New Clinical Nutrition Guidelines for Patients with Multiple Pathologies

Philipp Schuetz, Carla Wunderle e Filomena Gomes


Filomena Gomes, nutritionist, professor, and researcher in the research group Metabolism and Nutrition led by Conceição Calhau, is the first author of a new article that defines nutritional guidelines in the Clinical Nutrition journal, along with Carla Wunderle and Philipp Schuetz from the Cantonal Hospital Aarau and the University of Basel.

These nutritional guidelines are used by clinicians to make decisions about the most appropriate healthcare interventions. In the field of nutrition, the European Society for Clinical Nutrition and Metabolism (ESPEN) regularly publishes clinical guidelines to provide the best nutritional care for patients. Most of ESPEN's guidelines are developed for specific diseases or conditions, such as patients with cancer or neurological diseases. However, most of the hospitalized patients suffer from multiple chronic diseases, which increases their risk of malnutrition.

In 2016, a working group composed of 15  experts in nutritional support, coordinated by Filomena Gomes, was formed to create guidelines on nutritional support for polymorbid patients. In 2018, as a result of this work, ESPEN's first guidelines for patients with multiple pathologies were published. Since these guidelines need to be updated on a regular basis, always in accordance with the latest scientific evidence, this working group was reactivated in 2023.

We followed the rigorous methodology required for guideline development, and our literature searches found 60 new studies that were used to generate 32 recommendations covering various aspects of nutritional support including screening, route of feeding, energy and protein requirements, micronutrient requirements, timing and monitoring” explains Filomena Gomes.

The updated guidelines included new high-quality clinical trials that strengthened the evidence to recommend nutritional screening and individualized nutritional support for polymorbid patients, in order to reduce the consequences of malnutrition in this population, such as mortality, length of hospital stay and costs.

Filomena Gomes, who is also a senior manager of the "Healthy Mothers Healthy Babies" program at the Micronutrient Forum, reveals that they are also preparing a summarized and practical version of these guidelines, which they hope will be used worldwide by thousands of clinicians, with a significant impact on the clinical outcomes of this patient population.


The guidelines now published by the working group coordinated by Filomena Gomes in the field of clinical nutrition were presented at the European Congress of Clinical Nutrition and Metabolism - 45th ESPEN Congress 2023.

The complete article can be found here: ESPEN guideline on nutritional support for polymorbid medical inpatients - ScienceDirect.