The previous studies assessing malnutrition have used weight loss or BMI as a proxy for nutritional status20 21 or laboratory values.6 22 In an Italian case–control study, serum albumin levels were higher at days 1, 3 and 8 in patients undergoing HMIE, compared with OE.22 An American study suggested earlier oral intake in patients who underwent MIE, compared with OE.6 The results from the current study suggest that MIE has a greater negative effect on the patients’ food intake, compared with OE, which is the opposite of what we hypothesised a priori. Here, ALB is linked to malnutrition.