Adult starvation and disease-related malnutrition: A proposal for etiology-based diagnosis in the clinical practice setting from the International Consensus Guideline Committee
Abstract
Background & aims Multiple 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. Methods An 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. Results It 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. Conclusions This 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.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Patients with malnutrition and without inflammation could be classified as having 'Starvation-Related Malnutrition'.
“Patients with malnutrition and without inflammation could be classified as having “Starvation-Related Malnutrition.””
From Evolution of the diagnosis of malnutrition in adults: a primer for clinicians (2024) · cites this paper as [7]
In 2010, Jensen et al. suggested that inflammation-associated catabolism of skeletal muscle is a differentiating factor in the diagnosis of malnutrition and proposed an approach based upon etiology that incorporated the impact of the inflammatory response.
“In 2010 (Figure 1), Jensen et al. (7) suggested that inflammation-associated catabolism of skeletal muscle is a differentiating factor in the diagnosis of malnutrition and proposed an approach based upon etiology that incorporated the impact of the inflammatory response.”
From Evolution of the diagnosis of malnutrition in adults: a primer for clinicians (2024) · cites this paper as [7]
If inflammation is present at a mild to moderate degree, the patient could be classified as having 'Chronic Disease-Related Malnutrition'.
“If inflammation is present at a mild to a moderate degree, the patient could be classified as having “Chronic Disease-Related Malnutrition.””
From Evolution of the diagnosis of malnutrition in adults: a primer for clinicians (2024) · cites this paper as [7]
Undernutrition among adults can develop due to either starvation and/or disease-related inflammation, often due to acute injury or chronic disease.
“However, undernutrition among adults can develop due to either starvation and/or disease-related inflammation, often due to acute injury or chronic disease (7, 8).”
From Evolution of the diagnosis of malnutrition in adults: a primer for clinicians (2024) · cites this paper as [7]
If inflammation is present to a severe degree, the patient could be categorized as having 'Acute Disease or Injury-Related Malnutrition'.
“If inflammation is present to a severe degree, the patient could be categorized as having “Acute Disease or Injury-Related Malnutrition.””
From Evolution of the diagnosis of malnutrition in adults: a primer for clinicians (2024) · cites this paper as [7]
Acute or chronic inflammation results in altered body composition and reduced biological function, contributing to malnutrition via reduced food intake, increased resting energy expenditure, and muscle catabolism.
“It is commonly accepted that acute or chronic inflammation results in altered body composition and reduced biological function (7, 63), which contributes to malnutrition in several ways, including reduced food intake, increased resting energy expenditure, and muscle catabolism.”
From Evolution of the diagnosis of malnutrition in adults: a primer for clinicians (2024) · cites this paper as [7]
Modern guidelines for diagnosing malnutrition such as AND/ASPEN 2012 and GLIM 2018 incorporate screening and classification of patients based on inflammatory status, based on the work of Jensen et al.
“Based on the work of Jensen et al. (7), modern guidelines for diagnosing malnutrition such as AND/ASPEN 2012 and GLIM 2018 incorporate screening and classification of patients based on their inflammatory status.”
From Evolution of the diagnosis of malnutrition in adults: a primer for clinicians (2024) · cites this paper as [7]
Cites
Sarcopenic obesity: A new category of obesity in the elderly
Zamboni, M., Mazzali, G., Fantin, F., Rossi, A., & Di Francesco, V. (2008) · Nutrition, Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2007.10.002 · Cited by 953 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
ESPEN guidelines on definitions and terminology of clinical nutrition
Cederholm, T., Barazzoni, R., Austin, P., Ballmer, P., Biolo, G., Bischoff, S. C., Compher, C., Correia, I., Higashiguchi, T., Holst, M., et al. (2017) · Clinical Nutrition · doi:10.1016/j.clnu.2016.09.004 · Cited by 2,560 · see citing works
Self-citationDiagnostic criteria for malnutrition – An ESPEN Consensus Statement
Cederholm, T., Bosaeus, I., Barazzoni, R., Bauer, J., Van Gossum, A., Klek, S., Muscaritoli, M., Nyulasi, I., Ockenga, J., Schneider, S. M., et al. (2015) · Clinical Nutrition · doi:10.1016/j.clnu.2015.03.001 · Cited by 1,755 · see citing works
Self-citationBaijens, L. W., Clavé, P., Cras, P., Ekberg, O., Forster, A., Kolb, G., Leners, J. C., Masiero, S., Mateos del Nozal, J., Ortega, O., et al. (2016) · Clinical Interventions in Aging · doi:10.2147/cia.s107750 · Cited by 773 · see citing works
Nutritional considerations for healthy aging and reduction in age-related chronic disease
Shlisky, J., Bloom, D. E., Beaudreault, A. R., Tucker, K. L., Keller, H. H., Freund-Levi, Y., Fielding, R. A., Cheng, F. W., Jensen, G. L., Wu, D., et al. (2017) · Advances in Nutrition · doi:10.3945/an.116.013474 · Cited by 462 · see citing works
Self-citationVandewoude, M. F. J., Alish, C. J., Sauer, A. C., & Hegazi, R. A. (2012) · Journal of Aging Research · doi:10.1155/2012/651570 · Cited by 214 · see citing works
Stoppe, C., Goetzenich, A., Whitman, G., Ohkuma, R., Brown, T., Hatzakorzian, R., Kristof, A., Meybohm, P., Mechanick, J., Evans, A., et al. (2017) · Critical Care · doi:10.1186/s13054-017-1690-5 · Cited by 138 · see citing works
Keller, H., de van der Schueren, M. A. E., for the GLIM Consortium, Jensen, G. L., Barazzoni, R., Compher, C., Correia, M. I. T. D., Gonzalez, M. C., Jager‐Wittenaar, H., Pirlich, M., et al. (2020) · Journal of Parenteral and Enteral Nutrition · doi:10.1002/jpen.1806 · Cited by 131 · see citing works
Self-citationCederholm, T., Jensen, G. L., Ballesteros-Pomar, M. D., Blaauw, R., Correia, M. I. T. D., Cuerda, C., Evans, D. C., Fukushima, R., Ochoa Gautier, J. B., Gonzalez, M. C., et al. (2024) · Clinical Nutrition · doi:10.1016/j.clnu.2023.11.026 · Cited by 115 · see citing works
Self-citationJensen, G. L., Cederholm, T., Ballesteros‐Pomar, M. D., Blaauw, R., Correia, M. I. T. D., Cuerda, C., Evans, D. C., Fukushima, R., Gautier, J. B. O., Gonzalez, M. C., et al. (2024) · Journal of Parenteral and Enteral Nutrition · doi:10.1002/jpen.2590 · Cited by 84 · see citing works
Self-citationEvolution of the diagnosis of malnutrition in adults: a primer for clinicians
Hegazi, R., Miller, A., & Sauer, A. (2024) · Frontiers in Nutrition · doi:10.3389/fnut.2024.1169538 · Cited by 26 · see citing works
- Authors
- Jensen, G. L., Mirtallo, J., Compher, C., Dhaliwal, R., Forbes, A., Grijalba, R. F., Hardy, G., Kondrup, J., Labadarios, D., Nyulasi, I., Castillo Pineda, J. C., & Waitzberg, D.
- Affiliations
- Pennsylvania State University (US)
- The Ohio State University Wexner Medical Center (US)
- University of Pennsylvania (US)
- Kingston General Hospital (CA)
- University College Hospital (GB)
- Universidad Nacional de Asunción (PY)
- University of Auckland (NZ)
- University of Copenhagen (DK)
- Human Sciences Research Council (ZA)
- The Alfred Hospital (AU)
- Universidade de São Paulo (BR)
- Corresponding author
- Jensen, Gordon L.
- ORCID
- Venue
- Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2010-04
- Volume
- 29
- Issue
- 2
- Pages
- 151-153
- ISSN
- 0261-5614 (ISSN-L)
- OpenAlex
- W2016965180
- Cited by
- 270
- References
- 1
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 19 · 2023: 15 · 2022: 11 · 2021: 27 · 2020: 28 · 2019: 29 · 2018: 11 · 2017: 13 · 2016: 28 · 2015: 13 · 2014: 16 · 2013: 23 · 2012: 10
- FWCI
- 15.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Scientific Electronic Library Online (São Paulo Research Foundation, Latin American and Caribbean Center on Health Sciences Information, Conselho Nacional de Desenvolvimento Científico e Tecnológico) (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Health Professions › Health Information Management › Dietetics, Nutrition, and Education
- Keywords
- adult malnutrition, chronic inflammation, acute inflammation, consensus recommendations
- MeSH terms
- Acute Disease, Adult, Chronic Disease, Humans, Inflammation, Terminology as Topic, Starvation, Wounds and Injuries, Malnutrition
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
