According to Gram Research analysis, most Turkish ICU patients aren’t receiving their full nutritional needs despite hospitals generally following feeding guidelines. A 2025 study of 98 critically ill patients found that only 27.6% achieved 100% of both calorie and protein targets, with patients averaging 87% of needed calories and 82% of needed protein. Patients with multiple health conditions, higher weight, or kidney problems faced the biggest challenges meeting nutritional goals, suggesting that sicker patients need more targeted nutrition support.
Researchers in Turkey studied how well hospitals are feeding critically ill patients through feeding tubes. They looked at 98 patients in intensive care units and compared actual feeding practices to medical guidelines. While hospitals were generally following the rules about when and how to start tube feeding, most patients weren’t actually receiving their full nutritional needs. Only about 28% of patients got 100% of the calories and protein they needed. The study shows that even when hospitals follow guidelines, sicker patients with more health problems often fall short on nutrition, which could affect their recovery.
Key Statistics
A 2025 cross-sectional study of 98 ICU patients in Turkey found that only 27.6% achieved 100% of their required calorie and protein targets, despite 73.5% starting tube feeding within the recommended 48-hour window.
According to research reviewed by Gram, critically ill patients with multiple health conditions were significantly less likely to meet nutritional targets, with failure to achieve goals associated with higher comorbidity counts (p=0.007), elevated body mass index (p=0.017), and kidney dysfunction (p=0.041).
A 2025 Turkish ICU study found that patients receiving tube feeding averaged 87% of their needed calories and 82% of their needed protein, indicating a substantial gap between recommended and actual nutrition delivery in intensive care settings.
Research from six Turkish ICUs in 2025 revealed that 14.3% of patients continued receiving tube feeding despite medical contraindications, and these patients had significantly higher severity scores, suggesting need for clearer protocols on when to pause feeding.
The Quick Take
- What they studied: Whether Turkish intensive care units are properly feeding critically ill patients through feeding tubes according to medical guidelines, and whether patients are actually receiving the nutrition they need to recover.
- Who participated: 98 adult patients (average age 72 years, 61% male) who stayed in ICUs for at least 2 days and received tube feeding for at least 1 day across six hospitals in Turkey during July and August 2025.
- Key finding: While 73.5% of patients started tube feeding within the recommended 48-hour window, only 27.6% actually received 100% of their required calories and protein. Patients with more health problems were significantly less likely to meet their nutritional goals.
- What it means for you: If you or a loved one is in an ICU, hospitals are generally following feeding guidelines, but there’s a real gap between what patients should receive and what they actually get. Sicker patients face the biggest challenges meeting their nutrition needs, which could slow recovery.
The Research Details
Researchers conducted a point-prevalence study, which is like taking a snapshot at specific moments in time rather than following patients over weeks or months. They looked at all eligible patients in six Turkish ICUs on two specific dates: July 30 and August 30, 2025. This approach is useful for quickly understanding current practices without the time and expense of long-term studies.
The researchers didn’t change anything about how hospitals fed patients—they simply observed and recorded what was already happening. They checked whether practices matched recommendations from three major nutrition organizations: European, American, and Turkish clinical nutrition societies. They looked at when feeding started, what type of feeding tube was used, how much patients were fed, and whether feeding was stopped when it should have been.
This research approach is important because it shows real-world practices in actual hospitals, not ideal conditions in research settings. By comparing what hospitals actually do to established guidelines, the study identifies specific areas where improvements are needed. Understanding these gaps helps hospitals make targeted changes to improve patient outcomes.
This study has several strengths: it included all eligible patients (no cherry-picking), used objective measurements, and compared practices to internationally recognized guidelines. However, it’s limited to six hospitals in one country, so results may not apply everywhere. The study was observational only, meaning researchers couldn’t prove that guideline adherence directly improves patient outcomes. The relatively small sample size (98 patients) means some findings should be interpreted cautiously.
What the Results Show
The study found that hospitals in Turkey are generally doing well at following the basic rules about tube feeding. About 73.5% of patients started receiving nutrition within the recommended 48-hour window, which is important because early feeding helps prevent complications. However, the real problem emerged when researchers looked at whether patients actually received enough nutrition.
Only 27.6% of patients got 100% of both their calorie and protein targets. On average, patients received 87% of their needed calories and 82% of their needed protein. This gap is significant because adequate nutrition is crucial for critically ill patients to fight infection, heal wounds, and recover from their illness.
The study identified which patients struggled most: those with multiple health conditions, higher body weight, or kidney problems were significantly less likely to meet their nutritional targets. Interestingly, patients who were sicker (measured by severity scores) sometimes continued receiving tube feeding even when it wasn’t appropriate, suggesting doctors may need better guidance on when to pause or stop feeding.
The research revealed that 14.3% of patients continued receiving tube feeding despite having medical reasons to stop (contraindications). These patients tended to be much sicker overall, with higher severity scores. The study also found room for improvement in using medications that help the stomach move food through (prokinetic agents), though specific numbers weren’t detailed. These findings suggest that hospitals need better protocols for deciding when to pause feeding and clearer guidance on medication use.
This study aligns with previous research showing that achieving nutritional targets in ICU patients is challenging. Earlier studies from other countries have reported similar gaps between recommended and actual nutrition delivery. However, this Turkish study is valuable because it provides current data from 2025 and uses a standardized approach comparing multiple international guidelines. It confirms that the nutrition gap isn’t unique to one country or healthcare system—it’s a widespread challenge.
The study only looked at two specific dates, so it may not represent typical practices throughout the year. It included only six hospitals in Turkey, so results may not apply to other countries or regions with different healthcare systems. The study couldn’t prove that following guidelines actually improves patient outcomes—it only showed whether hospitals were following them. The relatively small number of patients (98) means some findings might change with a larger study. Finally, the study didn’t explore why patients weren’t receiving full nutrition, so we don’t know if it was due to medical complications, supply issues, or other factors.
The Bottom Line
Based on this research, ICU doctors and nutritionists should: (1) Continue starting tube feeding within 48 hours when appropriate—hospitals are doing this well; (2) Focus more effort on helping patients actually receive their full nutritional targets, especially those with multiple health conditions; (3) Develop clearer protocols for managing patients who need feeding paused due to medical complications; (4) Consider using stomach-motility medications more strategically to help patients tolerate full feeding. These recommendations have moderate confidence because the study shows current practices but doesn’t prove that changes will improve outcomes.
ICU doctors, nurses, and nutritionists should pay close attention to this research. Hospital administrators and quality improvement teams should use these findings to develop better feeding protocols. Patients and families should understand that while hospitals generally follow feeding guidelines, there’s often a gap between what patients should receive and what they actually get—this is worth discussing with the medical team. This research is less relevant to people who aren’t critically ill, as tube feeding practices in ICUs differ significantly from other settings.
Improvements in nutrition delivery could potentially affect patient outcomes within days to weeks. Better nutrition might reduce infection risk, speed wound healing, and shorten ICU stays. However, this study doesn’t provide specific timelines for seeing benefits, as it only measured current practices, not patient outcomes.
Frequently Asked Questions
Why do ICU patients not get enough nutrition even when hospitals follow feeding guidelines?
Hospitals often start feeding on time but struggle to deliver full amounts due to medical complications, feeding intolerance, or interruptions. Sicker patients with multiple health conditions face the biggest challenges. The study didn’t explore specific reasons, but barriers likely include stomach problems, medication side effects, and necessary feeding pauses for medical procedures.
What percentage of ICU patients actually receive their full nutritional needs?
Only 27.6% of patients in this 2025 Turkish study received 100% of both calorie and protein targets. Most patients received about 87% of needed calories and 82% of needed protein, showing a consistent gap between recommendations and actual delivery.
Does starting tube feeding early in the ICU really make a difference?
This study shows hospitals are doing well at starting feeding within 48 hours (73.5% of patients), which aligns with guidelines. However, the study didn’t measure whether early feeding actually improves outcomes—it only confirmed that hospitals are following this guideline.
Which ICU patients are most at risk for not getting enough nutrition?
Patients with multiple health conditions, higher body weight, or kidney problems were significantly less likely to meet nutritional targets in this study. Sicker patients overall faced more challenges, suggesting that the most vulnerable patients need extra attention to nutrition support.
Should families ask about nutrition targets when a loved one is in the ICU?
Yes. This research shows there’s often a gap between what patients should receive and what they actually get. Asking the medical team about daily calorie and protein delivery percentages helps ensure your loved one receives adequate nutrition, which is crucial for recovery.
Want to Apply This Research?
- If you’re tracking a loved one’s ICU care, ask the medical team daily: ‘What percentage of calorie and protein targets did the patient receive yesterday?’ Track this number in a simple spreadsheet or app. Aim for 80% or higher, and ask why if it drops below 70%.
- For caregivers: Request a meeting with the nutrition team to understand your loved one’s specific feeding plan. Ask about any barriers to meeting nutritional targets and what the team is doing to address them. For healthcare providers using a clinical app: Set daily reminders to review whether patients are meeting nutritional targets and document reasons if they’re not.
- Track weekly averages of calorie and protein delivery percentages. If a patient consistently receives less than 80% of targets, escalate to the nutrition team and physician. Monitor for changes in feeding tolerance, complications, or medical reasons for reduced feeding. Document any interventions attempted to improve nutrition delivery.
This research describes current practices in Turkish ICUs and should not be interpreted as medical advice. Nutrition decisions for critically ill patients must be made by qualified healthcare providers based on individual patient conditions, medical history, and clinical judgment. If you have questions about nutrition support for a patient in intensive care, discuss them directly with the ICU medical team and nutrition specialists. This study shows associations and current practices but does not prove that specific interventions will improve outcomes.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.