Nutritional deficiency in general practice: a systematic review

Abstract

Objective: Nutritional deficiency is an independent risk factor for mortality. Despite its clinical relevance, the prevalence in a primary care setting is poorly documented. We performed a systematic review of reported prevalence and clinical assessment of nutritional deficiency in general practice. Methods: From MEDLINE, Current Contents and EMBASE, we derived articles and checked the initially included ones for references on prevalence data. Of the eligible articles, we assessed the quality of research and results. Results: We finally included eight studies. The prevalence ranged from 0 to 13%. However, the study populations were heterogeneous and all studies contained methodological flaws, especially selection bias. In addition, the clinical assessment differed between studies. Conclusion: Literature on the prevalence of nutritional deficiency within general practice is rare and provides disputable prevalence assessments.

High prevalence of undernutrition in Dutch community-dwelling older individuals

“…Studies determining the prevalence of undernutrition in community-dwelling older individuals are scarce. Depending on the specific older study population and the definition used to determine undernutrition, prevalences range from 0 to 24% [16], [30] and [31]. More knowledge about the prevalence in the specific populations at risk of undernutrition in the home situation is needed to provide recommendations for the assessment and treatment of undernutrition in community-dwelling older individuals.…”

Nutritional deficiency in Dutch primary care: data from general practice research and registration networks

“…Comparison to the literature The few empirical data on nutrition deficiency in primary care reported percentages of 0-13% (van Wayenburg et al, 2005), which suggests a (much) higher impact of morbidity than came forward from the data of the networks presented. The elderly aged 75 y and older could be clearly identified as a population at risk for nutritional deficiency, which is in line with the literature (de Groot et al, 1999).…”

“…For this reason elderly people, particularly when suffering from chronic diseases, are at increased risk for nutritional deficiency. We previously found in the literature, the prevalence rates for nutritional deficiency in general practice of 9-13% (chronically ill) and 0-12% (elderly) (van Wayenburg et al, 2005). However, only few studies were available and all had methodological flaws.…”

Seeking the balance between individual and community-based nutritional interventions

“…A single paper presented during the conference identified inadequate (ie under) nutrition in the elderly and many hospitalized patients as a significant problem. (van Wayenburg et al, 2005). It was pointed out that these individuals are admitted from the community and are discharged back to the community where there is almost no strategy or plan for their monitoring or for improving their nutritional status.…”