To evaluate the tolerance (gastrointestinal) and acceptability of a new Oral Nutrition Supplement in patients with or at risk of disease related malnutrition, taken either orally or via a feeding tube

To evaluate tolerance and acceptability of a new Oral Nutrition Supplement in patients with or at risk of malnutrition, who require supplementary nutrition support, either taken orally or with a feeding tube. Outcomes of GI effects, compliance, product preference, convenience etc. will be recorded.

To obtain data to support an ACBS submission (to allow for prescription in the community at NHS expense).

Inclusion Criteria:

• Adult patients (≥18 years) who are able to communicate clearly.
• Diagnosis of renal disease or confirmed requirement for protein supplementation by a suitably qualified health care professional (e.g. dietitian)
• Participants with or at risk of malnutrition as determined by the SGA nutritional screening tool, MUST and/or by professional clinical judgement.
• Participants expected to require an ONS for at least 28 days from baseline, to take flavour variants orally and neutral via feeding tube.
• Informed consent obtained.

Exclusion Criteria:

• Participation in any other studies involving investigational or marketed products concomitantly or within seven days prior to entry into the study
• Patients with medical or dietary contraindication to any ingredients (see appendix 2 of protocol for full list.)
• No feeding tube for any patient taking the neutral variant.
• Patients with significant hepatic impairment.
• Patients with dysphagia requiring IDDSI level 1 (or higher) fluids.
• Patients with uncontrolled inflammatory bowel disease or previous bowel resection with ongoing gastrointestinal symptoms.
• Any patients having taken antibiotics over the previous 2 weeks leading up to the study.
• Any participant unable to give consent i.e., those with dementia.
• Participants under 18 years of age.
• Individuals who do not have sufficient proficiency with English language
• Investigator's uncertainty about the willingness or ability of the patient to comply with the protocol requirements.