As mentioned in my post last week, we have a problem of malnutrition in the clinical setting and a second problem is the gap between prevalence and actual diagnosis of malnutrition. In Argentina and many other countries, there is no consensus on how to diagnose malnutrition and criteria like ASPEN/Academy or ESPEN are barely used. The Subjective Global Assessment (SGA) tool is sometimes more popular. Its good to know now that, a few weeks ago, during ESPEN Congress, the Criteria for the Diagnosis of Malnutrition — a Consensus Report from the Global Clinical Nutrition Community were released. The report provides the much needed global consensus scheme for diagnosing malnutrition in adults in clinical settings. It was elaborated by the Global Leadership Initiative on Malnutrition (GLIM) working group with representatives from ASPEN, ESPEN, the Latin American Federation for Parenteral and Enteral Nutrition (FELANPE), and the Parenteral and Enteral Nutrition Society of Asia (PENSA). The consensus document can be found at doi.org/10.1002/jpen.1440 .
The five criteria for malnutrition include unintentional weight loss, low body mass index, and reduced muscle mass as phenotypic criteria, and reduced food intake/assimilation and inflammation/disease burden as etiologic criteria. It is proposed that the diagnosis of malnutrition be based upon the presence of at least one phenotypic criterion and one etiologic criterion. The severity of phenotypic criteria classifies malnutrition into severe or moderate (note that poor oral intake is not used to determine moderate vs severe malnutrition)
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Noviembre 2018
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