Immune-enhancing diets for stressed patients with a special emphasis on arginine content: analysis of the analysis.
OBJECTIVE
After two decades of intensive research, whether arginine-enriched diets for oral/enteral administration are beneficial or harmful for stressed patients remains uncertain. An American consensus and a meta-analysis provide divergent conclusions. The main goal of the present review is to analyze these documents.


RESULTS
The so-called immune-enhancing diets have been found to be beneficial to postoperative patients. Nothing proves, however, that arginine is responsible for these beneficial effects since immune-enhancing diets contain other pharmacologically active components (e.g. omega3 free fatty acids, RNAs, antioxidant vitamins). In fact, arginine-enriched diets may be harmful in hemodynamically unstable patients and those presenting with multiple organ failure.


CONCLUSIONS
In light of the current doubts and until convincing data are produced, immune-enhancing diets should not be used in unstable critically ill patients.
Cynober
Luc
L
Biochemistry Laboratory, Hôtel-Dieu Hospital AP-HO, and Nutrition Laboratory, University Paris 5, Paris, France. solange.ngon@htd.ap-hop-paris.fr
D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000627:therapeutic use; D001120:Arginine / Q000009:adverse effects / Q000276:immunology* / Q000627:therapeutic use; D003422:Critical Care; D016638:Critical Illness / Q000628:therapy*; D004750:Enteral Nutrition / Q000379:methods; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects*; D011182:Postoperative Care; D013312:Stress, Physiological / Q000178:diet therapy* / Q000276:immunology / Q000503:physiopathology
D000276:Adjuvants, Immunologic; D001120:Arginine