• Clin Nutr · Apr 2010

    Practice Guideline

    Adult starvation and disease-related malnutrition: a proposal for etiology-based diagnosis in the clinical practice setting from the International Consensus Guideline Committee.

    • Gordon L Jensen, Jay Mirtallo, Charlene Compher, Rupinder Dhaliwal, Alastair Forbes, Rafael Figueredo Grijalba, Gil Hardy, Jens Kondrup, Demetre Labadarios, Ibolya Nyulasi, Juan Carlos Castillo Pineda, Dan Waitzberg, and International Consensus Guideline Committee.
    • Department of Nutritional Sciences, 110 Chandlee Lab, Penn State University, University Park, PA 16802, USA. glj1@psu.edu
    • Clin Nutr. 2010 Apr 1;29(2):151-3.

    Background & AimsMultiple definitions for malnutrition syndromes are found in the literature resulting in confusion. Recent evidence suggests that varying degrees of acute or chronic inflammation are key contributing factors in the pathophysiology of malnutrition that is associated with disease or injury.MethodsAn International Guideline Committee was constituted to develop a consensus approach to defining malnutrition syndromes for adults in the clinical setting. Consensus was achieved through a series of meetings held at the ASPEN and ESPEN Congresses.ResultsIt was agreed that an etiology-based approach that incorporates a current understanding of inflammatory response would be most appropriate. The Committee proposes the following nomenclature for nutrition diagnosis in adults in the clinical practice setting. "Starvation-related malnutrition", when there is chronic starvation without inflammation, "chronic disease-related malnutrition", when inflammation is chronic and of mild to moderate degree, and "acute disease or injury-related malnutrition", when inflammation is acute and of severe degree.ConclusionsThis commentary is intended to present a simple etiology-based construct for the diagnosis of adult malnutrition in the clinical setting. Development of associated laboratory, functional, food intake, and body weight criteria and their application to routine clinical practice will require validation.Copyright 2009 European Society for Clinical Nutrition and Metabolism and ASPEN American Society for Parenteral and Enteral Nutrition. Published by Elsevier Ltd.. All rights reserved.

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