Module 9 References-White et al J Parenter Enteral Nutr 2012 Consensus Statement Identification and documentation of adult malnutrition

White et al J Parenter Enteral Nutr 2012 Consensus Statement Identification and documentation of adult malnutrition

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The document is a consensus statement from the Academy of Nutrition and Dietetics and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) published in the *Journal of Parenteral and Enteral Nutrition*. It discusses the identification and documentation of adult malnutrition, emphasizing adult undernutrition.<br /><br />Malnutrition is an imbalance in nutrition, and although this statement focuses on undernutrition, it also acknowledges the significant impact of obesity. Undernutrition occurs along a continuum of inadequate intake, increased requirements, impaired absorption, and altered nutrient utilization, often exacerbated by inflammation, which is a critical factor in malnutrition risk and intervention response.<br /><br />The consensus calls for a standardized approach to diagnosing adult malnutrition, which would help in recognizing and estimating its prevalence, guiding interventions, and improving patient outcomes while managing healthcare costs. The diagnostic criteria for adult malnutrition should include attributes reflecting nutrition status versus the inflammatory response. Identified characteristics include insufficient energy intake, weight loss, loss of muscle mass, loss of subcutaneous fat, fluid accumulation, and diminished functional status as measured by handgrip strength.<br /><br />A significant part of this effort is to develop a universally accepted approach for defining, diagnosing, and documenting malnutrition using reliable and valid screening tools. The statement also critiques the reliance on serum albumin and prealbumin as primary diagnostic indicators, given their poor correlation with nutrition status in the context of inflammation.<br /><br />The document highlights the need for routine assessment of these characteristics on patient admission and at frequent intervals during their stay across various healthcare settings. It also mentions the use of a standardized set of diagnostic characteristics, urging healthcare teams to determine accurate approaches to the measurement and documentation of malnutrition to predict the human and financial burdens effectively.<br /><br />The statement ends with a call to action for short- and long-term steps, including the establishment of tracking systems, standardized data collection, educational opportunities for healthcare professionals, and determining appropriate malnutrition and inflammatory markers to improve practice, documentation, and public health outcomes.

Keywords

adult malnutrition

undernutrition

nutrition imbalance

inflammation

diagnostic criteria

energy intake

muscle mass loss

screening tools

healthcare costs

public health outcomes