When older people lose weight unintentionally, nutritional drinks are often the easiest way to fill the energy and protein gap: A 200-ml bottle provides 300 kcal and 12 g of protein – as much as a small meal, but without chewing, without cooking, and drunk in two minutes. This guide explains to relatives and caregivers how to recognize the onset of malnutrition, what helps in everyday life, which nutritional drink is right for which situation, and how health insurance covers the costs.
The short version
- Warning signs: more than 5% weight loss in three months, loose clothing, loss of appetite, loss of strength, a body mass index below 20 in people over 65 – then have it checked by a doctor.
- Fortify first, then supplement: Cream, butter, oil, nuts, and milk powder in regular meals; plus 1–3 servings of nutritional drinks between meals, not instead of meals.
- By prescription: In cases of existing or imminent disease-related malnutrition, the family doctor prescribes fully balanced nutritional drinks such as CaloDrink Vanilla on a prescription covered by statutory health insurance (Form 16) – without an application, with a co-payment of €5–10 per pack.
- Without prescription: Powders such as CaloVital (approx. 354 kcal per serving with whole milk, 20 flavors) or the savory CaloSoup for those who do not like sweets.
Why underweight in old age is not harmless
With age, appetite, thirst sensation, and taste perception decrease; dental problems, swallowing difficulties, medications, loneliness, and illnesses are added to this. The result is a gradual weight loss that is often dismissed for a long time as "normal in old age." The German Society for Nutritional Medicine (DGEM) and the European professional society ESPEN classify malnutrition in older people as an independent disease risk: It is associated with muscle loss (sarcopenia), falls, longer hospital stays, and higher mortality. In the German hospital malnutrition study (Pirlich et al., 2006), already more than a quarter of all inpatients were malnourished – significantly more among those over 70. The good news: If detected early, weight loss can be stopped with simple means, and according to the ESPEN guideline, nutritional drinks are expressly part of the recommended measures for clinical nutrition in geriatrics when food alone is no longer enough.
How relatives can recognize the onset of malnutrition
- Weight: more than 5% loss in three months or more than 10% in six months (for a starting weight of 60 kg, that is 3 or 6 kg). Weigh monthly and record.
- Body mass index: According to the GLIM criteria, a BMI below 20 is considered noteworthy under 70 years, and a BMI below 22 from 70 years.
- Visible signs: Clothing, ring, or watch become loose; cheeks and temples hollow out; upper arms become thin.
- Behavior: Meals are skipped, plates remain half full, "no hunger," fatigue, loss of strength when getting up, frequent infections, wounds that heal poorly.
- Environment: Empty refrigerator or full of expired food, cooking is avoided.
To the doctor, not just for a shake: Unintentional weight loss often has a treatable cause (teeth, medications, depression, swallowing difficulty, illness). Nutritional drinks complement the therapy, they do not replace the medical assessment. In case of swallowing difficulties (choking, coughing while drinking), discuss the consistency with a doctor or speech therapist beforehand.
7 practical tips that really help in everyday life
- Fortify energy, not increase volume. A tablespoon of cream in coffee, butter in vegetables, oil in soup, grated cheese, nut paste in porridge – every ingredient brings 50–100 kcal without making the portion larger. Also 1–2 measuring spoons of flavor-neutral CaloVital can be stirred into yogurt, pudding, or mashed potatoes.
- Six small instead of three large meals. Older people get full more quickly. Plan snacks at 10, 15, and 21 o'clock – this is where nutritional drinks have their place.
- Nutritional drinks between meals, not before. A bottle 30 minutes before eating takes away the appetite. Better: one hour after breakfast and in the afternoon.
- Chilled, in small sips, spread throughout the day. An opened bottle of CaloDrink keeps in the refrigerator for 24 hours – no one has to drink 200 ml at once.
- Variety beats discipline. Alternate sweet and savory (shake, soup, bar), rotate flavors, freeze nutritional drinks as ice cream, or stir into oatmeal. The sample pack with 20 flavors helps find the favorite flavor.
- Do not forget protein. In old age, 1.0–1.2 g of protein per kg of body weight per day is recommended – so 55–66 g for 55 kg. One bottle of CaloDrink (12 g) or a glass of CaloVital with milk (approx. 16 g) covers a quarter of that.
- Eat together. Those who eat alone eat less. Plan meals together, eat together, cook childhood favorite dishes – appetite depends heavily on company and memory.
Which nutritional drink is right for which situation?
| Situation | Suitable product | Why |
|---|---|---|
| Disease-related malnutrition, diagnosed by a doctor | CaloDrink Vanilla (ready to drink, 200 ml) | Fully balanced (14 vitamins, 14 minerals), 300 kcal and 12 g of protein per bottle, prescribable on a prescription covered by statutory health insurance, PZN 20366080 (24-pack) |
| Chewing or mild swallowing problems | CaloDrink Vanilla | Ready to drink, creamy, fiber-free, low lactose – no preparation, no chewing |
| Little appetite, but still able to eat | CaloVital (powder, 500 g) | 194–354 kcal per serving, 20 flavors, can be stirred into food, from approx. €1.67 per serving |
| "Something sweet again?" | CaloSoup (potato or leek cream soup) | Savory warm snack, 275 kcal per serving with whole milk, 20 servings per can |
| Lactose intolerance or vegan diet | CaloVital Vegan | Lactose-free, gluten-free, pea protein, 195–199 kcal per serving with water |
| Nighttime hunger, restless sleep | CaloSleep | Evening serving with 122–200 kcal, vitamin B6 contributes to the normal function of the nervous system; discuss melatonin content beforehand with the doctor if medications are taken |
| On the go, in the waiting room, traveling | CaloCake bar | Up to 592 kcal per bar, no preparation, long shelf life |
| Diabetes | Only after consultation with the doctor | High-calorie nutritional drinks contain quickly available carbohydrates; monitor blood sugar closely |
How the health insurance covers the costs
Nutritional drinks are not an exception to self-payment, but in cases of disease-related malnutrition, the standard case of statutory health insurance (§ 31 SGB V, Arzneimittel-Richtlinie §§ 18–26):
- Family doctor appointment with weight log. Recorded weights of the last months, current weight, height, list of medications, and a short description of what and how much is eaten – this speeds up the assessment.
- Diagnosis by the doctor: existing or imminent disease-related malnutrition, and normal diet – even with fortification – is not enough.
- Prescription Form 16 with product name, package size, and PZN, for example CaloDrink Vanilla 24 × 200 ml, PZN 20366080. No application to the health insurance, no approval.
- Ordered from the pharmacy via the wholesaler, usually by the next business day. Co-payment: 10% of the price, at least €5 and at most €10 per pack; exemption according to the usual rules.
- Follow-up prescriptions like with long-term medication – the doctor determines the quantity and duration (1–3 bottles daily as a supplement).
The powder products CaloVital, CaloVital Vegan, and CaloSoup do not run through the prescription; they are available in every pharmacy via PZN and directly at calo-shop.com (free shipping in Germany, delivery in 1–3 business days). For doctors, care services, and pharmacies, there is the CaloDrink prescription information with PDF.
Checklist for the doctor's conversation
- Weight development of the last 3–6 months (date, kg)
- Current height and weight → BMI
- Appetite, amount of food, meals per day, drinks
- Dental status, dentures, swallowing difficulties
- Medication list (many active ingredients dampen appetite or taste)
- Mood, loneliness, memory
- Question: "Is a prescription for nutritional drinks according to § 31 SGB V indicated?"
For relatives: let them try first
The CaloVital sample pack contains 50-g portion bags in 20 flavors for €4.49 per bag – so the flavor that still tastes good after weeks can be found. CaloDrink Vanilla is available as a 4-pack starter set.
View sample pack View CaloDrink VanillaFrequently asked questions from relatives
Which nutritional drink is best for seniors with underweight?
In cases of malnutrition diagnosed by a doctor, a fully balanced, ready-to-drink nutritional drink with 1.5 kcal/ml like CaloDrink Vanilla (300 kcal and 12 g of protein per bottle, prescribable). Those who still eat normally and only want to supplement calories will get by cheaper with a powder like CaloVital (approx. 354 kcal per serving with whole milk, 20 flavors). The deciding factor is that the flavor tastes good and is drunk daily.
How many bottles of nutritional drinks per day are reasonable?
As a supplement to meals, 1–3 bottles (300–900 kcal) daily, between meals and not directly before. Only if no normal diet is possible at all, 5–7 bottles are used as exclusive nutrition under medical supervision.
Does the health insurance pay for nutritional drinks for seniors?
Yes, in cases of existing or imminent disease-related malnutrition (§ 31 SGB V). The family doctor prescribes a fully balanced nutritional drink on a prescription covered by statutory health insurance Form 16 with PZN – without an application. The co-payment is 10%, at least €5 and at most €10 per pack. CaloDrink Vanilla is listed as a balanced diet in the Lauer-Taxe (PZN 20363609, 20593746, 20366074, 20366080).
What to do if the mother or father rejects the nutritional drink?
Serve chilled, distribute in small glasses throughout the day, change flavors and forms (shake, savory soup, bar), stir the powder inconspicuously into yogurt, porridge, or soup, and eat together. With the sample pack, the right flavor can be found before a large pack is purchased.
From what weight loss should one take action?
From 5% weight loss in three months (for 60 kg, that is 3 kg) or a BMI below 20 in people over 65, the family doctor should be involved. Even before that, fortification of food and small, frequent meals help.
Is nutritional drink also suitable for diabetes?
High-calorie nutritional drinks contain quickly available carbohydrates and should only be used in diabetes after consultation with the doctor and under blood sugar control. Protein-rich, low-sugar variants like CaloDrink+ (4.7 g of sugar per 100 g) can be an option – also only with medical coordination.
- Volkert D, Beck AM, Cederholm T et al. (2019): ESPEN guideline on clinical nutrition and hydration in geriatrics. Clinical Nutrition 38(1):10–47. doi:10.1016/j.clnu.2018.05.024 pubmed.ncbi.nlm.nih.gov
- Volkert D, Beck AM, Cederholm T et al. (2022): ESPEN practical guideline: Clinical nutrition and hydration in geriatrics. Clinical Nutrition 41(4):958–989. doi:10.1016/j.clnu.2022.01.024 pubmed.ncbi.nlm.nih.gov
- Volkert D, Bauer JM, Frühwald T et al. (2013): Guideline of the German Society for Nutritional Medicine (DGEM) in cooperation with GESKES, AKE, and DGG: Clinical nutrition in geriatrics. Aktuelle Ernährungsmedizin 38(3):e1–e48. doi:10.1055/s-0033-1343169 Now replaced by the S3 guideline 2025 (next entry). dgem.de
- Volkert D, Bauer J, Benzinger P et al. (2025): S3 guideline Clinical nutrition and hydration in old age. Published by the German Society for Nutritional Medicine (DGEM) in cooperation with AKE, GESKES, and DGG. Aktuelle Ernährungsmedizin 50(4):220–283. doi:10.1055/a-2548-7209. AWMF register no. 073-019. dgem.de
- Cederholm T, Jensen GL, Correia MITD et al. (2019): GLIM criteria for the diagnosis of malnutrition – A consensus report from the global clinical nutrition community. Clinical Nutrition 38(1):1–9. doi:10.1016/j.clnu.2018.08.002 pubmed.ncbi.nlm.nih.gov
- Pirlich M, Schütz T, Norman K et al. (2006): The German hospital malnutrition study. Clinical Nutrition 25(4):563–572. doi:10.1016/j.clnu.2006.03.005 pubmed.ncbi.nlm.nih.gov
- Social Code (SGB) Fifth Book (V) – Statutory health insurance, § 31 Medicines and medical supplies, prescription authorization (especially para. 5: Claim to balanced diets for enteral nutrition). Online at gesetze-im-internet.de, accessed 18.10.2026. gesetze-im-internet.de
- § 61 sentence 1 SGB V – Co-payments: 10 percent of the retail price, at least 5 euros, at most 10 euros. Accessed on 18.10.2026. gesetze-im-internet.de
- Federal Joint Committee (G-BA) (version of 22 January 2009, last amended 16 July 2026, in force since 3 October 2026): Guideline on the prescription of medicinal products in contract medical care (Medicinal Products Guideline, AM-RL), Section I (§§ 18 to 26): Balanced diets for enteral nutrition. Online, accessed 18 October 2026. g-ba.de
- Nutritional and pricing information according to the product pages on calo-shop.com, as of 23 August 2026.
The laws, guidelines, scientific publications and databases mentioned relate to nutrition and care in general, not to CaloDrink or other CaloShop products themselves. Product information for CaloShop products is excluded; it is taken from their labels and nutritional information.
CaloDrink Vanilla is a food for special medical purposes for the dietary management of disease-related malnutrition and should only be used under medical supervision. This post is for general information purposes and is not a substitute for medical advice. Nutritional and pricing information according to the product pages on calo-shop.com, as of 23 August 2026.
Vorkasse – Banküberweisung