Individuelle, evidenzbasierte Ernährung des medizinischen Spitalpatienten: Wo stehen wir heute?

 

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Zusammenfassung

Evidenzbasierte Medizin berücksichtigt die Grundsätze „Beste wissenschaftliche Evidenz“, „Klinische Expertise“ und „Patientenpräferenzen“ und bildet damit die Basis der klinischen Entscheidungsfindung in der modernen Medizin. Ziel ist, die Ernährungsmedizin in gleicher Weise zu praktizieren.

Groß angelegte klinische Studien sind Voraussetzung, um die Ernährungsmedizin wissenschaftlich auf das Niveau der evidenzbasierten Ernährungsmedizin zu heben.

Die Ernährungsmedizinische Forschung steht traditionell vielen Herausforderungen gegenüber. Aufgrund fehlender, hochqualitativer randomisierter Studien war es in der Vergangenheit schwierig, einen hohen Evidenzgrad für Ernährungsmedizinische Fragestellungen zu erlangen und in einigen Bereichen der Ernährungsmedizin ist die Evidenz zur Wirksamkeit von Ernährungsinterventionen noch immer unzureichend.

In den letzten Jahren wurden aber große Fortschritte auf dem Weg zur evidenzbasierten Ernährungsmedizin gemacht. Neue Erkenntnisse aus aktuellen, groß angelegten klinischen Studien und systematischen Analysen haben z. B. die bedeutenden klinischen Verbesserungen, die mit einer zielgerichteten Ernährungstherapie bei mangelernährten hospitalisierten Patienten assoziiert sind, aufgezeigt und damit eine wichtige Lücke im Wissen der Ernährungsmedizin geschlossen.

Abstract

Evidence-based medicine is the art of combining “best external evidence”, “clinical judgement” and “patient values” for an improved daily clinical decision making in modern medicine. The field of medical nutrition should follow these same basic principles. For raising medical nutrition to the level of evidence-based decision making, the availability of high-quality randomized trials and their meta-analyses is crucial. Historically, clinical nutrition research faces different challenges and there was an important lack of strong evidence from large and high-quality trials. While for some questions in medical nutrition there is still insufficient evidence today, in the field of malnutrition important progress has been made over the last years. Particularly, recent trials suggest that individualized nutritional support in malnourished inpatients has strong effects on mortality and other patient-relevant outcomes. These data support an active approach for patient screening, assessment and nutritional treatment when indicated.

Publication History

Article published online:
23 October 2020

© 2020. Thieme. All rights reserved.

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