Schuetz P, et al. – In EFFORT—a pragmatic, investigator-initiated, open-label, multicenter study—researchers investigated whether protocol-guided individualized nutritional support to reach protein and caloric goals reduces the risk of adverse clinical outcomes in medical inpatients at nutritional risk. The study sample consisted of 2,088 medical patients at nutritional risk (nutritional risk screening 2002 score ≥ 3 points) with an expected length of hospital stay of > 4 days from eight Swiss hospitals. Patients were randomized (1:1) to receive either protocol-guided individualized nutritional support to reach protein and caloric goals (intervention group; n=1,050) or standard hospital food (control group; n=1,038). A total of 35 and 25 patients in the intervention and control groups, respectively, withdrew consent during the trial. During the hospital stay, 79% of patients reached caloric goals, and 76% reached protein goals in the intervention group. By 30 days, however, 23% of patients in the intervention group experienced an adverse event vs 27% of patients in the control group. By day 30, 7% of patients had died in the intervention group vs 10% in the control group. There was no difference in the proportion of patients who experienced side-effects from nutritional support between the two groups. Overall, compared with standard hospital food, the implementation of individualized nutritional support during the hospital stay improved important clinical outcomes, such as survival, in medical inpatients at nutritional risk. Findings from this study support the strategy of systematically screening medical inpatients upon hospitalization regarding nutritional risk, irrespective of their medical condition, followed by a nutritional assessment and introduction of individualized nutritional support in at-risk patients.