This systematic review and meta-analysis evaluated high-protein supplementation (≥10 g/serving) during cancer therapy. Across 35 randomised controlled trials (3701 patients), high-protein supplements reduced weight loss, improved muscle strength, and lowered hospitalisation rates. No significant effect was found on health-related quality of life. Effects on survival, fat mass, and therapy toxicity were inconsistent. Supplements were generally safe and well-tolerated. Most studies had moderate to high risk of bias, so results should be interpreted cautiously. High-protein supplementation may benefit cancer patients, especially those with prior weight loss, but more robust trials are needed.

Malnutrition is common in gynecologic cancer patients and worsens surgical outcomes. Immunonutrition (special nutrients like arginine, omega-3s, nucleotides, antioxidants) may help reduce infections, improve healing, and shorten hospital stays when used as part of Enhanced Recovery After Surgery (ERAS) protocols. However, challenges include high cost, poor patient compliance after surgery, and lack of standard guidelines. Evidence is promising but not yet conclusive—more research is needed before routine use.

The 2025 ERAS Society guideline provides updated, evidence-based recommendations for perioperative care in elective colorectal surgery. Key elements include preadmission education, risk and comorbidity assessment, nutritional screening, and early oral feeding. The protocol emphasises multimodal pain relief, early mobilisation, and minimally invasive surgery. Some recommendations have changed: prehabilitation is no longer specifically recommended, immunonutrition is now considered for malnourished patients, and a slightly positive fluid balance is preferred. Adherence to the full ERAS protocol improves recovery, reduces complications, and shortens hospital stay, though evidence quality varies across interventions.

Malnutrition is common and often overlooked in surgical patients, especially those with cancer. This ESPEN guideline emphasises early screening, individualised nutrition interventions, and integrating nutrition into surgical care (including Enhanced Recovery After Surgery protocols). Early oral feeding, prehabilitation, and multidisciplinary teamwork are recommended to improve outcomes, reduce complications, and support recovery.

Malnutrition and sarcopenia are highly prevalent but often under-recognised and under-treated in adults with cancer. Both conditions are associated with poorer treatment tolerance, reduced quality of life, and worse clinical outcomes. This COSA position statement provides practical recommendations for routine screening of all cancer patients for malnutrition and sarcopenia, using validated tools. It emphasises early identification, comprehensive assessment, and timely, individualised interventions—including nutrition therapy, exercise, and multidisciplinary care. The statement highlights the importance of integrating nutrition and muscle health into standard oncology practice to improve patient outcomes and recovery.

Malnutrition is a frequent and serious concern in patients with cancer, yet nutritional risk is often under-recognised and under-treated by clinicians and care teams. These ESPEN practical guidelines provide clear, evidence-based recommendations for the screening, assessment, and management of nutrition in adult cancer patients. The guidance emphasises early and regular nutritional evaluation from diagnosis, individualised interventions (including dietary counseling, oral nutritional supplements, enteral or parenteral nutrition as needed), and the importance of maintaining physical activity. The guidelines also address nutrition support during surgery, radiotherapy, chemotherapy, and in palliative care, highlighting the need for a multidisciplinary approach to optimise patient outcomes, treatment tolerance, and quality of life.

Older adults with cancer are at high risk for malnutrition and cachexia, particularly when undergoing chemotherapy. Despite this, nutritional risk is often under-recognised and under-treated in this population. This systematic review highlights that malnutrition is common both before and during chemotherapy, with digestive symptoms and weight loss frequently observed. Malnutrition is associated with poorer tolerance to chemotherapy, early treatment discontinuation, increased toxicity, and higher mortality. The authors recommend routine nutritional assessment and early, individualised interventions as part of comprehensive geriatric oncology care.

Malnutrition and muscle wasting are common and serious concerns for patients with cancer, yet nutritional risk is often under-recognised and under-treated by clinicians and care teams. This review highlights that early and proactive nutritional screening, assessment, and individualised intervention are essential parts of oncology care. Evidence and guidelines support integrating nutrition counseling and, when needed, oral nutritional supplements to improve body composition, treatment tolerance, quality of life, and survival. A multidisciplinary approach, with nutrition as a central component, is recommended to optimise outcomes for cancer patients.

Malnutrition in cancer patients is a critical yet often under-treated issue that significantly affects treatment outcomes and survival. This short systematic review outlines practical strategies for early diagnosis and management, including validated screening tools, nutritional therapy, and exercise. It emphasises the importance of regular dietetic counselling and monitoring of muscle mass, with additional support for patients diagnosed with cancer cachexia.

Cancer-related cachexia is often under-recognised and inadequately managed, despite its impact on treatment outcomes and patient quality of life. These ESMO Clinical Practice Guidelines offer practical recommendations for identifying and managing cachexia in adult cancer patients, emphasising early intervention and a multidisciplinary approach.

The 2025 ERAS guidelines mark a major leap in perioperative nutrition care, introducing preoperative immunonutrition and refined postoperative strategies. With stronger evidence and a proactive approach, they offer essential tools for optimising outcomes in colorectal surgery.

In this international survey, it explores current knowledge gaps regarding malnutrition and dysphagia among healthcare professionals across 54 countries and discusses opportunties for improved care, management and identification strategies.

In this meta-analysis of randomised control trials, it details how texture-modified diets increase dietary intake of energy and protein in addition to fluif intake for adults with dysphagia.

In this retrospective observational study it examines the increased nutritional risks in adults who undergo GLP-1 RA therapy, including those with type 2 diabetes, prediabetes, and obesity.

This case report presents the clinical experience with four cases of post-stroke dysphagia. A comprehensive approach to management with thickened fluids decreased the risk of aspiration pneumonia and facilitated effective management of dietary recommendations both during hospitalisation and after discharge.

The present guideline provides 32 evidence-based recommendations and 8 statements for hospitalised patients with acute or chronic kidney disease, defining how to assess nutritional status, how to define patients at risk, how to choose the route of feeding, and how to integrate nutrition with kidney replacement therapy.

This literature review demonstrates that the EAT-10 dysphagia screening tool can be used as a primary screening instrument for detecting dysphagia in routine clinical practice, and provides complementary information to other diagnostic tools.

Children with developmental delays are often dependent on enteral nutrition. This study evaluated the benefits of switching to a 100% whey, peptide-based formula from an intact protein based formula, which resulted in improved symptoms of feeding intolerance in the majority (92%) of developmentally delayed children eligible for the study.

An open label, randomised, crossover study that looks at the effect and tolerance of a diabetes-specific formula on acute glucose, insulin, and triglyceride responses in patients with type 2 diabetes mellitus (T2DM). This study demonstrated that the diabetes-specific formula resulted in lower post-meal blood glucose and insulin levels as compared with an isocaloric meal.

Gastrointestinal intolerance is a common problem with enteral nutrition. This randomised controlled trial investigated the influence of a soluble fibre known as PHGG (partially hydolysed guar gum) in medical and surgical enterally fed patients with GI intolerance. Results demonstrated that enteral nutrition supplemented with PHGG lowered diarrhoea rates in patients receiving total and supplemental enteral nutrition, as well as experiencing fewer side effects and less interruption to feeding schedules.

Information for health professionals on nutrition management of critically ill patients, including guidelines on the nutritional management of COVID-19. Please note that all clinical decisions need to be made by the healthcare professional, taking the medical information of the patient into consideration.

A national, anonymous 41-question, online purpose-designed survey explores whteher older adults understand and value muscle health, tjheir avility to take action and overall knowledge and confidence to manage their health.

A national, anonymous 33-item, online purpose-designed survey of GPs and Practice Nurses explores awareness and attitudes toward sarcopenia, and how clinicians play a role in its management. Barriers to effective implementation in primary practice are also identified and discussed.

40 recommendations for nutritional care of older persons with dementia were developed with an emphasis on nutritional adequacy being an integral part of dementia management.

This research explores participant acceptability, adherence, safety, and experiences of using a short-term total diet replacement and a food-based low energy diet in adults living with chronic kidney disease and obesity.

The Global Leadership Initiative on Malnutrition (GLIM) provides consensus criteria for the diagnosis of malnutrition that can be widely applied. However, once malnutrition is diagnosed, skeletal muscle function should be investigated as a relevant component of sarcopenia and for complete nutrition assessment of persons with malnutrition. Barazzoni et al. 2022; Clinical Nutrition, 41 (6): 1425-33.

An Australian based open-label, non-randomized, multicenter trial by Gold et al. 2022 uses an amino acid-based formula (AAF) supplemented with two human milk oligosaccharides (HMO) to demonstrate normal growth, good tolerance and significant microbiome shift in infants with a cow’s milk protein allergy (CMPA). 

In a randomised multicenter trial by Puccio et al. 2017, it demonstrates that infant formula with 2'FL and LNnT is safe, well-tolerated, and supports age-appropriate growth. Secondary outcome findings show associations between consuming HMO-supplemented formula and lower parent-reported morbidity (particularly bronchitis) and medication use (antipyretics and antibiotics). 

In a randomised clinical trial by Vandenplas et al. 2022, using an extensively hydrolyzed formula (EHF) supplemented with two human milk oligosaccharides (HMO) in infants with cow’s milk protein allergy (CMPA), it demonstrated a reduction in frequency of upper respiratory tract infections and a lower incidence of ear infections at 12 months as well as supporting normal growth in infants with CMPA. 

Children with medical complexity switched to AA-MCT formula demonstrated growth. Formula was well tolerated, as shown by increased intake of formula, appropriate growth for age and BMI z-scores up to 1 year post-switch.

A systematic review looking at the positive effects of immunonutrition in head and neck cancer patients undergoing cancer treatment in improving or maintaining nutritional status.

Markovic, TP. et al 2022   An algorithm has been developed to (i) assist primary care physicians in treatment decisions for non-pregnant adults with obesity, and (ii) provide a practical clinical tool to guide the implementation of existing guidelines for the treatment of obesity in the Australian primary care setting.  

This article aims to review the latest nutrition care recommendations for the prevention and treatment of pressure injuries, including recommendations tailored to special populations. A secondary objective is to translate nutrition recommendations into actionable steps for the healthcare professional to implement as part of a patient plan of care.

Consensus recommendations were established based on eight clinically relevant questions regarding enteral nutrition (EN) indications as deemed by the Enteral Nutrition Committee. These consensus recommendations may act as a guide for clinicians and stakeholders on difficult questions pertaining to indications for EN. This paper was approved by the ASPEN Board of Directors.

The lectures highlight the role and use of nutrition intervention for diabetes management and potential to achieve diabetes remission. Topics include weight management and very low energy diets, use of nutritional supplements in diabetes care, and sarcopenia and diabetes.

These recommendations were developed by a panel of experts in the area of gastroenterology, and include recommendations on the use of fibre in enteral nutrition, such as PHGG (partially hydrolysed guar gum). ‘To prevent enteral nutrition induced diarrhoea in post surgical and in critical ill patients, supplementing enteral nutrition with PHGG is effective.' (Recommendation A)

Nutrition support during the acute phase post allogeneic haematopoietic stem cell transplantation (HSCT) is required to optimise short- and long-term outcomes for children. An algorithm was developed and evaluated to assist clinicians to make objective and consistent enteral feeding decisions and has shown to help support better weight outcomes and reduced LOS in this patient cohort.

This webinar informs on the emerging research demonstrating the benefits of partially hydrolysed guar gum (PHGG) for a range of health outcomes, including gut health and as a prebiotic. PHGG exerts the nutritional function of a dietary fibre, while being very low viscosity in solution. This webinar explores PHGG and its specific benefits for gut health.

This retrospective observational audit describes the characteristics of the paediatric patients who have been prescribed a hydrolysed whey protein, medium chain triglycerides (MCT) based formula, Peptamen Junior® and the nutritional outcomes. This study demonstrates that semi elemental formula Peptamen Junior® appears to be well tolerated in paediatric patients with a variety of medical conditions that have complex pathologies and may have wider scope of use in a more diverse group of medical conditions than currently indicated.

This review addresses the critical role of nutrition therapy in perioperative optimisation to improve surgical outcomes. It describes recent evidence for screening and treatment and practical guidance on perioperative nutrition care pathways for patients requiring major surgery.

This webinar discusses the ageing process and how ageing affects the musculoskeletal system and its key determinant of mobility impairment, how ageing affects nutritional status of older people, the relationship between malnutrition, sarcopenia and frailty and how malnutrition in older adults can be addressed with specific nutrients with optimal protein and omega-3 ingestion and loading.

This review covers the importance of early, multi-modal nutrition interventions across the continuum of care that are individualised and can improve the outcomes of those with COVID-19. The authors describe multi-modal nutritional therapy which includes a combination of nutritional interventions, e.g. dietary counselling, food fortification, texture modification, thickened fluids, oral nutritional supplements, enteral tube feeding, chosen depending on the individual needs of the patient, in addition to the use of specific individual nutrients, e.g. protein, vitamin D, omega-3 fatty acids, where appropriate (for muscle-targeted nutritional support).

This presentation focuses on the epidemiology and pathophysiology of long COVID and addresses its nutritional consequences and potential treatment options. Access this webinar on demand on the ASPEN website (register for FREE).

This study demonstrates that the use of Sn-2 formula compared to standard infant formula may be associated with improved behaviors and stool characteristics in infants.

This study looks at gastrointestinal tolerance, acceptability and safety of high sn-2 infant formulas among healthy term infants by measure of stool frequency and associated characteristics, and general gut symptoms.

This study looks at the effect of increasing the amount of palmitic acid esterified in the sn-2 position in infant formula on neurodevelopment in healthy full-term infants and explores association of this effect with the altered gut Bifidobacteria.

This podcast explores how prebiotic fibre differs from other fibres and probiotics, and its specific role in supporting gut health. It also touches on which patients benefit from boosting their prebiotic intake and debunks some of the most common myths in the gut health space. In particular the podcast will explore diets that are typically low in prebiotic goodness, how prebiotic fibres can alleviate symptoms of constipation, the role of Partially Hydrolysed Guar Gum (PHGG), a type of prebiotic fibre and top tips for dietitians who see patients with gut health issues.

This study aims at Identifying the risk factors for dysphagia in ICU patients with COVID-19 pneumonia requiring invasive mechanical ventilation, and at determining the frequency of postextubation dysphagia in this population.

Type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD) are highly prevalent diseases associated with an increased risk of morbidity and mortality. Obesity/overweight and dietary intake are important risk factors. Jamy Ard focused on the benefits of meal replacements to promote increased weight loss and increased rates of T2DM remission. Wajahat Mehal discussed sustained weight loss and improved liver health and focused on meal replacements and very-low-calorie diets (VLCD)for the management of NAFLD/NASH.

This pilot randomised control trial tests the feasibility and potential efficacy of remotely supported intermittent low-energy diets (ILEDs) and continuous low-energy diets (CLEDs) in people with type 2 diabetes (T2D). The study demonstrated feasibility and efficacy for remote ILEDs and CLEDs for weight loss and HbA1c reduction.

Guidelines for the provision of nutrition support therapy in the adult critically ill patient by The American Society for Parenteral and Enteral Nutrition(ASPEN). This guideline updates recommendations made from the 2016 American Society of Parenteral and Enteral Nutrition(ASPEN)/Society of Critical Care Medicine(SCCM) critical nutrition guideline for five foundational questions central to critical care nutrition support.

This podcast, which features dietitian and researcher Gabrielle Maston, explains what VLEDs are and tips and tricks to improve the compliance of patients on a VLED. It discusses the results of the DiRECT trial and the role of VLEDs in diabetes remission. It explores why dietitians are hesitant to prescribe VLEDs and how they can improve their confidence in recommending VLEDs to patients and clients. This podcast was hosted and created by Dietitian Connection.

This podcast which features Dr Emma Ridley, who is a Senior Research Fellow and Senior Clinical ICU Dietitian, discusses the nutrition consequences, typical nutrition intake and barriers and nutritional management of patients in ICU, including strategies to improve nutrition intake post-ICU, particularly for COVID-19 patients.

This podcast, which features psychologist Glenn Mackintosh, discusses the psychological aspects to consider when a client is trying to lose weight, such as what to consider when a client walks into a clinic for weight loss advice, importance of support from a professional and how to help clients normalise lapses and relapses. This podcast was hosted and created by Dietitian Connection.

Recent years have seen a surge in popularity of eating patterns involving intermittent fasting as a way to manage and optimise health. This webinar reviews the health and physiological benefits of intermittent fasting, exploring the two most popular forms of intermittent energy restriction (The 5:2 Diet and Alternate-Day fasting).

COVID-19 presents significant challenges, not only in caring for patients, but also the mental health of those looking after the patients. This webinar shares practical evidence based strategies from a health psychologist to help clinical dietitians manage stress, maintain optimism, and cultivate self-compassion during this difficult and uncertain time.

In this webinar, clinical dietitian Steph Yap and community dietitian Kate Dacanay discuss the different pathways they use to manage malnourished patients in their respective settings, focusing on optimal transition from hospital to community and reflect on the challenges that COVID-19 has presented in their work.

This clinical paper reviews the evidence available on the use of thickening agents for the management of dysphagia. It includes discussion on different types of thickeners, and looks at their effects on the bioavailability of water, absorption of medications and feelings of satiety when consuming different viscosities.

This study investigates the therapeutic effect of a xantham-gum based thickener on the swallowing function of patients with dysphagia. Results demonstrated that the xanthan-gum based thickener improves the safety of swallow without increasing residue providing a viscosity-dependent therapeutic effect for patients with oropharyngeal dysphagia.

This study assesses the feasibility of thickening video fluoroscopic contrast agents for dysphagia, including using a xantham gum-based thickener. The results showed that for optimal patient outcomes, only diagnostic materials and thickening agents for which reliable viscosity data are available should be used.

The use of thickening agents to alter bolus rheology is particularly commonplace; however, the precise effects of these alterations on swallowing remain uncertain. The aim of this study was to compare the effects of a thin contrast fluid versus a contrast fluid thickened with a xanthan gum-based thickener and a starch-based thickener.

This comparative study investigates the safety and efficacy of a xanthan gum-based versus a starch-based thickener in post-stroke patients with oropharyngeal dysphagia. Both thickeners were effective in improving swallowing safety however the xanthan gum-based thickener does not increase the prevalence of oral and pharyngeal residue, better avoiding the risk of aspiration after the swallow.

Paediatric Nutrition in Practice (PNP) eLearning Program aims to provide information to healthcare professionals who are looking for practical guidance on relevant issues surrounding the nutrition management of infants, children and adolescents. This eLearning Program has 12 modules that can be completed.

This study was to determine the effect of an intermittent defined formula diet on growth and disease activity in children with Crohn’s disease and growth failure. The results indicate that an intermittent defined formula diet can improve growth failure and significantly decrease disease activity in children with Crohn's disease.

Neurological disability is often associated with feeding and gastrointestinal disorders leading to malnutrition and growth failure. These clinical guidelines by ESPGHAN provide necessary nutritional and clinical guidance including assessment and monitoring of nutritional status, definition of nutritional requirements, diagnosis and treatment of gastro-oesophageal reflux disease, and indications for and modalities of nutritional support.

This single blind case control study aim was to compare the effect of a peptide-based formula versus a standard polymeric formula on feeding tolerance parameters and other clinical outcomes among critically ill children. The study found that the peptide-based formula feeding was better tolerated than standard polymeric formula feeding in critically ill pediatric patients. However, the choice of patients receiving the peptide-based formula needs to be further evaluated.

This study showed whey-based formulas reduce the number of episodes of vomiting by improving the rate of gastric emptying in patients 3 years or older with profound mental retardation, spastic quadriplegia, developmental delay, and scoliosis in comparison to patients that were fed casein-based formula.

The objective of this study was to compare anthropomorphic measures and dietary intake of calcium, vitamin D, total calories, protein and fat between children with and without reported food allergy using The National Health and Nutrition Examination Survey (NHANES). This study which showed that mean weight, height, BMI & height-for-age percentile and calcium intake were significantly lower in children aged 2-17 years compared with those without CMPA.

This study looked at the heterogeneity of extenstively hydrolysed formulas (eHFs) and compared the molecular weight profiles among eHF's from different manufacturers. The survey highlights the need for a more meaningful definition of EHF products. However, the clinical implications of it's findings are uncertain and further studies are required.

HMO academy- Human Milk Oligosaccharides (HMOs)are an exciting and central area of research in infant nutrition. Scientific advances on HMOs are helping us know more about the role and importance of these essential components of Human milk. The HMO Academy has been created to share evidence-based information in interactive and user-friendly way from more than a decade of research on HMO.

An online symposium from Nestlé Health Science presented by Dr. Rosan Meyer, Prof. Kari Nadeau and Dr. Carina Venter that looks at the nutritional strategy to prevent food allergy. This webinar discusses the topics such as the introduction of solid foods, making sense of allergy prevent guidelines around the world and diversity of foods .

A double-blind randomised clinical trial in which he results indicated that consumption of a high beta-palmitate formula affects infant crying patterns during the first weeks of life, reducing crying duration and frequency, primarily during the afternoon and evening hours, thereby improving the wellbeing of formula fed infants and their parents.

In this randomised, double-blind controlled trial, it evaluated the impacts of infants consuming high beta-palmitate (Sn-2) formula on anthropometric measures and bone strength. After 12 weeks of consumption, changes in bone SOS (speed of sound) were comparable to those infants consuming breast milk and favourable compared to infants consuming low beta-palmitate (Sn-2) formula.

A double-blind, randomised trial of a synthetic triacylglycerol in formula-fed term infants that demonstrated infants fed the higher sn-2 formula compared to a standard formula, measured bone mineral content, softer stools and lower stool fatty acid soaps, similar to that of breast-fed infants. The study noted that the greater bone mass measured could be important if it persisted beyond the trial period and would merit further investigation.

This study demonstrated that infant formula enriched with sn-2 palmitate fed in infantcy is safe, improves stool consistency (from 2 weeks to 2 months) and increase bone mineral content (at 4 months).

Patients with cancer are at particularly high risk for malnutrition because both the disease and its treatments threaten their nutritional status. However, cancer-related nutritional risk is sometimes overlooked or under-treated by clinicians, patients and their families. These ESPEN expert group recommendations provide clinical guidance in managing cancer related malnutrition.

Evidence based guidelines which were developed to translate current best evidence and expert opinion and translated into recommendations for multi-disciplinary teams responsible for identification, prevention, and treatment of malnutrition in adult cancer patients. These guidelines were commissed and financially supported by ESPEN and by the European Partnership for Action Against Cancer(EPAAC).

A comparative study that showed that early nutritional intervention in patients with Head and Neck Cancer (HNC) receiving concurrent chemoradiotherapy resulted in improved treatment tolerance and fewer admissions to hospital. Suggesting that nutritional intervention must be initiated before chemoradiotherapy, and continued after treatment completion.

A study evaluating the benefit of oral nutritional supplements(ONS) in addition to nutritional counselling in head and neck cancer(HNC) patients undergoing radiotherapy. HNC patients receiving radiotherapy and nutritional counselling with ONS had better weight maintenance, protein-calorie intake and quality of life than those patients who did not receive ONS.

This program reviews the latest evidence around the role of nutrition intervention for the prevention and treatment of cancer. Learn about the role of CT scans as predictors of outcomes and identifying hidden sarcopenia and understand how cancer death is related to chronic inflammation. Several common nutrition supplements are reviewed including fish oil, types and amount of protein, antioxidants, vitamin D, probiotics and more recent data around Specialized Pro-resolving Mediators (SPMs).

A systematic review and meta-analysis evaluating the impact of partially hydrolysed guar gum(PHGG) supplementation on constipation related outcomes in apparently healthy individuals. Results suggested that PHGG consumption led to a favourable impact on constipation prevention of the similar magnitude that was achieved with laxatives.

This study evaluated the progress of symptoms and the modifications in the frequency of evacuations in subjects affected by irritable bowel syndrome and regularly taking PHGG. The study demonstrated that PHGG inclusion in the diet assists in the dietary management of IBS and helps to manage the incidence of flatulence, pain and bloating.

The aim of this prospective study was to investigate the effect of guar gum on colonic transit time (CTT) and symptoms of chronic constipation. The results showed that four-week PHGG use accelerates colon transit time in patients with chronic constipation, especially in those with slow transit, and improves many of their symptoms including frequency of bowel movements.

The effects of partially hydrolysed guar gum (PHGG) were compared in a multicentre randomised open trial in patients with irritable bowel syndrome for 12 weeks. Gastrointestinal symptoms, quality of life and psychological symptoms were evaluated and improved significantly after the first month of administration until follow-up compared to those at baseline.

A systematic review and meta-analysis on the benefits of nutritional support in patients with type 1 or type 2 diabetes. This study demonstrated that that short and long term use of diabetes-specific formulas such as oral nutrition supplements and tube feeds are associated with improved glycaemic control compared with standard formulas.

A randomised, clinical trial exploring the effect of skipping breakfast on blood glucose levels after a subsequent isocaloric lunch and dinner. The study found that skipping breakfast increases post-prandial glucose levels after lunch and dinner, demonstrating a long-term influence of breakfast on glucose regulation throughout the day.

This guideline aims to cover nutritional aspects of the Enhanced Recovery After Surgery(ERAS) concept and the special nutritional needs of patients undergoing major surgery and of those developing severe complications despite best perioperative care. This guideline presents 37 recommendations for clinical practice.

ASPEN Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient. This guideline also answers a range of questions in relation to the provision and assessment of Nutrition Support Therapy which healthcare professionals can use in providing care for the adult critically ill patient.

This practical guideline gives guidance to health care providers involved in the management of cancer patients to offer optimal nutritional care. A total of 43 recommendations are presented with short commentaries for the nutritional and metabolic management of patients with neoplastic diseases. The disease-related recommendations are preceded by general recommendations on the diagnostics of nutritional status in cancer patients.

ESPEN provide updated guidelines on clinical nutrition in ICU. These guidelines define who are the patients at risk, how to assess nutritional status of an ICU patient, how to define the amount of energy to provide, the route to choose and how to adapt according to various clinical conditions. When to start and how to progress in the administration of adequate provision of nutrients is also described.

This ESPEN guideline will help inform healthcare professionals about the indications and contradictions for home enteral nutrition (HEN), and it’s implementation and monitoring. The guideline is based on current evidence and expert opinion and consists of 61 recommendations that address the indications for HEN, relevant access devices, products recommended, monitoring and criteria for termination of HEN, and the structural requirements needed to perform HEN.

This prospective double blind, controlled study evaluates the use of partially hydrolysed guar gum (PHGG) in enteral feeds, to prevent diarrhoea in intensive care unit (ICU) patients. The results showed that enteral nutrition formulae enriched with PHGG was related to a decrease of diarrhoeal episodes in ICU patients with pre-existing diarrhoea.

This randomised controlled trial investigated the use of PHGG (partially hydolysed guar gum) in critically ill patients with diarrhoea receiving enteral nutrition. The results illustrated that total enteral nutrition supplemented with soluble fibre is beneficial in reducing the incidence of diarrhoea in tube-fed full-resuscitated and mechanically ventilated septic patients.

A randomised, double-blind, clinical trial which investigated the effect of FODMAP content in enteral nutrition formula on gastrointestinal intolerance and nutrition status in hospitalised patients. The results demonstrate that low-FODMAP enteral nutrition improves diarrhoea and nutritional status in patients receiving enteral nutrition.

A controlled clinical trial which aimed to compare the effects of a renal-specific oral nutrition supplement (RS-ONS) and a standard recommended nutrition regime on biochemical and nutrition markers in malnourished patients with CKD on hemodialysis. Long-term oral nutrition supplementation improves outcomes in malnourished patients with chronic kidney disease on hemodialysis.

Protein energy wasting (PEW) is common in patients with chronic kidney disease (CKD) and is associated with adverse clinical outcomes, especially in individuals receiving maintenance dialysis therapy. This publication is an International Consensus Statement by the International Society of Renal Nutrition and Metabolism on the prevention and treatment of protein energy wasting in chronic kidney disease patients.

This systematic review looks at potential benefits of nutrition support (oral or tube feeding) in patients with chronic kidney disease. The study suggests that enteral multinutrient support significantly increases serum albumin concentrations and improves total dietary intake which may benefit clinical outcome, especially in malnourished patients.

Outcomes associated with intradialytic oral nutritional supplements in patients undergoing maintenance hemodialysis: a quality improvement report. This report showed that maintenance hemodialysis patients with albumin levels ≤3.5 g/dL who received monitored intradialytic oral nutritional supplements showed survival significantly better than similar matched patient controls, with the as-treated analysis highlighting the potentially large effect of this strategy in clinical practice.

The MNA® (Mini Nutrition Assessment) tool was designed and validated in numerous studies in Europe and the U.S over the course of 5 years. At the publication date of this paper, the MNA® was utilised in over 2000 clinical research all over the world, ranging from community care to hospital settings. This paper reviews 30 years of clinical research and practice which has utilised the MNA® tool worldwide.

A randomised controlled trial that investigated the use of a short-term nutritional intervention consisting of oral nutritional supplements and calcium and vitamin D supplementation and supported by dietetic counseling in malnourished older adults decreases the number of patients who fall and fall incidents.

A cluster randomised controlled study examined whether the nutritional status of aged undernourished residents in care could be improved through dietary modification to increase energy intake but not portion size. Results suggest that enriching food could help address undernutrition and slow chronic weight loss. Interventions of a longer duration are needed to confirm or exclude the value of food enrichment.

This systematic review highlights that the use of Oral Nutritional Supplements (ONS) use in community and care homes produces an overall cost advantage. Many clinically relevant outcomes favouring ONS were reported: improved quality of life, reduced infections, reduced minor post-operative complications, reduced falls, and functional limitations. Of the cost-effectiveness analyses involving quality adjusted life years or functional limitations, most favoured the ONS group.

Few trials have explored the effect of nutrition support on quality of life (QoL). This randomised controlled trial of 104 malnourished residential care residents indicates that oral nutritional supplements (ONS) can improve quality of life (QoL) and nutritional intake more effectively than dietary advice alone.

In this updated systematic review and meta-analysis of 27 trials including 6803 patients, nutritional support provided during hospitalisation was associated with: Significantly lower rates of mortality (24% risk reduction) (primary study outcome) (P=0.03) Significantly lower nonelective hospital readmissions (secondary study outcome) (P=0.02) Higher energy and protein intake (secondary study outcome) and weight increase (secondary study outcome).

A randomised controlled trial which had the aim of investigating whether providing a lower volume of ONS at a higher frequency during medication rounds would improve the intake of supplements.  The results showed that a higher frequency of a lower volume of ONS during medication rounds increased the compliance of patients needing ONS.

This systematic review demonstrates the cost and cost effectiveness of using standard oral nutritional supplements (ONS) in the hospital setting. The mean cost saving was ~12% and was associated with significantly improved outcomes such as reduced mortality, reduced complications and reduced length of hospital stay.

To help older people (>65 years) maintain and regain lean body mass and function, the PROT-AGE study group recommends average daily intake at least in the range of 1.0 to 1.2g protein per kilogram of body weight per day. Additionally, both endurance and resistance type exercises are recommended at individualised levels that are safe and tolerated.

MNA® (Mini Nutritional Assessment) is a validated nutrition screening/assessment tool to identify individuals 65 year and above who are malnourished or at risk of malnutrition. The online resource utilises a number of questions which patients answer and provides them with a score at the end in which they can determine what category they fit into whether they have: a normal nutritional status, at risk of malnutrition or malnourished.

This pilot study demonstrates the potential for a specialised wound healing nutritional supplement to accelerate the rate of pressure ulcer healing in spinal cord injury patients. A 2.5-fold greater rate of healing was observed in patients consuming the arginine-containing nutritional supplement until full healing compared with those who ceased taking the supplement.

In this clinical study, spinal-cord injured patients with pressure ulcers received a commercial powdered nutritional supplement containing 9g of arginine per day. An approximate 2-fold improvement in pressure ulcer healing was seen in well nourished community spinal patients receiving the arginine-containing nutritional supplement, compared with historical controls.

In this clinical study, hospital inpatients with pressure ulcers were randomised to receive daily a standard hospital diet; a standard diet plus two high-protein/energy supplements; or a standard diet plus two high-protein/energy supplements containing additional arginine, vitamin C and zinc. Subjects receiving the arginine-containing nutritional supplement had a significantly improved rate of pressure ulcer healing over the course of three weeks. 

Evidence based guidelines by the Trans Tasman Dietetic Wound Care Group on the dietetic management of adults with pressure injuries. The recommendations made are designed to guide practice and assist in the decision making process that is undertaken when assessing and treating patients. A Trans-Tasman approach was taken for the review of these guidelines to facilitate use by New Zealand Registered Dietitians as well as Australian Accredited Practicing Dietitians.

An eLearning module from Nestlé Health Science which discusses nutrition for wound healing and management. This education module goes through the three stages of wound healing, why wounds may fail to heal, the nutritional management of wounds and highlights individuals who are most at risk of pressure injuries.

Algorithm for prevention of pressure injuries

Malnutrition is known to contribute to wound development and impair wound healing through reduction in the availability of nutrients to maintain optimal cell maintenance and repair. This review examines studies from the last decade to identify evidence for the effectiveness of nutritional interventions in wound healing. Studies reported identified included 61 primary studies and 6 systematic reviews.

A randomised controlled trial which investigated the rate of weight loss on the rate of regain in people who are obese (fast versus slow weight loss). The interpretation of the results were that the rate of weight loss does not affect the proportion of weight regained within 144 weeks. These findings are not consistent with present dietary guidelines which recommend gradual over rapid weight loss, based on the belief that rapid weight loss is more quickly regained.

A review and meta-analysis of the benefits of weight management for those who are at risk or have type 2 diabetes. As obesity is a major risk factor for development of diabetes, a systematic review of the medical literature to assess the impact of obesity and weight gain on risk of diabetes and CHD was conducted.

A randomised control trial investigating the use of energy restricted diets delivered through primary care channels, with the aim of achieving remission for people with type 2 diabetes. Findings show that, at 12 months, almost half of participants on a total diet replacement program achieved diabetes remission.

This review paper addresses questions surrounding the use of very low energy diets (VLEDs) for the management of overweight/obesity. It discusses fast versus slow weight loss and long-term results, as well advantages of VLEDs, side effects, and how it should be used. Behavioural change, active follow-up and pharmacotherapy are also discussed for optimal results.

This review paper explores the properties and current status of very low energy diets (VLEDs) in the management of obesity.  VLEDs are defined as diets which contain energy levels of less than 3.4MJ (800kcal) per day and contain daily allowances of all essential nutritional requirements and have been used in clinical settings for over 20 years.

A very low energy diet (VLED) can result in substantial, rapid weight loss and is increasingly prescribed before obesity surgery to minimise risk and difficulty by reducing liver size and abdominal adiposity. This observational study demonstrates the efficacy of using a VLED pre-bariatric surgery for 2-6 weeks. 

The effects of overweight and obesity are widely recognised as one of Australia’s leading health concerns, involving all age and socioeconomic groups. These Guidelines are designed for use primarily at the level of the individual who is overweight or obese, while acknowledging that individual choices are shaped by the wider environmental and social context. The evidence-based recommendations and practice points focus on clinical and physical aspects of care.