Clinical nutritional assessment: A perspective

Hooley, Ruth

doi:10.1016/s1094-7159(21)03591-1

Cited by 7 publications

(1 citation statement)

References 11 publications

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“…The concept was reinforced in 1979 when Seltzer et al ( 35 ) recommended that serum albumin be 1 of 2, the other being total lymphocyte count, biochemical parameters for an “instant nutrition assessment”. Subsequently, serum albumin and transferrin became highly utilized markers of malnutrition for hospitalized patients ( 36 , 37 ). However, clinicians at this time simply considered inflammation to be an identifying symptom of malnutrition and not a causative agent, as would be discovered later.…”

Section: Evolution Of Diagnostic Framework For Diagnosing Malnutritionmentioning

confidence: 99%

Evolution of the diagnosis of malnutrition in adults: a primer for clinicians

Hegazi,

Miller,

Sauer

2024

Front. Nutr.

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During the last two decades, the definition, diagnosis, and management of malnutrition have significantly evolved. Malnutrition is generally defined as deficiencies, excesses, or imbalances in a person’s intake of energy and/or nutrients. While malnutrition is associated with a significantly increased risk of morbidity, mortality, and healthcare cost, it is often underdiagnosed both in healthcare and community settings. One contributing factor is the lack of a consensus on its definition and appropriate diagnostic indicators. In the current article, we review the evolution of frameworks for the diagnosis of malnutrition. Recently published consensuses by prominent clinical nutrition societies have established a trajectory for the uniform global diagnosis of malnutrition. Limiting the use of body mass index (BMI) as a diagnostic criterion while emphasizing the use of muscle mass enables a more consistent and accurate diagnosis of malnutrition in the clinical setting. Guidance for the unified methodology and terminology for diagnosing malnutrition, such as the one proposed in the current article will enable policy makers to systematically address the two faces of malnutrition, starvation- and disease-related malnutrition applicable to both pediatric and adult populations. Policies and programs that could address issues of food insecurity and scarcity as well as early diagnosis and management of disease-related malnutrition will empower better care of community nutrition.

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Section: Evolution Of Diagnostic Framework For Diagnosing Malnutritionmentioning

confidence: 99%

Evolution of the diagnosis of malnutrition in adults: a primer for clinicians

Hegazi,

Miller,

Sauer

2024

Front. Nutr.

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Nutritional status in advanced upper gastrointestinal cancer

Singh

1985

Journal of Surgical Oncology

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Fifty-four patients with advanced upper gastrointestinal cancer were assessed for their nutritional status prior to any form of therapy. Anthropometric parameters--weight loss, arm muscle circumference, skin-fold thickness--and biochemical parameters--serum albumin and delayed cutaneous hypersensitivity reactions to purified protein derivative (PPD) and phytohemagglutinin (PHA)--were used for nutritional assessment. Using standard values for comparison, about 80% of all patients were found to be nutritionally depleted. Immunocompetence did not show significant correlation with other nutritional parameters.

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The Use of Visceral Proteins as Nutrition Markers: An ASPEN Position Paper

et al. 2020

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Serum albumin and prealbumin, well‐known visceral proteins, have traditionally been considered useful biochemical laboratory values in a nutrition assessment. However, recent literature disputes this contention. The aim of this document is to clarify that these proteins characterize inflammation rather than describe nutrition status or protein‐energy malnutrition. Both critical illness and chronic illness are characterized by inflammation and, as such, hepatic reprioritization of protein synthesis occurs, resulting in lower serum concentrations of albumin and prealbumin. In addition, the redistribution of serum proteins occurs because of an increase in capillary permeability. There is an association between inflammation and malnutrition, however, not between malnutrition and visceral‐protein levels. These proteins correlate well with patients’ risk for adverse outcomes rather than with protein‐energy malnutrition. Therefore, serum albumin and prealbumin should not serve as proxy measures of total body protein or total muscle mass and should not be used as nutrition markers. This paper has been approved by the American Society for Parenteral and Enteral Nutrition Board of Directors.

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Clinical nutritional assessment: A perspective

Cited by 7 publications

References 11 publications

Evolution of the diagnosis of malnutrition in adults: a primer for clinicians

Evolution of the diagnosis of malnutrition in adults: a primer for clinicians

Nutritional status in advanced upper gastrointestinal cancer

The Use of Visceral Proteins as Nutrition Markers: An ASPEN Position Paper

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