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Malnutrition has been known in hospital and outpatient care for more than 30 years. It is estimated that an average of 30% of patients are affected, and in the majority of cases the problem remains unrecognized and untreated. Moreover, this disease-related malnutrition increases health costs by 30-70% as recent studies have shown, exceeding even the costs of obesity. Nutrition interventions, generating in comparison only a small cost, may therefore result in substantial absolute savings. This publication gives an overview of the current state of affairs in Europe and the US, also examining the economics of malnutrition. Also discussed are reimbursement models for enteral nutrition as well as regulatory aspects and their impact on practice. The book closes with a discussion of future challenges and opportunities. Considering the extent of the problem, this publication will be of interest not only to doctors directly involved in the care of patients, but also to policy makers and administrative personnel.

Among inflammatory bowel diseases, Crohn's disease and ulcerative colitis are of particular importance to gastroenterologists treating both children and adults. Although the etiology of these diseases is still largely unknown, knowledge of their immunopathology is increasing. Typically, proinflammatory cytokine production is abnormal, and particularly in Crohn's disease, the consequent inflammation is responsive to nutritional intervention or anticytokine therapy. The contributions in this volume focus on nutritional therapy, which is important for both the repletion of associated protein-energy malnutrition and for modulation of the inflammatory response. Highlights include the growing role of enteral nutrition as primary therapy in pediatric practice and investigations into the ideal diet composition, including type of formula (polymeric, protein hydrolysate or amino acid). Furthermore, the pro- and anti-inflammatory effects of omega-6 and omega-3 fatty acids, respectively, and their impact on clinical response receive special attention. This publication offers a wealth of information for gastroenterologists dealing with both adults and children, as well as for clinical and research nutritionists, clinical immunologists and others interested in dietetic therapy.