joaqu\u00edn","family":"Alfaro-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Complejo Hospitalario Universitario de Albacete, c\/Hermanos Falc\u00f3, 37, 02008 Albacete, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Sanz-Par\u00eds","sequence":"additional","affiliation":[{"name":"Endocrinology Department, University Hospital Miguel Servet, Paseo de Isabel la Cat\u00f3lica, 1-3, 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.clnu.2016.07.015","article-title":"ESPEN guidelines on nutrition in cancer patients","volume":"36","author":"Arends","year":"2017","journal-title":"Clin. 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