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Cited by 355Clinical Nutrition and GastroenterologyNutrition and Health in AgingDietetics, Nutrition, and Education

Management of disease-related malnutrition for patients being treated in hospital

Open access
Schuetz, Philipp, Seres, David, Lobo, Dileep N, Gomes, Filomena, Kaegi-Braun, Nina, Stanga, Zeno·2021·The Lancet
DOI 10.1016/s0140-6736(21)01451-3
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Abstract

Disease-related malnutrition in adult patients who have been admitted to hospital is a syndrome associated with substantially increased morbidity, disability, short-term and long-term mortality, impaired recovery from illness, and cost of care. There is uncertainty regarding optimal diagnostic criteria, definitions for malnutrition, and how to identify patients who would benefit from nutritional intervention. Malnutrition has become the focus of research aimed at translating current knowledge of its pathophysiology into improved diagnosis and treatment. Researchers are particularly interested in developing nutritional interventions that reverse the negative effects of disease-related malnutrition in the hospital setting. High-quality randomised trials have provided evidence that nutritional therapy can reduce morbidity and other complications associated with malnutrition in some patients. Screening of patients for risk of malnutrition at hospital admission, followed by nutritional assessment and individualised nutritional interventions for malnourished patients, should become part of routine clinical care and multimodal treatment in hospitals worldwide.

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Crossref · 10.1016/s0140-6736(21)01451-3

Cites

14 of 14 references verified0 citation errors · 0 not checkable

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  • Inflammation is a key factor with several important metabolic effects at a cellular level (e.g., increasing insulin resistance and inhibiting nutrition entering cells) and on organs such as the brain, intestines, and muscle (e.g., causing disease-related anorexia, reduced food intake, catabolism, and sarcopenia).

    “Thereby, inflammation is a key factor with several important metabolic effects on a cellular level (e.g., increase in insulin resistance leading to an inhibition of nutrition entering cells) and on different organs such as the brain (e.g., causing disease-related anorexia and reduced food intake), the intestines and on muscle (e.g., causing catabolism and sarcopenia).”

    From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [165]

  • Type of underlying disease, severity of disease, and extent of the acute-phase reaction have an impact on the effect of nutrition therapy.

    “There is growing evidence that type of underlying disease, severity of disease and extend of the acute-phase reaction have an impact on the effect of nutrition therapy [165].”

    From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [165]

  • These findings may explain differences in results of nutritional trials depending on clinical setting, with several nutritional studies in ICU settings or in patients with advanced cancer not showing significant benefits from nutrition in regard to clinical outcomes.

    “These findings may also explain differences in results of nutritional trials, depending on the clinical setting with several nutritional studies in the ICU setting or in patients with advanced cancer not showing significant benefits form nutrition in regard to clinical outcomes [165,168].”

    From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [165]

  • Patients with cachexia may show less response to nutritional intervention compared to patients with less severe stages or phenotypes of malnutrition.

    “For example, it has been known for long that patients with cachexia may show less response compared to patients with less severe stages or phenotypes of malnutrition [165,188].”

    From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [165]

  • Other studies found sarcopenia to be a predictor of non-response to nutritional treatment in mixed populations.

    “There are several studies looking at biomarkers of muscle strength and/or function with some suggesting that low muscle strength measured by HGS is a predictor for response [134] (Level of evidence 1þþ) while others found sarcopenia to be a predictor of non-response in mixed populations [165,188].”

    From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [165]

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Authors
Schuetz, P., Seres, D., Lobo, D. N., Gomes, F., Kaegi-Braun, N., & Stanga, Z.
Affiliations
  • Columbia University Irving Medical Center (US)
  • Nottingham University Hospitals NHS Trust (GB)
  • New York Academy of Sciences (US)
  • Kantonsspital Aarau (CH)
  • University of Bern (CH)
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2021-11
Volume
398
Issue
10314
Pages
1927-1938
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(21)01451-3
OpenAlex
W3205452795
Cited by
355
References
14
Citations by year
2026: 79 · 2025: 82 · 2024: 82 · 2023: 71 · 2022: 40 · 2021: 1
FWCI
6.46
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
  • Repository@Nottingham (University of Nottingham) (acceptedVersion, other-oa)
  • BORIS (University Library Bern) (submittedVersion)
Funders
Swiss National Science Foundation
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
disease-related malnutrition, hospital malnutrition, nutritional assessment, nutritional screening, dietary intervention, malnutrition diagnosis, inpatient care, morbidity and mortality, recovery from illness, cost of care
MeSH terms
Adult, Hospitalization, Humans, Nutrition Assessment, Malnutrition, Nutrition Therapy

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