Interpretation of the 2023 ESPEN Guideline on Nutritional Support for Polymorbid Medical Inpatients

Abstract

Due to the accelerating trend of aging and transformation of residents' lifestyles and behaviors in China, multiple chronic conditions have become a major public health challenge. The phenomenon of comorbidities complicates patients' conditions and poor nutritional status, causing a heavy burden on patients' health and society. In 2018, the European Society for Clinical Nutrition and Metabolism (ESPEN) published the ESPEN Guidelines on Nutritional Support for Polymorbid internal medicine patients, which provides 22 recommendations and four statements on nutritional screening, assessment, requirements, monitoring and procedure of intervention for polymorbid medical inpatients. Based on continuously updated research evidence, the 2018 version of the guideline was updated by the ESPEN Guideline Working Group in June 2023, ESPEN Guideline on Nutritional Support for Polymorbid Medical Inpatients, to provide evidence-based recommendations on nutritional support for the polymorbid patient population hospitalized in medical wards. This article interprets and focuses 15 key points of the guideline, include nutritional screening and assessment, oral nutritional supplements, enteral nutrition and parenteral nutrition, estimation of energy requirements, protein targets, micronutrients supplementation, disease-specific nutritional supplementation, early nutritional support, post-discharge nutritional support, monitoring of physical functions, energy and protein requirements, organizational changes in nutritional support, impact of underlying diseases on nutritional support, drug-nutrient interactions and nutritional biomarkers. In order to provide guidance for nutritional management of polymorbid patients in China.

Keywords

• multiple chronic conditions|multimorbidity|comorbidity|nutritional support|management|guidelines|interpretation