Malnutrition is a major problem within hospitals. As many as 50% of patients enter with malnutrition. This is a statistic of great concern because malnutrition is associated with many adverse outcomes for patients. Malnutrition is associated with increased mortality, morbidity, and length of hospital stay. Inadequate dietary intake can lead to poor functioning of the immune system, damage to the mucosal layer of the gut, increased risk of diarrhea, malabsorption, and infection. Insufficient caloric intake is also associated with muscle wasting. For these reasons it is very important to carefully screen every new patient for malnutrition.
While there is evidence for the importance of proper nutrition in the inpatient population, it is also necessary to identify patients who may not benefit from aggressive nutritional intervention. Feeding during acute severe illness may be ill-advised. Recent recommendations suggest a low calorie intervention during the first week of critical illness possibly will provide the best outcomes. Unfavorable consequences due to refeeding or early feeding have been reported with interventions occurring too early. It may be that the loss of appetite during illness is advantageous to the patient.
Schuetz P. Food for thought: why does the medical community struggle with research about nutritional therapy in the acute care setting? BMC Med. 2017;15(38):1-4. DOI: 10.1186/s12916-017-0812-x.