• Luc Cynober.
• Biochemistry Laboratory, Hôtel-Dieu Hospital AP-HO, and Nutrition Laboratory, University Paris 5, Paris, France. solange.ngon@htd.ap-hop-paris.fr
• Curr Opin Clin Nutr Metab Care. 2003 Mar 1; 6 (2): 189-93.

Purpose Of ReviewAfter 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.Recent FindingsThe 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.SummaryIn light of the current doubts and until convincing data are produced, immune-enhancing diets should not be used in unstable critically ill patients.

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