Although these trials were smaller than originally designed, they provide practical information that can guide decisions about feeding stroke survivors. First, routine oral supplementation probably does not improve outcomes in many patients with acute stroke. Whether oral supplementation may be beneficial, specifically in undernourished patients after stroke, is not known, although Milne and colleagues' meta-analysis in this issue (6) suggests that oral supplementation may be associated with reduced mortality in general in hospitalized patients who are undernourished. Second, early tube feeding does not seem to benefit and, in fact, may harm patients. Thus, clinicians can feel comfortable in initially hydrating a patient who has had a stroke, observing swallowing function for at least several days, and taking the time to thoughtfully discuss issues of tube feeding with the patient and family. These trials also are reassuring in that only 28% of patients who received nasogastric tube feeding in the second trial later required a PEG tube; therefore, providing nutrition through a nasogastric tube does not inevitably lead to long-term supplementation through a PEG tube. The PEG tubes should, therefore, be reserved for patients with previous stroke who cannot swallow safely after 2 to 3 weeks of nasogastric feeding. In this group of patients, PEG tubes are not only safer but also may be associated with decreased mortality compared with long-term nasogastric feeding (7 - 8).