Protein-energy malnutrition is a common problem in hospital patients. Studies have reported that 40% of surgical and medical patients are malnourished on admission to the hospital. Most patients experienced nutritional depletion during their hospital admission, which was more severe in those patients who were already depleted at the time of their admission. The consequences of pre-operative malnutrition were first recognized in the 1930s. It was observed that a direct relationship between preoperative weight loss and operative mortality rate, independent of factors such as age, impaired cardiorespiratory function, and type of surgery. The importance of nutritional depletion as a major determinant of the development of postoperative complications has subsequently been confirmed the absence of a standardized definition of nutritional depletion has led to surrogate markers of nutritional status being utilized. Albumin, muscle function tests, immunological status and weight loss are used as these show correlation with postoperative morbidity and mortality. Traditional restrictions on oral intake after surgery are not based on scientific evidence. Several historical issues such as postoperative nausea, vomiting and ileus plus fears of anastomotic dehiscence has led to the practice of restrictive postoperative oral nutrition (nil per mouth). In addition to early oral feeding, dietary supplementation can provide added benefits in terms of reduction in fatigue, weight loss and overall morbidity in patients who are normal swell as malnourished. The combination of specific nutrients such as arginine, Nucleotides, 3 fatty acids and glutamine (i.e., immune nutrition) has been shown to improve nutritional, immunological and inflammatory parameters. A recent systematic review has shown that in elective surgical patients, immune nutrition can lead to a significantly lower

Early Oral Feeding, Postoperative Dietary Supplement