{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:51:34Z","timestamp":1786978294532,"version":"build-2736575974"},"reference-count":98,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,3,12]],"date-time":"2023-03-12T00:00:00Z","timestamp":1678579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004484","name":"Tehran University of Medical Sciences and Health Services","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004484","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nut in Clin Prac"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>We conducted an umbrella review to summarize the existing evidence on the effect of early enteral nutrition (EEN) compared with other approaches, including delayed enteral nutrition (DEN), parenteral nutrition (PN), and oral feeding (OF) on clinical outcomes in hospitalized patients. We performed a systematic search up to December 2021, in MEDLINE (via PubMed), Scopus, and Institute for Scientific Information Web of Science. We included systematic reviews with meta\u2010analyses (SRMAs) of randomized trials investigating EEN compared with DEN, PN, or OF for any clinical outcomes in hospitalized patients. We used \u201cA Measurement Tool to Assess Systematic Reviews\u201d (AMSTAR2) and the Cochrane risk\u2010of\u2010bias tool for assessing the methodological quality of the systematic reviews and their included trial, respectively. The certainty of the evidence was rated using the \u201cGrading of Recommendations Assessment, Development, and Evaluation\u201d (GRADE) approach. We included 45 eligible SRMAs contributing with a total of 103 randomized controlled trials. The overall meta\u2010analyses showed that patients who received EEN had statistically significant beneficial effects on most outcomes compared with any control (ie, DEN, PN, or OF), including mortality, sepsis, overall complications, infection complications, multiorgan failure, anastomotic leakage, length of hospital stay, time to flatus, and serum albumin levels. No statistically significant beneficial effects were found for risk of pneumonia, noninfectious complications, vomiting, wound infection, as well as number of days of ventilation, intensive care unit days, serum protein, and pre\u2013serum albumin levels. Our results indicate that EEN may be preferred over DEN, PN, and OF because of the beneficial effects on many clinical outcomes.<\/jats:p>","DOI":"10.1002\/ncp.10976","type":"journal-article","created":{"date-parts":[[2023,3,12]],"date-time":"2023-03-12T07:32:29Z","timestamp":1678606349000},"page":"564-579","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Early vs delayed enteral nutrition or parenteral nutrition in hospitalized patients: An umbrella review of systematic reviews and meta\u2010analyses of randomized trials"],"prefix":"10.1002","volume":"38","author":[{"given":"Sepide","family":"Talebi","sequence":"first","affiliation":[{"name":"Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics Tehran University of Medical Sciences Tehran Iran"},{"name":"Students' Scientific Research Center (SSRC) Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheida","family":"Zeraattalab\u2010Motlagh","sequence":"additional","affiliation":[{"name":"Department of Community Nutrition, School of Nutritional Sciences and Dietetics Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahdi","family":"Vajdi","sequence":"additional","affiliation":[{"name":"Student Research Committee, Department of Community Nutrition School of Nutrition and Food Science Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina Mai","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Section for Biostatistics and Evidence\u2010Based Research, The Parker Institute Bispebjerg and Frederiksberg Hospital Copenhagen Denmark"},{"name":"Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark Odense University Hospital Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Talebi","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy Department, Faculty of Pharmacy Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abed","family":"Ghavami","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, School of Nutrition and Food Science Isfahan University of Medical Sciences Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0108-187X","authenticated-orcid":false,"given":"Sajjad","family":"Moradi","sequence":"additional","affiliation":[{"name":"Halal Research Center of IRI, FDA Tehran Iran"},{"name":"Nutritional Sciences Department, School of Nutritional Sciences and Food Technology Kermanshah University of Medical Sciences Kermanshah Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erfan","family":"Sadeghi","sequence":"additional","affiliation":[{"name":"Research Consultation Center (RCC) Shiraz University Of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahsa","family":"Ranjbar","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sajedeh","family":"Habibi","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Sadeghi","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2046-7356","authenticated-orcid":false,"given":"Hamed","family":"Mohammadi","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,12]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(18)30036-0"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOG.0000000000000047"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2020.110814"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/jpen.1499"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607115625638"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/nop2.99"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCC.0000000000000504"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2018.08.037"},{"issue":"7","key":"e_1_2_10_10_1","article-title":"Early enteral nutrition within 24 hours of lower gastrointestinal surgery versus later commencement for length of hospital stay and postoperative complications","volume":"7","author":"Herbert G","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.14140"},{"key":"e_1_2_10_12_1","first-page":"243","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Higgins JP","year":"2011"},{"key":"e_1_2_10_13_1","volume-title":"GRADE Handbook for Grading Quality of Evidence and Strength of Recommendations","author":"Sch\u00fcnemann H","year":"2009"},{"key":"e_1_2_10_14_1","doi-asserted-by":"crossref","unstructured":"GatesM GatesA PieperD et al. Reporting guideline for overviews of reviews of healthcare interventions: The Preferred Reporting Items for Overviews of Reviews (PRIOR) Explanation & Elaboration.2022.","DOI":"10.31222\/osf.io\/23b6j"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j4008"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"issue":"000142","key":"e_1_2_10_18_1","first-page":"142","article-title":"Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions","volume":"10","author":"Cumpston M","year":"2019","journal-title":"The Cochrane Database Syst Rev"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2011.01.012"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLR.0000062554.74615.4C"},{"issue":"1","key":"e_1_2_10_22_1","article-title":"Enteral versus parenteral nutrition for acute pancreatitis","volume":"2010","author":"Al\u2010Omran M","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"issue":"4","key":"e_1_2_10_23_1","article-title":"Early enteral nutrition within 24h of colorectal surgery versus later commencement of feeding for postoperative complications","author":"Andersen HK","year":"2006","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2021.02.050"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2019.06.002"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1159\/000189382"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2010.06.008"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-009-1664-4"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-016-1298-1"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000008648"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.2147\/OTT.S73275"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2004.06.003"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v13.i39.5253"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-008-0592-x"},{"issue":"6","key":"e_1_2_10_35_1","article-title":"Enteral versus parenteral nutrition and enteral versus a combination of enteral and parenteral nutrition for adults in the intensive care unit","volume":"6","author":"Lewis SR","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0064926"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.892770"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200112000-00005"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38118.593900.55"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-007-0362-1"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1080\/01635581.2017.1324996"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607110385698"},{"issue":"10","key":"e_1_2_10_43_1","article-title":"Early enteral nutrition (within 48 hours) versus delayed enteral nutrition (after 48 hours) with or without supplemental parenteral nutrition in critically ill adults","volume":"2019","author":"Padilla PF","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/dote.12337"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114508123443"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.143.11.1111"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003445"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/jpen.1139"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/698248"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1159\/000094345"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-013-1089-y"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.3892\/etm.2016.3559"},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000011871"},{"key":"e_1_2_10_54_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003152"},{"issue":"3","key":"e_1_2_10_55_1","article-title":"Early versus delayed enteral nutrition support for burn injuries","author":"Wasiak J","year":"2006","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_56_1","doi-asserted-by":"publisher","DOI":"10.1080\/10376178.2018.1513809"},{"key":"e_1_2_10_57_1","doi-asserted-by":"publisher","DOI":"10.21037\/apm-21-3071"},{"key":"e_1_2_10_58_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.51.6685"},{"key":"e_1_2_10_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinre.2020.101594"},{"key":"e_1_2_10_60_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000014864"},{"key":"e_1_2_10_61_1","doi-asserted-by":"publisher","DOI":"10.1136\/jim-2016-000083"},{"issue":"5","key":"e_1_2_10_62_1","first-page":"4755","article-title":"Early versus delayed enteral nutrition in critically ill patients: a meta\u2010analysis of randomized controlled trials","volume":"12","author":"Zheng X\u2010X","year":"2019","journal-title":"Int J Clin Exp Med"},{"key":"e_1_2_10_63_1","doi-asserted-by":"publisher","DOI":"10.1159\/000353136"},{"key":"e_1_2_10_64_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13741-021-00179-3"},{"key":"e_1_2_10_65_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-015-0737-8"},{"key":"e_1_2_10_66_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0954422420000165"},{"key":"e_1_2_10_67_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607115621863"},{"key":"e_1_2_10_68_1","doi-asserted-by":"publisher","DOI":"10.1177\/0115426592007003100"},{"key":"e_1_2_10_69_1","doi-asserted-by":"publisher","DOI":"10.1097\/shk.0b013e31805569df"},{"key":"e_1_2_10_70_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1091-255X(99)80067-5"},{"key":"e_1_2_10_71_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0899-9007(98)00047-1"},{"key":"e_1_2_10_72_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0712140105"},{"key":"e_1_2_10_73_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40560-017-0245-9"},{"key":"e_1_2_10_74_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v16.i26.3310"},{"key":"e_1_2_10_75_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.42.3.431"},{"key":"e_1_2_10_76_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1409860"},{"key":"e_1_2_10_77_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32146-3"},{"key":"e_1_2_10_78_1","doi-asserted-by":"publisher","DOI":"10.4037\/ccn2014243"},{"key":"e_1_2_10_79_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-009-1744-5"},{"key":"e_1_2_10_80_1","doi-asserted-by":"publisher","DOI":"10.1210\/en.2011-2068"},{"issue":"8","key":"e_1_2_10_81_1","first-page":"621","article-title":"Effect of tolerating macronutrient deficit on the development of intensive\u2010care unit acquired weakness: a subanalysis of the EPaNIC trial","volume":"1","author":"Hermans G","year":"2013","journal-title":"Lancet"},{"key":"e_1_2_10_82_1","doi-asserted-by":"publisher","DOI":"10.1002\/jpen.1930"},{"key":"e_1_2_10_83_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199902000-00024"},{"key":"e_1_2_10_84_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000001311"},{"key":"e_1_2_10_85_1","doi-asserted-by":"publisher","DOI":"10.1002\/jpen.1996"},{"key":"e_1_2_10_86_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v12.i27.4352"},{"key":"e_1_2_10_87_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.00335.2015"},{"key":"e_1_2_10_88_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000011874"},{"key":"e_1_2_10_89_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2002.05979.x"},{"key":"e_1_2_10_90_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200011000-00007"},{"key":"e_1_2_10_91_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa011300"},{"key":"e_1_2_10_92_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.323.7316.773"},{"issue":"2","key":"e_1_2_10_93_1","first-page":"60","article-title":"Enteral nutrition in severe acute pancreatitis: future development","volume":"5","author":"Dervenis C","year":"2004","journal-title":"JOP"},{"key":"e_1_2_10_94_1","doi-asserted-by":"publisher","DOI":"10.1159\/000051964"},{"key":"e_1_2_10_95_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCO.0b013e32835c1fa5"},{"key":"e_1_2_10_96_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2010.08.003"},{"key":"e_1_2_10_97_1","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivu324"},{"key":"e_1_2_10_98_1","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/3047732"},{"key":"e_1_2_10_99_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2016.04.005"}],"container-title":["Nutrition in Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ncp.10976","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ncp.10976","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ncp.10976","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T12:31:20Z","timestamp":1760963480000},"score":1,"resource":{"primary":{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ncp.10976"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,12]]},"references-count":98,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1002\/ncp.10976"],"URL":"https:\/\/doi.org\/10.1002\/ncp.10976","archive":["Portico"],"relation":{},"ISSN":["0884-5336","1941-2452"],"issn-type":[{"value":"0884-5336","type":"print"},{"value":"1941-2452","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,12]]},"assertion":[{"value":"2022-08-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}