Empleo de suplementos nutricionales orales basado en la evidencia

The main objective when prescribing any form of nutritional support is to improve nutritional status. The indications and benefits of the use of enteral supplements are not well defined. The present article aims to provide an evidence-based review of various factors related to the use of enteral supplements. This review analyzes: a) the definition of nutritional supplement, b) the criteria for selection and classification of nutritional supplements, c) the possible forms of administration, and d) the benefits of their use in distinct diseases. The 84 randomized controlled trials discussed in a review published in Clinical Nutrition in December 1999 were used. In addition, a search was performed in Medline (PubMed) and the Cochrane Library Controlled Trials Register for articles published between 2000 and 2004. This search yielded a further 134 articles, of which only four were prospective randomized trials and one was a meta-analysis. The main inclusion criteria was selection of prospective randomized trials on the use of supplements in surgery, chronic obstructive pulmonary disease (COPD), chronic liver disease, cystic fibrosis, AIDS, and the elderly. The definition of nutritional supplements, as well as the criteria for selection, classification and form of administration, is based on expert opinion with level 5 evidence. Concerning the benefits of nutritional supplements in various diseases there is level I evidence for recommending their use in surgery, COPD, chronic liver disease, cystic fibrosis and in a variety of disorders affecting the elderly.