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- W2037112277 abstract "Des Spence’s article “Bad medicine: medical nutrition” contains factual inaccuracies that could result in harm to patients if doctors believed and acted on them.1He says that total calorie intake is the main issue in malnutrition, but protein and micronutrients are probably more important in improving clinical outcomes in sick, malnourished patients. Protein rich oral nutritional supplements (ONS) reduce the incidence of complications such as infection, poor wound healing, and ulcers in patients with hip fracture, leg ulcer, and acute illness in hospitals and community settings (10 trials, n=1830; odds ratio 0.68, 95% confidence interval 0.55 to 0.83).2 They also significantly reduce (by a quarter) the risk of developing pressure ulcers in high risk patients (four trials, n=1224; odds ratio 0.75, 0.62 to 0.89).3ONS increase protein intake in older people in hospitals and community settings.4 5 They work in patients recently discharged home and in malnourished older patients in hospital, even compared with controls who did not receive ONS but received careful attention by nursing staff to try to ensure that they finished meals (65% v 32% protein intake, P <0.0001).6 7 That ONS improve function and clinical …" @default.
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- W2037112277 date "2012-02-14" @default.
- W2037112277 modified "2023-09-25" @default.
- W2037112277 title "Tim Bowling and colleagues reply to Des Spence" @default.
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- W2037112277 doi "https://doi.org/10.1136/bmj.e811" @default.
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