The Seven Methods for the Evaluation of Nutritional Status—ABCDEFG: Narrative Review

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Nutritional status assessment is the first stage of the Nutrition Care Process (NCP), a framework standardized by the Academy of Nutrition and Dietetics.

“Nutritional status assessment is the first stage of the Nutrition Care Process (NCP), a framework standardized by the Academy of Nutrition and Dietetics to ensure an integrated and reproducible approach in both clinical and community settings.”

• cites [1] Carbajal, 2020, Nutrition Care Process: Elements for its implementation and use by Nutrition and Dietetics Professionals, Rev. Esp. Nutr. Hum. Diet. sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The NCP consists of four interrelated phases: assessment, diagnosis, intervention, and monitoring, with assessment serving as the foundation for evidence-based decision-making in health and nutrition.

“The NCP consists of four interrelated phases: assessment, diagnosis, intervention, and monitoring, with assessment serving as the foundation for evidence-based decision-making in health and nutrition [1].”

• cites [1] Carbajal, 2020, Nutrition Care Process: Elements for its implementation and use by Nutrition and Dietetics Professionals, Rev. Esp. Nutr. Hum. Diet. sourceSupported

May combine two claims.

Lipid profile assesses cardiovascular risk and fat metabolism.

“Lipid Profile: Total cholesterol (<200 mg/dL). LDL (<100 mg/dL) HDL (>40 mg/dL in men and >50 mg/dL in women) Triglycerides (<150 mg/dL) Assesses cardiovascular risk and fat metabolism.[23]”

• cites [23] Picó, C., Serra, F., Rodríguez, A.M., Keijer, J., and Palou, A. (2019). Biomarkers of Nutrition and Health: New Tools for New Approaches. Nutrients, 11. sourcePartly supported

  Section 2 (Biomarkers of Nutritional Status; page unavailable) links plasma cholesterol and triglycerides to cardiovascular disease, supporting the cardiovascular-risk part. Section 6.5 discusses lipidomics and lipid metabolism, but does not establish that the listed clinical lipid profile assesses fat metabolism; the paper also does not provide the cited cholesterol, LDL, HDL, or triglyceride cutoffs. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Folate is indispensable in DNA synthesis and red blood cell formation.

“Folate (>3 ng/mL) Indispensable in DNA synthesis and red blood cell formation.[25]”

• cites [25] Powers, 2021, Approaches to Setting Dietary Reference Values for Micronutrients, and Translation into Recommendations, Proc. Nutr. Soc. sourceCould not verify

  The ‘Considerations when setting dietary reference values’ section discusses folate metabolism and its biomarkers, but does not address DNA synthesis or red blood cell formation. Searches for those functions and for the cited >3 ng/mL threshold found no supporting passage in our copy. (LLM, conf=0.72)

  Experimental — accuracy not yet measured

May combine two claims.

Fasting glucose assesses carbohydrate metabolism and may indicate hypoglycemia, insulin resistance or diabetes.

“Fasting Glucose (70-100 mg/dL) Assesses carbohydrate metabolism and may indicate hypoglycemia, insulin resistance or diabetes.[22]”

• cites [22] Jarvis, 2023, Continuous Glucose Monitoring in a Healthy Population: Understanding the Post-Prandial Glycemic Response in Individuals without Diabetes Mellitus, Metabolism sourcePartly supported

  Section 2 (Post-prandial Hyperglycemia; page unavailable) links poorer fasting blood-glucose control with insulin resistance and reports lower fasting glucose among people with normal glucose tolerance. But the paper does not present 70–100 mg/dL as a fasting range or state that fasting glucose indicates hypoglycemia or diagnoses diabetes; Section 3 describes hypoglycemia specifically after meals. (LLM, conf=0.84)

  Experimental — accuracy not yet measured

May combine two claims.

Prealbumin is a more sensitive indicator of nutritional status, useful to evaluate recent changes in protein intake.

“Prealbumin (15-36 mg/dL) More sensitive indicator of nutritional status, useful to evaluate recent changes in protein intake.[20]”

• cites [20] Keller, U. (2019). Nutritional Laboratory Markers in Malnutrition. J. Clin. Med., 8. sourcePartly supported

  Section 3.2 says prealbumin’s shorter half-life makes it more favorable than albumin for tracking acute changes in nutritional state. It does not establish that prealbumin measures recent changes in protein intake or give the cited 15–36 mg/dL range. Section 3.3 further cautions that prealbumin can remain unchanged despite substantial nutritional deprivation. (LLM, conf=0.87)

  Experimental — accuracy not yet measured

May combine two claims.

Low albumin levels may suggest malnutrition, inflammation or liver disease.

“Albumin (3.5-5.0 g/dL) Indicator of long-term protein status.Low levels may suggest malnutrition, inflammation or liver disease.[20]”

• cites [20] Keller, U. (2019). Nutritional Laboratory Markers in Malnutrition. J. Clin. Med., 8. sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

The wide range of methods and contexts in which anthropometry is applied has created a growing need for written protocols, equipment calibration, and standardized training to ensure data accuracy and comparability.

“The wide range of methods and contexts in which anthropometry is applied has created a growing need for written protocols, equipment calibration, and standardized training to ensure data accuracy and comparability [7].”

• cites [7] Semler, 2025, Considerations for Anthropometry Specific to People with Disproportionate Short Stature, Adv. Ther. sourcePartly supported

  The Key Summary Points say that a written local SOP, personnel training, and equipment calibration improve measurement reproducibility for people with disproportionate short stature. The General Considerations section also addresses accuracy and consistency across clinical and research settings, but it does not establish a growing need caused by the widening range of anthropometry applications. (LLM, conf=0.84)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Somatotype values allow determination of a somatotype profile-of which 13 variants are described-and its application in evaluating and optimizing athletic performance.

“These values allow the determination of a somatotype profile-of which 13 variants are described-and its application in evaluating and optimizing athletic performance [13] (Figure 5).”

• cites [13] Martínez-Mireles, X., Nava-González, E.J., López-Cabanillas Lomelí, M., Puente-Hernández, D.S., Gutiérrez-López, M., Lagunes-Carrasco, J.O., López-García, R., and Ramírez, E. (2025). The Shape of Success: A Scoping Review of Somatotype in Modern Elite Athletes Across Various Sports. Sports, 13. sourcePartly supported

  The Introduction describes a three-number somatotype score derived from anthropometric measurements, and the Conclusions say somatotype profiles can inform training and performance enhancement. The Results list multiple classifications, but our copy does not state that there are 13 variants (searched for “13 somatotype categories” and “thirteen somatotype profiles”). (LLM, conf=0.86)

  Experimental — accuracy not yet measured

May combine two claims.

Vitamin B12 deficiency is associated with megaloblastic anemia and neuropathies.

“Vitamin B12 (>200 pg/mL) Deficiency associated with megaloblastic anemia and neuropathies.[25]”

• cites [25] Powers, 2021, Approaches to Setting Dietary Reference Values for Micronutrients, and Translation into Recommendations, Proc. Nutr. Soc. sourceCould not verify

  The 'Criteria of adequacy' section mentions nerve conduction changes and clinical symptoms of micronutrient depletion generally, but does not link them to vitamin B12. The 'Considerations when setting dietary reference values' section discusses a B12 biomarker, not megaloblastic anemia or neuropathies; searches for those conditions found no supporting passage. No page numbers were provided in our copy. (LLM, conf=0.72)

  Experimental — accuracy not yet measured

May combine two claims.

Elevated serum creatinine levels are indicative of decreased glomerular filtration rate (GFR) and may suggest acute or chronic kidney disease.

“Elevated serum creatinine levels are indicative of decreased glomerular filtration rate (GFR) and may suggest acute or chronic kidney disease.”

• cites [23] Picó, C., Serra, F., Rodríguez, A.M., Keijer, J., and Palou, A. (2019). Biomarkers of Nutrition and Health: New Tools for New Approaches. Nutrients, 11. sourceCould not verify

  Section 4 says creatinine travels through the blood to the kidneys and is excreted in urine; Section 2 lists urinary creatinine as a proposed marker of meat and fish intake. Neither passage, nor the additional searches for GFR and kidney disease, addresses whether elevated serum creatinine indicates reduced filtration or suggests acute or chronic kidney disease. Page numbers were not available in our copy. (LLM, conf=0.76)

  Experimental — accuracy not yet measured

May combine two claims.

Kinanthropometry enables the calculation of the three somatotype components, which are widely used in disciplines such as soccer.

“Kinanthropometry also enables the calculation of the three somatotype components, which are widely used in disciplines such as soccer [11].”

• cites [11] Leal, 2024, Exploring Body Composition and Somatotype Profiles among Youth Professional Soccer Players, Mediterr. J. Nutr. Metab. sourceSupported

May combine two claims.

Serum iron and ferritin assess iron stores and risk of anemia.

“Serum iron (50-170 mcg/dL) and Ferritin (12-300 ng/mL in men, 12-150 ng/mL in women) They assess iron stores and risk of anemia.[25]”

• cites [25] Powers, 2021, Approaches to Setting Dietary Reference Values for Micronutrients, and Translation into Recommendations, Proc. Nutr. Soc. sourcePartly supported

  In “Considerations when setting dietary reference values” (page not available), the paper discusses plasma iron concentration in relation to iron intake and biomarkers of status or function. It does not identify ferritin, give the stated reference ranges, or say that serum iron and ferritin assess iron stores and anemia risk. (LLM, conf=0.72)

  Experimental — accuracy not yet measured

May combine two claims.

Measurements of rectus femoris muscle thickness show strong correlations with functional indicators such as handgrip strength (HGS) and the fat-free mass index, supporting its value as a surrogate marker of muscular function and overall physical performance.

“For example, measurements of rectus femoris muscle thickness show strong correlations with functional indicators such as handgrip strength (HGS) and the fat-free mass index, supporting its value as a surrogate marker of muscular function and overall physical performance [16].”

• cites [16] Ogawa, 2023, Reliability and Validity of Quadriceps Muscle Thickness Measurements in Ultrasonography: A Comparison with Muscle Mass and Strength, Prog. Rehabil. Med. sourcePartly supported

  Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured

May combine two claims.

Biochemical evaluation constitutes a core pillar of nutritional assessment, and its proper interpretation integrated with clinical, anthropometric, and dietary information facilitates the development of effective intervention strategies aimed at improving patient health.

“Accordingly, biochemical evaluation constitutes a core pillar of nutritional assessment.Its proper interpretation-integrated with clinical, anthropometric, and dietary information-facilitates the development of effective intervention strategies aimed at improving patient health [27].”

• cites [27] Urdampilleta, 2014, Parámetros bioquímicos básicos, hematológicos y hormonales para el control de la salud y el estado nutricional en los deportistas, Rev. Esp. Nutr. Hum. Diet. sourcePartly supported

  Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Vitamin D is important in bone health and immune function.

“Vitamin D (30-50 ng/mL) Important in bone health and immune function.[25]”

• cites [25] Powers, 2021, Approaches to Setting Dietary Reference Values for Micronutrients, and Translation into Recommendations, Proc. Nutr. Soc. sourcePartly supported

  In “Considerations when setting dietary reference values” (page unavailable), the paper links vitamin D status to musculoskeletal health, supporting the bone-health part of the claim. It does not establish an immune-function benefit; it says evidence for nonmusculoskeletal outcomes was inadequate for setting dietary reference values. It also does not support the cited sentence’s 30–50 ng/mL range, instead identifying a population-protective threshold of 25 nmol/L. (LLM, conf=0.88)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

The adipose mass is not the same as the percentage of body fat, because the adipose mass includes all components of the adipocyte, including water and minerals in addition to fat mass.

“It should be considered that the adipose mass is not the same as the percentage of body fat, because the adipose mass contemplates all the components of the adipocyte, that is to say, in addition to the fat mass, water and minerals [11].”

• cites [11] Leal, 2024, Exploring Body Composition and Somatotype Profiles among Youth Professional Soccer Players, Mediterr. J. Nutr. Metab. sourceCould not verify

  The Results section refers to “fat or adipose mass,” and the Material section lists body-composition measures, but neither explains what adipose mass contains. Searches for the distinction from percentage body fat and for adipocyte water and minerals found no passage addressing the claim. (LLM, conf=0.72)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Zinc is related to the immune system and healing.

“Zinc (70-120 mcg/dL) Related to the immune system and healing.[25]”

• cites [25] Powers, 2021, Approaches to Setting Dietary Reference Values for Micronutrients, and Translation into Recommendations, Proc. Nutr. Soc. sourceCould not verify

  The copy’s References section lists a work titled “Zinc and skin: an update,” but does not state that zinc is related to immune function or healing. Searches for zinc, immune function, healing, and the 70–120 mcg/dL range found no passage addressing those claims; page numbers were not available. (LLM, conf=0.73)

  Experimental — accuracy not yet measured

May combine two claims.

The multimodal approach of BIA and MU improves diagnostic accuracy for conditions such as sarcopenia and cachexia and enhances the capacity to track intervention-related changes over time.

“This multimodal approach improves diagnostic accuracy for conditions such as sarcopenia and cachexia and enhances the capacity to track interventionrelated changes over time [16].”

• cites [16] Ogawa, 2023, Reliability and Validity of Quadriceps Muscle Thickness Measurements in Ultrasonography: A Comparison with Muscle Mass and Strength, Prog. Rehabil. Med. sourcePartly supported

  The Discussion (page unavailable) says ultrasound muscle-thickness measurements can track a patient’s condition over time and assess the efficacy of nutritional and rehabilitation therapies. The Methods and Results (pages unavailable) use BIA to compare muscle mass with ultrasound thickness, but the paper does not show that combining them improves diagnostic accuracy for sarcopenia or cachexia, or that the combination improves tracking of intervention-related changes. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

May combine two claims.

Clinical signs alone are not diagnostic; however, when interpreted alongside biochemical, dietary, and anthropometric data, they contribute to a comprehensive and accurate evaluation of the patient's nutritional status.

“It is important to highlight that clinical signs alone are not diagnostic; however, when interpreted alongside biochemical, dietary, and anthropometric data, they contribute to a comprehensive and accurate evaluation of the patient's nutritional status [30].”

• cites [30] Reber, E., Gomes, F., Vasiloglou, M.F., Schuetz, P., and Stanga, Z. (2019). Nutritional Risk Screening and Assessment. J. Clin. Med., 8. sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

Among children, vitamin A deficiency significantly elevates morbidity and mortality risk.

“Among children, this deficiency significantly elevates morbidity and mortality risk [36].”

• cites [36] Imdad, 2017, Vitamin A Supplementation for Preventing Morbidity and Mortality in Children from Six Months to Five Years of Age, Cochrane Database Syst. Rev. sourcePartly supported

  The Background (page not available) says vitamin A deficiency may cause death and increase susceptibility to infection, supporting the link to mortality and morbidity. The review also reports reductions in all-cause mortality and some illnesses with supplementation, but those comparisons do not establish that deficiency itself significantly elevates both risks. (LLM, conf=0.82)

  Experimental — accuracy not yet measured

May combine two claims.

The Clinical Assessment of Nutritional Status (CANS) Score integrates clinical signs of fat and muscle stores, allowing for an accessible and reliable evaluation of neonatal nutritional condition, particularly in settings where biochemical or anthropometric data may be limited.

“The Clinical Assessment of Nutritional Status (CANS) Score is another useful tool that enhances the identification of nutritional status in newborns.This scoring system integrates clinical signs of fat and muscle stores, allowing for an accessible and reliable evaluation of neonatal nutritional condition, particularly in settings where biochemical or anthropometric data may be limited [45].”

• cites [45] Medina, 2021, Utilidad del CANs SCORE para valoración clínica del estado nutricional del recién nacido, Gac. Médica Boliv. sourcePartly supported

  Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured

May combine two claims.

Advanced vitamin A deficiency can lead to keratomalacia and increased susceptibility to infectious diseases.

“Advanced deficiency can lead to keratomalacia (corneal softening) and increased susceptibility to infectious diseases.”

• cites [35] West, 2003, Vitamin A Deficiency Disorders in Children and Women, Food Nutr. Bull. sourceSupported

May combine two claims.

Chronic calcium deficiency contributes to decreased bone mineral density and osteoporosis, while in children it may impair growth and bone development due to inadequate mineralization during key developmental stages.

“Chronic deficiency contributes to decreased bone mineral density and osteoporosis, while in children, it may impair growth and bone development due to inadequate mineralization during key developmental stages [40].”

• cites [40] Shertukde, 2022, Calcium Intake and Metabolism in Infants and Young Children: A Systematic Review of Balance Studies for Supporting the Development of Calcium Requirements, Adv. Nutr. sourcePartly supported

  The Introduction (page not provided) says inadequate calcium intake during childhood may increase the risk of rickets and fractures and prevent attainment of maximal peak bone mass. It also describes calcium’s role in growing bones. It does not state that chronic deficiency causes decreased bone mineral density or osteoporosis, so those parts of the claim are unsupported by this copy. (LLM, conf=0.87)

  Experimental — accuracy not yet measured

May combine two claims.

Measuring dietary intake is particularly difficult and subject to both random and systematic measurement errors, so practitioners must know the strengths and weaknesses of each method.

“Measuring the dietary intake of subjects, however, is particularly difficult and subject to both random and systematic measurement errors, so it is of great importance for the practitioner to know the strengths and weaknesses of each of the methods.”

• cites [46] Bates, C., Bogin, B., and Holmes, B. (2017). Nutritional Assessment Methods. Human Nutrition, Oxford University Press.Not checked yet

  Not checked in the free run.

• cites [47] Dao, 2018, Dietary Assessment Toolkits: An Overview, Public Health Nutr. sourcePartly supported

  The Introduction describes dietary assessment as complicated and says methods have different strengths and weaknesses. “The case for toolkits to guide dietary assessment choice” identifies multiple sources of error and explicitly discusses systematic bias. Our copy does not explicitly identify random measurement error, so that specific part of the claim is not established. (LLM, conf=0.82)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

Iron deficiency is the most prevalent nutritional deficiency globally.

“Iron deficiency is the most prevalent nutritional deficiency globally [33].”

• cites [33] Kolarš, B., Mijatović Jovin, V., Živanović, N., Minaković, I., Gvozdenović, N., Dickov Kokeza, I., and Lesjak, M. (2025). Iron Deficiency and Iron Deficiency Anemia: A Comprehensive Overview of Established and Emerging Concepts. Pharmaceuticals, 18. sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

Vitamin A deficiency commonly results in ocular alterations such as xerophthalmia, night blindness, and Bitot's spots.

“Vitamin A deficiency commonly results in ocular alterations such as xerophthalmia (dryness of the conjunctiva), night blindness, and the presence of Bitot's spots, which are keratinized plaques on the conjunctival surface [35].”

• cites [35] West, 2003, Vitamin A Deficiency Disorders in Children and Women, Food Nutr. Bull. sourceSupported

May combine two claims.

Vitamin C deficiency produces symptoms including bleeding gums, petechiae, ecchymoses, impaired wound healing, and arthralgia.

“Vitamin C Deficiency: Vitamin C deficiency produces symptoms including bleeding gums, petechiae, ecchymoses, impaired wound healing, and arthralgia [37].”

• cites [37] Alberts, A., Moldoveanu, E.-T., Niculescu, A.-G., and Grumezescu, A.M. (2025). Vitamin C: A Comprehensive Review of Its Role in Health, Disease Prevention, and Therapeutic Potential. Molecules, 30. sourcePartly supported

  The Introduction (page unavailable) links severe vitamin C deficiency to scurvy and describes gingival pathology, hemorrhages, and delayed wound healing. It does not specifically identify bleeding gums, petechiae, ecchymoses, or arthralgia; the reported lower-limb pain is not identified as joint pain. (LLM, conf=0.82)

  Experimental — accuracy not yet measured

May combine two claims.

Clinical signs may be nonspecific and can be associated with multiple causes, not only nutritional ones.

“It is essential to highlight that clinical signs may be nonspecific and can be associated with multiple causes, not only nutritional ones.”

• cites [41] Fleet, J. (2022). Vitamin D-Mediated Regulation of Intestinal Calcium Absorption. Nutrients, 14. sourceCould not verify

  The paper’s section on vitamin D’s physiological role discusses calcium absorption, while its references mention nutritional and hereditary rickets. Neither addresses whether clinical signs are nonspecific or can have nutritional and nonnutritional causes. Searches for clinical signs, symptoms, and alternative causes found no passage making that point. (LLM, conf=0.76)

  Experimental — accuracy not yet measured
• cites [42] Eidelberg, A., and Newberry, C. (2022). Dietary Composition and Nutritional Deficiencies. Nutrition, Weight, and Digestive Health, The Clinician’s Desk Reference, Springer. sourceNot checked — no full text of the source

May combine two claims.

The Dys-R questionnaire was developed in Brazil in 2023 using a sample of 219 individuals with chronic diseases and a control group of 52 healthy participants from a tertiary hospital.

“The Dys-R questionnaire was developed in Brazil in 2023 using a sample of 219 individuals with chronic diseases and a control group of 52 healthy participants from a tertiary hospital.”

• cites [79] Balmant, B.D., Fonseca, D.C., Rocha, I.M., Callado, L., Torrinhas, R.S.M.d.M., and Waitzberg, D.L. (2023). Dys-R Questionnaire: A Novel Screening Tool for Dysbiosis Linked to Impaired Gut Microbiota Richness. Nutrients, 15. sourcePartly supported

  Methods §2.1 reports recruitment at a São Paulo hospital, with 167 patients with chronic diseases and 52 healthy volunteers. Methods §2.5 gives 219 as the total number of individuals used in the analysis, not the number with chronic diseases. The claim gets the group sizes wrong by treating the total as the chronic-disease group. (LLM, conf=0.93)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

Picking the proper nutritional assessment method depends greatly on the setting, the objective of the study, and the characteristics of the population.

“Given the diversity of nutritional assessment tools, picking the proper method depends greatly on the setting, the objective of the study, and the characteristics of the population [59,60].”

• cites [59] D’Alessandro, C., Benedetti, A., Di Paolo, A., Giannese, D., and Cupisti, A. (2022). Interactions between Food and Drugs, and Nutritional Status in Renal Patients: A Narrative Review. Nutrients, 14. sourceCould not verify

  Section 2 discusses the importance of nutritional status in patients with chronic kidney disease, while the Conclusive Remarks discuss dietetic interviews and food–drug interactions. Neither addresses how to choose a nutritional assessment method. Searches for assessment-tool selection by setting, study objective, and population characteristics found no supporting passage in our copy. (LLM, conf=0.73)

  Experimental — accuracy not yet measured
• cites [60] Boullata, 2012, Drug–Nutrient Interactions: A Broad View with Implications for Practice, J. Acad. Nutr. Diet. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Dysbiosis is frequent among oncologic patients.

“Dysbiosis is also frequent among oncologic patients, where medical treatments can yield substantial benefits when nutritional status is adequate but may also generate secondary effects or complications depending on the stage of disease [84].”

• cites [84] 2020, Prevalencia del riesgo de desnutrición y situación de la terapia nutricional en pacientes adultos hospitalizados en Perú, Rev. Nutr. Clin. Metab. sourceCould not verify

  The Results and Discussion report nutritional risk in approximately 44% of hospitalized oncology patients, not dysbiosis. A search for dysbiosis and microbiota found no passage addressing their prevalence in oncology patients. The paper also does not link cancer-treatment benefits or side effects to nutritional status or disease stage. (LLM, conf=0.76)

  Experimental — accuracy not yet measured

May combine two claims.

Data interpretation must be cautious due to high inter-individual variability, lack of standardization in pipelines, and the absence of a universally defined healthy microbiome.

“Data interpretation must be cautious due to high inter-individual variability, lack of standardization in pipelines, and the absence of a universally defined healthy microbiome [76,77].”

• cites [76] Kers, J.G., and Saccenti, E. (2022). The Power of Microbiome Studies: Some Considerations on Which Alpha and Beta Metrics to Use and How to Report Results. Front. Microbiol., 12. sourcePartly supported

  The Discussion (page unavailable) cautions that the choice of alpha and beta diversity metrics can affect findings and that incomplete reporting makes results difficult to judge. The paper does not identify high inter-individual variability, lack of pipeline standardization, or the absence of a universally defined healthy microbiome as the reasons for caution stated in the citing sentence. (LLM, conf=0.86)

  Experimental — accuracy not yet measured
• cites [77] Mensah, G., Maseng, M., Allard, S., and Gilbert, J. (2024). The Microbiome, Metabolism, and Networks in Precision Nutrition. Precision Nutrition, Academic Press. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Advances in sequencing technologies and bioinformatics have significantly enhanced our ability to profile microbial communities, providing insights into their contributions to health and disease.

“Advances in sequencing technologies and bioinformatics have significantly enhanced our ability to profile these microbial communities, providing insights into their contributions to health and disease [65].”

• cites [65] Fox, 2024, Bioinformatic Methodologies in Assessing Gut Microbiota, Microbiol. Res. sourceSupported

May combine two claims.

The Dys-R questionnaire showed a positive predictive value of 79% and good performance to rule out dysbiosis.

“The results showed that there were notable differences between the groups, evidencing a lower richness of intestinal microbiota as the main marker of intestinal dysbiosis and a positive predictive value of 79%, concluding that the new Dys-R questionnaire showed a good performance to rule out dysbiosis [79].”

• cites [79] Balmant, B.D., Fonseca, D.C., Rocha, I.M., Callado, L., Torrinhas, R.S.M.d.M., and Waitzberg, D.L. (2023). Dys-R Questionnaire: A Novel Screening Tool for Dysbiosis Linked to Impaired Gut Microbiota Richness. Nutrients, 15. sourceSupported

May combine two claims.

The Timed Up and Go test evaluates mobility in older adults and has been used to assess functional mobility and as a predictor of falls and mortality.

“The Timed Up and Go (TUG) test evaluates mobility in older adults [134].Also, TUG has been used to assess functional mobility [135] and as a predictor of falls and mortality.”

• cites [134] Podsiadlo, 1991, The Timed “Up & Go”: A Test of Basic Functional Mobility for Frail Elderly Persons, J. Am. Geriatr. Soc. sourceNot checked — no full text of the source
• cites [135] Ascencio, E., Cieza-Gómez, G., Carrillo-Larco, R., and Ortiz, P. (2022). Timed up and Go Test Predicts Mortality in Older Adults in Peru: A Population-Based Cohort Study. BMC Geriatr., 22. sourceSupported

May combine two claims.

Functional assessment is a key component in the evaluation of nutritional status and in the follow-up of nutritional interventions, since loss of muscle function is an essential feature in malnutrition, and its recovery is an indicator of nutritional improvement.

“Functional assessment is a key component in the evaluation of nutritional status and in the follow-up of nutritional interventions, since loss of muscle function is an essential feature in malnutrition, and its recovery is an indicator of nutritional improvement [104].”

• cites [104] Serón-Arbeloa, C., Labarta-Monzón, L., Puzo-Foncillas, J., Mallor-Bonet, T., Lafita-López, A., Bueno-Vidales, N., and Montoro-Huguet, M. (2022). Malnutrition Screening and Assessment. Nutrients, 14. sourceSupported

May combine two claims.

In older adults, correlations have been observed between microbial diversity and composition and parameters of muscle mass, strength, and physical performance, with some intervention studies showing functional improvements after microbiota modulation.

“In fact, in older adults, correlations have been observed between microbial diversity and composition and parameters of muscle mass, strength, and physical performance, with some intervention studies showing functional improvements after microbiota modulation [88].”

• cites [88] Liu, 2021, Understanding the Gut Microbiota and Sarcopenia: A Systematic Review, J. Cachexia Sarcopenia Muscle sourcePartly supported

  Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured

May combine two claims.

A completion time greater than 13.5 s on the Timed Up and Go test has been proposed as a threshold for predicting fall risk in community-dwelling older adults, though this predictive value depends on the individual's physical condition and is more relevant for those with lower functional capacity.

“A completion time greater than 13.5 s has been proposed as a threshold for predicting fall risk in community-dwelling older adults, though this predictive value depends on the individual's physical condition and is more relevant for those with lower functional capacity [136].”

• cites [136] 2021, Sensibilidad y Especificidad de La Prueba Timed Up and Go. Tiempos de Corte y Edad En Adultos Mayores, Rev. Med. Chile sourcePartly supported

  Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured

May combine two claims.

In states of dysbiosis, increased intestinal permeability can facilitate translocation of endotoxins into the portal circulation, thereby exacerbating liver inflammation, insulin resistance, and metabolic dysfunction and contributing to diseases such as fatty liver disease, dyslipidemia, or metabolic syndrome.

“In states of dysbiosis, increased intestinal permeability can facilitate the translocation of endotoxins into the portal circulation, thereby exacerbating liver inflammation, insulin resistance, and metabolic dysfunction and contributing to the development or progression of diseases such as fatty liver disease, dyslipidemia, or metabolic syndrome [94][95][96][97].”

• cites [94] Muscogiuri, 2022, Nutritional Guidelines for the Management of Insulin Resistance, Crit. Rev. Food Sci. Nutr. sourceNot checked — no full text of the source
• cites [95] Annunziata, 2025, Endocrinologist’s Crucial Role in Metabolic Dysfunction-Associated Steatotic Liver Disease: A Comprehensive Review, Minerva Endocrinol.Not checked yet

  Not checked in the free run.

• cites [96] Annunziata, 2025, Nutritional Strategies for Battling Obesity-Linked Liver Disease: The Role of Medical Nutritional Therapy in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Management, Curr. Obes. Rep. sourcePartly supported

  Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured
• cites [97] Buchynskyi, M., Kamyshna, I., Halabitska, I., Petakh, P., Kunduzova, O., Oksenych, V., and Kamyshnyi, O. (2025). Unlocking the Gut-Liver Axis: Microbial Contributions to the Pathogenesis of Metabolic-Associated Fatty Liver Disease. Front. Microbiol., 16. sourcePartly supported

  Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Accumulating evidence suggests that the microbiota influences the regulation of appetite, eating behavior, common mental illnesses, immunity, and emotional states.

“Accumulating evidence suggests that the microbiota influences the regulation of appetite, eating behavior, common mental illnesses, immunity, and even emotional states [89,90].”

• cites [89] Terry, 2022, A Critical Analysis of Eating Disorders and the Gut Microbiome, J. Eat. Disord. sourceSupported
• cites [90] Agus, 2021, Gut Microbiota-Derived Metabolites as Central Regulators in Metabolic Disorders, Gut sourcePartly supported

  The Introduction (page unavailable) says the gut microbiota contributes to immune-system maturation. The section on microbiota-derived metabolites (page unavailable) links microbiota-modulated serotonin to feeding behaviour and satiety, supporting the appetite and eating-behaviour parts. Our copy does not address common mental illnesses or emotional states. (LLM, conf=0.88)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

The gut-liver axis reflects the bidirectional relationship between the gut microbiota, intestinal permeability, microbial metabolites, and hepatic functionality.

“The gut-liver axis reflects the bidirectional relationship between the gut microbiota, intestinal permeability, microbial metabolites, and hepatic functionality [93].”

• cites [93] Hsu, 2023, The Gut-Liver Axis and Gut Microbiota in Health and Liver Disease, Nat. Rev. Microbiol. sourceSupported

May combine two claims.

Handgrip strength is a useful indicator of general health status and, specifically, of early mortality from any cardiovascular cause, as well as disability.

“HGS is a useful indicator of general health status and, specifically, of early mortality from any cardiovascular cause, as well as disability [110,111].”

• cites [110] Soysal, 2021, Handgrip Strength and Health Outcomes: Umbrella Review of Systematic Reviews with Meta-Analyses of Observational Studies, J. Sport Health Sci. sourceSupported
• cites [111] Tribolet, 2021, Value of Handgrip Strength to Predict Clinical Outcomes and Therapeutic Response in Malnourished Medical Inpatients: Secondary Analysis of a Randomized Controlled Trial, Am. J. Clin. Nutr. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The four-meter gait speed test has established protocols and normative values for adults.

“A common variant of this measure is the four-meter gait speed test, which has established protocols and normative values for adults [129].”

• cites [129] Bohannon, 2019, Four-Meter Gait Speed: Normative Values and Reliability Determined for Adults Participating in the NIH Toolbox Study, Arch. Phys. Med. Rehabil. sourceSupported

May combine two claims.

Gut microbiota composition is now recognized as a determinant of energy homeostasis, immune modulation, and nutrient bioavailability.

“Gut microbiota composition is now recognized as a determinant of energy homeostasis, immune modulation, and nutrient bioavailability [156].”

• cites [156] Liu, 2022, Functions of Gut Microbiota Metabolites, Current Status and Future Perspectives, Aging Dis. sourceSupported

May combine two claims.

Changes in weight, lipid markers, or quality of life from personalized nutrition were generally inconsistent or not significant.

“However, changes in parameters such as weight, lipid markers, or quality of life were generally inconsistent or not significant.”

• cites [142] Shyam, S., Lee, K., Tan, A., Khoo, T., Harikrishnan, S., Lalani, S., and Ramadas, A. (2022). Effect of Personalized Nutrition on Dietary, Physical Activity, and Health Outcomes: A Systematic Review of Randomized Trials. Nutrients, 14. sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Nutrigenetics and nutrigenomics offer promising conceptual frameworks for understanding how genetic variants affect nutrient response and how diet can modulate gene expression.

“On the other hand, nutrigenetics and nutrigenomics offer promising conceptual frameworks for understanding how genetic variants affect nutrient response and how diet can modulate gene expression [143,144].”

• cites [143] Lagoumintzis, 2023, Triangulating Nutrigenomics, Metabolomics and Microbiomics toward Personalized Nutrition and Healthy Living, Hum. Genom. sourcePartly supported

  The Abstract and Conclusions and future perspectives state that genetic variants affect individuals’ responses to dietary intake. The Introduction’s “Microbiomics versus genotyping and nutrigenomics” section describes nutrigenomics as studying interactions between dietary components and genes, but the passages do not establish the more specific claim that diet modulates gene expression. (LLM, conf=0.83)

  Experimental — accuracy not yet measured
• cites [144] Grosso, G., Laudisio, D., Frias-Toral, E., Barrea, L., Muscogiuri, G., Savastano, S., and Colao, A. (2022). Anti-Inflammatory Nutrients and Obesity-Associated Metabolic-Inflammation: State of the Art and Future Direction. Nutrients, 14. sourcePartly supported

  Section 8 says genetics plays a pivotal role in inflammatory responses to dietary exposure, supporting the genetic-response part of the claim. Section 2 describes food ingestion activating transcription factors and upregulating pro-inflammatory genes, supporting a diet–gene-expression link. The paper does not discuss nutrigenetics and nutrigenomics together as conceptual frameworks; it names nutrigenetics only in a reference title. (LLM, conf=0.82)

  Experimental — accuracy not yet measured

May combine two claims.

Positive effects of personalized nutrition were observed in reducing salt intake and, in some cases, improvements in fat consumption patterns.

“Positive effects were observed in reducing salt intake and, in some cases, improvements in fat consumption patterns.”

• cites [142] Shyam, S., Lee, K., Tan, A., Khoo, T., Harikrishnan, S., Lalani, S., and Ramadas, A. (2022). Effect of Personalized Nutrition on Dietary, Physical Activity, and Health Outcomes: A Systematic Review of Randomized Trials. Nutrients, 14. sourceSupported

May combine two claims.

The trials of personalized nutrition were mainly conducted in North American and European populations, which limits their global applicability.

“In addition, the trials were mainly conducted in North American and European populations, which limits their global applicability.”

• cites [142] Shyam, S., Lee, K., Tan, A., Khoo, T., Harikrishnan, S., Lalani, S., and Ramadas, A. (2022). Effect of Personalized Nutrition on Dietary, Physical Activity, and Health Outcomes: A Systematic Review of Randomized Trials. Nutrients, 14. sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

The inclusion of renal function and micronutrient biomarkers aligns with ESPEN and ASPEN recommendations that advocate for multidimensional biochemical panels in clinical nutrition practice.

“The inclusion of renal function and micronutrient biomarkers aligns with current European Society of Clinical Nutrition and Metabolism (ESPEN) [153] and American Society for Parenteral and Enteral Nutrition (ASPEN) [154] recommendations that advocate for multidimensional biochemical panels in clinical nutrition practice.”

• cites [153] Berger, 2022, ESPEN Micronutrient Guideline, Clin. Nutr. sourcePartly supported

  The ESPEN guideline recommends measuring C-reactive protein alongside any micronutrient analysis (Recommendation 3, p. 9), and says albumin is desirable when a series of micronutrients is measured (Comment, p. 9). This supports combining micronutrient biomarkers with contextual biochemical tests, but the cited guideline does not recommend a panel that includes renal-function tests. The separate ASPEN citation is not assessed here. (LLM, conf=0.85)

  Experimental — accuracy not yet measured
• cites [154] Stoppe, 2024, Highlights in the Clinical Nutrition Literature: A Critical Appraisal of Current Research, JPEN J. Parenter. Enteral Nutr. sourceCould not verify

  The Conclusion (page unavailable) highlights the importance of micronutrient and metabolomic data for certain patients, and the critical-care discussion says biomarkers may help monitor nutrition support. Neither passage states an ASPEN recommendation for a multidimensional biochemical panel that includes renal-function and micronutrient biomarkers. Searches for those panel components and for biochemical-monitoring recommendations found no such passage in our copy. (LLM, conf=0.72)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

The lack of standardized bioinformatic pipelines and reference values continues to hinder the translation of microbiome analysis into routine nutritional practice.

“Nevertheless, as other authors note [157], the lack of standardized bioinformatic pipelines and reference values continues to hinder the translation of microbiome analysis into routine nutritional practice.”

• cites [157] Bautista, J., Echeverría, C.E., Maldonado-Noboa, I., Ojeda-Mosquera, S., Hidalgo-Tinoco, C., and López-Cortés, A. (2025). The Human Microbiome in Clinical Translation: From Bench to Bedside. Front. Microbiol., 16. sourcePartly supported

  In “Risk and challenges in microbiome-based therapeutics” (page unavailable), the paper says bioinformatic variability produces inconsistent profiles and calls for standardized pipelines and reference databases. “Conclusions and future perspectives” (page unavailable) says a healthy microbiome remains difficult to define. These passages support barriers to clinical translation generally, but do not specifically address reference values or routine nutritional practice. (LLM, conf=0.84)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

After title and abstract screening and exclusion of studies lacking relevance to nutritional assessment or the conceptual development of the ABCDEFG framework, a final set of 65 publications was included.

“After title and abstract screening and exclusion of studies lacking relevance to nutritional assessment or the conceptual development of the ABCDEFG framework, a final set of 65 publications was included.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Database searches yielded approximately 98 records.

“Database searches yielded approximately 98 records.”

Probably not a substantial claim: may not pass S4 (based).

The ABCDEFG framework's application is especially valuable for the early detection and management of malnutrition, sarcopenia, and chronic diseases.

“Its application is especially valuable for the early detection and management of malnutrition, sarcopenia, and chronic diseases, and it also provides a robust foundation for advancing research in nutrigenomics and the gut microbiota.”

• AssumptionRests on an assumption: The literature lacks an integrated framework that combines ecological-microbiota, functional, and genomic/nutrigenomic dimensions with traditional assessment domains.

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

The ABCDEFG framework provides a robust foundation for advancing research in nutrigenomics and the gut microbiota.

“Its application is especially valuable for the early detection and management of malnutrition, sarcopenia, and chronic diseases, and it also provides a robust foundation for advancing research in nutrigenomics and the gut microbiota.”

• AssumptionRests on an assumption: The literature lacks an integrated framework that combines ecological-microbiota, functional, and genomic/nutrigenomic dimensions with traditional assessment domains.

Probably not a substantial claim: may not pass S4 (based).

By integrating traditional methods with ecological, functional, and genomic evaluations, the ABCDEFG framework supports the shift toward personalized and precision nutrition.

“By integrating traditional methods with ecological, functional, and genomic evaluations, it supports the shift toward personalized and precision nutrition.”

• AssumptionRests on an assumption: The literature lacks an integrated framework that combines ecological-microbiota, functional, and genomic/nutrigenomic dimensions with traditional assessment domains.

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

The proposed ABCDEFG framework for nutritional assessment provides a comprehensive tool for both clinical and community settings.

“The proposed ABCDEFG framework for nutritional assessment provides a comprehensive tool for both clinical and community settings.”

• AssumptionRests on an assumption: The literature lacks an integrated framework that combines ecological-microbiota, functional, and genomic/nutrigenomic dimensions with traditional assessment domains.

Probably not a substantial claim: may not pass S3 (load-bearing).

Titles and abstracts were independently screened by two reviewers (R.Z.-V. and L.D.D.B.) to assess relevance.

“Titles and abstracts were independently screened by two reviewers (R.Z.-V.and L.D.D.B.) to assess relevance.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The muscle-bone index provides an estimate of the muscular potential permitted by the underlying skeletal frame, providing insight into constitutional morphology, structural robustness, and functional capacity.

“The musclebone index, in contrast, provides an estimate of the muscular potential permitted by the underlying skeletal frame, providing insight into constitutional morphology, structural robustness, and functional capacity (Figure 3).”

Probably not a substantial claim: may not pass S3 (load-bearing).

Reference lists of selected publications were manually screened to identify additional relevant sources.

“Reference lists of selected publications were also manually screened to identify additional relevant sources.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Articles were advanced to full-text review only when both reviewers agreed on inclusion.

“Articles were advanced to full-text review only when both reviewers agreed on inclusion.”

May combine two claims.

In clinical practice, biochemical procedures are used to diagnose nutritional deficiencies, evaluate the response to dietary interventions, and monitor health status in individuals with chronic or acute conditions.

“In clinical practice, these procedures are used to diagnose nutritional deficiencies, evaluate the response to dietary interventions, and monitor health status in individuals with chronic or acute conditions.”

• cites [26] Jenab, 2009, Biomarkers in Nutritional Epidemiology: Applications, Needs and New Horizons, Hum. Genet. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

No formal flow diagram was applied, as sources were selected based on conceptual relevance and contribution to emerging assessment domains beyond traditional models.

“No formal flow diagram was applied, as sources were selected based on conceptual relevance and contribution to emerging assessment domains beyond traditional models.”

Classified as probably not a substantial claim.

The expanded ABCDEFG framework reflects the evolution of nutritional science toward a more integrative perspective that goes beyond morphological and biochemical indicators to include functional, molecular, and environmental factors affecting health.

“This expanded framework reflects the evolution of nutritional science toward a more integrative perspective that goes beyond morphological and biochemical indicators to include functional, molecular, and environmental factors affecting health [6].”

• cites [6] Almeida, 2021, Morphofunctional Assessment of Patient’s Nutritional Status: A Global Approach, Nutr. Hosp.Not checked yet

  Not checked in the free run.

Classified as probably not a substantial claim.

The expanded ABCDEFG model incorporates three additional components alongside the traditional four: E (Ecological assessment and gut microbiota), F (Functional assessment), and G (Genomic and nutrigenomic assessment).

“This has led to the development of the expanded ABCDEFG model, which incorporates three additional components alongside the traditional four: E (Ecological assessment and gut microbiota), F (Functional assessment), and G (Genomic and nutrigenomic assessment) (Figure 1).”

Classified as probably not a substantial claim. May combine two claims.

Biomarkers used in biochemical assessment provide objective and sensitive information that complements anthropometric and clinical findings, allowing early detection of nutritional risk and guiding targeted interventions.

“These biomarkers provide objective and sensitive information that complements anthropometric and clinical findings, allowing early detection of nutritional risk and guiding targeted interventions.”

May combine two claims.

BIA has demonstrated solid clinical utility in diverse populations, including individuals with chronic kidney disease undergoing hemodialysis, where it supports nutritional monitoring and fluid status evaluation.

“BIA has demonstrated solid clinical utility in diverse populations, including individuals with chronic kidney disease undergoing hemodialysis, where it supports nutritional monitoring and fluid status evaluation [14].”

• cites [14] Cintoni, 2025, Concordance between Muscle Ultrasound and Bioelectrical Impedance Analysis for Muscle Assessment in Gastric Cancer Patients: A Prospective Study, Clin. Nutr. ESPEN sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

Lower adipose-muscle index values denote a more favorable balance between muscle and adipose tissue.

“Lower adipose-muscle index values denote a more favorable balance between muscle and adipose tissue.”

Classified as probably not a substantial claim. May combine two claims.

Incorporating BIA and MU into routine clinical practice supports earlier detection, targeted nutritional strategies, and optimized rehabilitation interventions.

“Considering the rising prevalence of muscle-wasting disorders in aging populations, incorporating both tools into routine clinical practice supports earlier detection, targeted nutritional strategies, and optimized rehabilitation interventions.”

Probably not a substantial claim: may not pass S3 (load-bearing).

BIA's rapid application, portability, and relatively low cost make it suitable for both clinical and field settings.

“Its rapid application, portability, and relatively low cost make it suitable for both clinical and field settings.”

May combine two claims.

The identification of clinical signs related to nutrition is a valuable tool in nutritional status assessment; these signs, in conjunction with dietary, anthropometric, and biochemical information, allow for a comprehensive patient evaluation and can reveal specific nutrient deficiencies or excesses.

“The identification of clinical signs related to nutrition is a valuable tool in nutritional status assessment.These signs, in conjunction with dietary, anthropometric, and biochemical information, allow for a comprehensive patient evaluation and can reveal specific nutrient deficiencies or excesses [43].”

• cites [43] Esper, 2015, Utilization of Nutrition-Focused Physical Assessment in Identifying Micronutrient Deficiencies, Nutr. Clin. Pract. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

The level of assessment and the method must be carefully selected in relation to the objective of the research or intervention.

“Therefore, the level of assessment and the method must be carefully selected in relation to the objective of the research or intervention to be achieved, in the case that the assessment is at the individual level.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The Nutrition-Focused Physical Exam for Adults: An Illustrated Handbook provides a comprehensive and clinically structured physical examination approach and includes pictorial representations of various stages of muscle and fat depletion, vitamin and mineral deficiencies, and fluid imbalance.

“The Nutrition-Focused Physical Exam for Adults: An Illustrated Handbook provides a comprehensive and clinically structured physical examination approach and includes pictorial representations of various stages of muscle and fat depletion, vitamin and mineral deficiencies, and fluid imbalance [44].”

• cites [44] Hamilton, C., Jevenn, A., Hipskind, P., Galand, M., and Pogatschnik, C. (2022). Nutrition-Focused Physical Exam for Adults: An Illustrated Handbook, American Society for Parenteral and Enteral Nutrition (ASPEN). [2nd ed.].Not checked yet

  Not checked in the free run.

May combine two claims.

Systematic identification of clinical signs related to nutrition provides essential information about an individual's nutritional status and may reveal deficiencies or excesses of specific nutrients.

“In addition to dietary and anthropometric assessments, the systematic identification of clinical signs related to nutrition provides essential information about an individual's nutritional status and may reveal deficiencies or excesses of specific nutrients [28].”

• cites [28] Hummell, 2022, Role of the Nutrition-focused Physical Examination in Identifying Malnutrition and Its Effectiveness, Nutr. Clin. Pract. sourceNot checked — no full text of the source

May combine two claims.

Clinical signs related to nutrition can be subtle or pronounced and may affect diverse systems, including the skin, hair, nails, eyes, oral cavity, cardiovascular system, gastrointestinal tract, and nervous system.

“These signs can be subtle or pronounced and may affect diverse systems, including the skin, hair, nails, eyes, oral cavity, cardiovascular system, gastrointestinal tract, and nervous system [29].”

• cites [29] 2023, Anthropometric indexes and cardiovascular risk in Ecuadorian university students: A comparison with international references, Revis BionaturaNot checked yet

  Not checked in the free run.

May combine two claims.

Advanced vitamin C deficiency may cause scurvy, presenting with severe fatigue, musculoskeletal pain, gingival hypertrophy, and widespread hemorrhagic manifestations.

“In advanced cases, scurvy may occur, presenting with severe fatigue, musculoskeletal pain, gingival hypertrophy, and widespread hemorrhagic manifestations [38].”

• cites [38] Granger, 2018, Dietary Vitamin C in Human Health, Adv. Food Nutr. Res. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

Tools such as standardized portion sizes, standardized home measurements, and images and food models must be specific for the population under study.

“For this, tools have been designed, such as the determination of standardized portion sizes, the use of standardized home measurements, and images and food models, which must be specific for the population under study.”

May combine two claims.

A food atlas allows the quantification of food and nutrient intake and decreases the bias of people's self-assessment.

“Among the visual materials studied, a food atlas has proved to be the most effective, clear and easily accessible tool for consultation and transport, which allows the quantification of food and nutrient intake and decreases the bias of people's self-assessment.”

• cites [49] FAO (2018). Dietary Assessment: A Resource Guide to Method Selection and Application in Low Resource Settings, Food and Agriculture Organization of the United Nations. Available online: https://www.fao.org/4/i0351e/i0351e12.pdf.Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

Severe protein-energy malnutrition can progress to kwashiorkor, a syndrome characterized by generalized edema, abdominal ascites, dermatoses, and changes in hair pigmentation and texture.

“In severe forms, protein-energy malnutrition can progress to kwashiorkor, a syndrome characterized by generalized edema, abdominal ascites, dermatoses, and changes in hair pigmentation and texture [32].”

• cites [32] Singh, 2018, From Kwashiorkor to Edematous Malnutrition, Indian Pediatr. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The second edition of Ecuador's food atlas presents 142 foods in their usual form of consumption and 49 representative home measurements for the Ecuadorian population.

“This second edition presents 142 foods in their usual form of consumption and 49 representative home measurements for the Ecuadorian population.”

• cites [56] Herrera, M.E., Chisaguano, M., Rodríguez, G.V., and Crispim, S.P. (2022). Manual Fotográfico de Porciones Para Cuantificación Alimentaria del Ecuador, USFQ Press. [2nd ed.]. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Ecuador published its first food atlas in 2019 and a second edition in 2022.

“Ecuador published its first food atlas in 2019 [55] and a second edition in 2022 [56] as a support tool for professionals.”

• cites [55] (2019). Manual Fotografico de Porciones Para Cuantificacion Alimentaria—Ecuador, USFQ-Press.Not checked yet

  Not checked in the free run.

• cites [56] Herrera, M.E., Chisaguano, M., Rodríguez, G.V., and Crispim, S.P. (2022). Manual Fotográfico de Porciones Para Cuantificación Alimentaria del Ecuador, USFQ Press. [2nd ed.]. sourceNot checked — no full text of the source

May combine two claims.

Ecuador has a food composition table for the city of Cuenca and a table of chemical composition of foods based on nutrients of interest to the Ecuadorian population.

“Ecuador has two tools available: the food composition table of the city of Cuenca, which presents information on foods prepared in this city [57], and the table of chemical composition of foods based on nutrients of interest to the Ecuadorian population, which provides the nutritional content of more than a thousand locally used foods, including information on the nutritional labeling of more than”

• cites [57] Ortiz, J., Rubio, G., Donoso, S., and Ochoa-Avilés, A. (2018). Tabla de Composición de Alimentos, Cuenca—Ecuador 2018, Universidad de Cuenca.Not checked yet

  Not checked in the free run.

• cites [58] (2021). Tabla de Composición Química de los Alimentos: Basada en Nutrientes de Interés Para la Población Ecuatoriana, USFQ Press.Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

Lifestyle determinants, medication exposure, and dietary patterns modulate microbial diversity, composition, and function.

“This ecological perspective also integrates lifestyle determinants, medication exposure, and dietary patterns, all of which modulate microbial diversity, composition, and function.”

May combine two claims.

Screening for nutrient-drug interactions complements dietary intake measurement and enhances the clinical applicability of the ABCDEFG model by incorporating pharmaceutical influences into nutritional decision-making.

“Therefore, screening for NDIs not only complements dietary intake measurement but also enhances the clinical applicability of the ABCDEFG model by incorporating pharmaceutical influences into nutritional decision-making.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

Digital photography has proven to be unobtrusive and accurate and has become the method of choice for assessing food consumption, both individually and collectively.

“Moreover, digital photography has proven to be unobtrusive and accurate and has become the method of choice for assessing food consumption, both individually and collectively.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

Including validated tools to assess nutrient-drug interactions in clinical practice enhances patient safety, optimizes therapeutic efficacy, and supports personalized nutrition strategies.

“Including validated tools to assess NDIs in clinical practice enhances patient safety, optimizes therapeutic efficacy, and supports personalized nutrition strategies.”

May combine two claims.

Treatment-induced toxicity disrupts the intestinal microbiota, which in turn indirectly compromises nutritional status.

“This treatment-induced toxicity disrupts the intestinal microbiota, which in turn indirectly compromises nutritional status [86].”

• cites [86] National Cancer Institute (2025, October 23). National Cancer Institute’s Common Terminology Criteria for Adverse Events: Diarrheaa, Available online: https://www.ncbi.nlm.nih.gov/books/NBK65768.4/table/CDR0000062736__287/?report=objectonly.Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

The Academy of Nutrition and Dietetics and the American Society for Parenteral and Enteral Nutrition recommend the use of handgrip strength to document impaired physical function, depending on the patient's circumstances.

“The Academy of Nutrition and Dietetics and the American Society for Parenteral and Enteral Nutrition recommend the use of HGS to document impaired physical function, depending on the patient's circumstances [112].”

• cites [112] White, 2012, Consensus Statement: Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition: Characteristics Recommended for the Identification and Documentation of Adult Malnutrition (Undernutrition), JPEN J. Parenter. Enteral Nutr. sourceNot checked — no full text of the source

May combine two claims.

The gut-muscle, gut-brain, and gut-liver axes elucidate how microbial metabolites and community composition affect metabolic homeostasis, immune responses, and host physiology, which are essential elements of nutritional status.

“This broader viewpoint emphasizes the gut-muscle, gut-brain, and gut-liver axes, which together elucidate how microbial metabolites and community composition affect metabolic homeostasis, immune responses, and host physiology, essential elements of nutritional status.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The Short Physical Performance Battery is an objective tool to assess three domains (balance, repeated rising from a chair, and gait speed) of lower-extremity physical function.

“The SPPB (Figure 7) is an objective tool to assess three domains (balance, repeated rising from a chair, and gait speed) of lower-extremity physical function”

May combine two claims.

Similar nutritional profiles may reflect distinct metabolic or inflammatory states when dysbiosis, recent antibiotic exposure, or impaired gastrointestinal function are present, leading to different diagnostic priorities and targeted interventions focused on microbiota modulation rather than solely on nutrient quantity or caloric intake.

“Similar nutritional profiles may therefore reflect distinct metabolic or inflammatory states when dysbiosis, recent antibiotic exposure, or impaired gastrointestinal function are present, leading to different diagnostic priorities and targeted interventions focused on microbiota modulation rather than solely on nutrient quantity or caloric intake.”

May combine two claims.

Muscle function tests are sensitive indicators of nutritional status and effective tools for monitoring nutritional interventions.

“Muscle function tests are sensitive indicators of nutritional status and effective tools for monitoring nutritional interventions [126].”

• cites [126] Scott, 2020, Nutritional Strategies for Maintaining Muscle Mass and Strength from Middle Age to Later Life: A Narrative Review, Maturitas sourceNot checked — no full text of the source

May combine two claims.

Gait velocity is a valid, reliable, and sensitive measure of functional capacity, commonly used to assess general health in various populations.

“Gait velocity (GV) is a valid, reliable, and sensitive measure of functional capacity, commonly used to assess general health in various populations.”

May combine two claims.

Alterations in gut microbiota composition affect metabolic regulation, microbial metabolite production, and inflammation, potentially predisposing individuals to metabolic, liver, and inflammatory disorders.

“This, in turn, affects metabolic regulation, microbial metabolite production, and inflammation, potentially predisposing individuals to metabolic, liver, and inflammatory disorders [99].”

• cites [99] 2024, The Impact of a Western Diet on Gut Microbiota and Circadian Rhythm: A Comprehensive Systematic Review of in Vivo Preclinical Evidence, Life Sci. sourceNot checked — no full text of the source

May combine two claims.

Genetic food intolerance testing facilitates dietary adaptation to avoid adverse symptoms and improve nutrient absorption.

“Facilitates dietary adaptation to avoid adverse symptoms and improve nutrient absorption.”

• cites [140] Braakhuis, 2021, Consensus Report of the Academy of Nutrition and Dietetics: Incorporating Genetic Testing into Nutrition Care, J. Acad. Nutr. Diet. sourceNot checked — no full text of the source

May combine two claims.

Nutrient-drug interactions represent a clinically relevant interface in which medications may alter nutrient absorption, metabolism, distribution, and excretion, while nutrients may influence drug pharmacokinetics and therapeutic efficacy.

“NDIs represent a clinically relevant interface in which medications may alter nutrient absorption, metabolism, distribution, and excretion, while nutrients may influence drug pharmacokinetics and therapeutic efficacy [60].”

• cites [60] Boullata, 2012, Drug–Nutrient Interactions: A Broad View with Implications for Practice, J. Acad. Nutr. Diet. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S2 (checkable).

These findings underscore the need to jointly assess structural and physiological parameters when predicting clinical outcomes and monitoring recovery.

“Together, these findings underscore the need to jointly assess structural and physiological parameters when predicting clinical outcomes and monitoring recovery.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The ecological component represents one of the most innovative contributions of the ABCDEFG model.

“According to the ecological component, it represents one of the most innovative contributions of the ABCDEFG model.”

May combine two claims.

In clinical and community contexts, the functional dimension plays a central role in frailty screening, the diagnosis and longitudinal monitoring of sarcopenia, and the planning of targeted rehabilitation strategies aimed at restoring or preserving functional capacity.

“In clinical and community contexts, the functional dimension (F) plays a central role in frailty screening, the diagnosis and longitudinal monitoring of sarcopenia, and the planning of targeted rehabilitation strategies aimed at restoring or preserving functional capacity.”

May combine two claims.

By incorporating nutrient-drug interactions into routine assessment, the ABCDEFG model strengthens the link between dietary behavior, biochemical and functional markers, therapeutic effectiveness, and patient safety, thereby enhancing its clinical relevance and rigor.

“By incorporating NDIs into routine assessment, the ABCDEFG model strengthens the link between dietary behavior, biochemical and functional markers, therapeutic effectiveness, and patient safety, thereby enhancing its clinical relevance and rigor.”

May combine two claims.

Nutrigenetics influences health and can condition the nutritional status of an individual, and knowledge of genetic variants allows the personalization of a food plan.

“Nutrigenetics influences health and can condition the nutritional status of an individual [137], which is why it is essential to adhere to this parameter in nutritional assessment; knowledge of genetic variants allows the personalization of a food plan [138].”

• cites [137] Eynard, 2022, Nutrigenetics: Potentials and Applications in Cardiovascular Diseases and Associated Risk Factors, Rev. Fac. Cien. Med. Univ. Nac. CordobaNot checked yet

  Not checked in the free run.

• cites [138] Reglero, 2021, de Test nutrigenéticos como herramienta para una alimentación de precisión, Rev. Esp. Nutr. Hum. Diet.Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S4 (based).

Within clinical and community settings, genetic assessment supports personalized dietary recommendations by identifying genetic variants that influence nutrient metabolism, food tolerances, and individual dietary responses.

“Within clinical and community settings, the genetic assessment supports personalized dietary recommendations by identifying genetic variants that influence nutrient metabolism, food tolerances, and individual dietary responses.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

The findings of this narrative review demonstrate that the ABCDEFG framework represents a significant conceptual evolution in nutritional assessment, providing a multidimensional perspective that bridges classical and emerging methodologies.

“The findings of this narrative review demonstrate that the ABCDEFG framework represents a significant conceptual evolution in nutritional assessment, providing a multidimensional perspective that bridges classical and emerging methodologies.”

Classified as probably not a substantial claim.

Within the ABCDEFG framework, functional impairment modifies the clinical relevance of anthropometric or biochemical findings, prioritizing interventions aimed at restoring physical performance, muscle strength, and functional reserve rather than focusing exclusively on body composition correction or isolated nutrient deficits.

“Within the ABCDEFG framework, functional impairment modifies the clinical relevance of anthropometric or biochemical findings, prioritizing interventions aimed at restoring physical performance, muscle strength, and functional reserve rather than focusing exclusively on body composition correction or isolated nutrient deficits.”

Classified as probably not a substantial claim. May combine two claims.

Functional indicators are essential for community-based fall-risk surveillance, supporting early identification of mobility decline and guiding preventive interventions to maintain independence and quality of life.

“Moreover, functional indicators are essential for community-based fall-risk surveillance, supporting early identification of mobility decline and guiding preventive interventions to maintain independence and quality of life.”

May combine two claims.

Analysis of vitamin-related genes identifies risks of vitamin deficiencies, allowing specific nutritional interventions.

“Identifies risks of vitamin deficiencies, allowing specific nutritional interventions.”

• cites [139] Robinson, 2021, Effect of Incorporating Genetic Testing Results into Nutrition Counseling and Care on Dietary Intake: An Evidence Analysis Center Systematic Review—Part I, J. Acad. Nutr. Diet. sourceNot checked — no full text of the source

May combine two claims.

These bidirectional nutrient-drug interaction effects are particularly relevant in individuals with chronic diseases, multimorbidity, or polypharmacy, where NDIs can distort apparent dietary adequacy, mask nutrient deficiencies, precipitate metabolic imbalances, or modify the expected response to nutritional interventions.

“These bidirectional effects are particularly relevant in individuals with chronic diseases, multimorbidity, or polypharmacy, where NDIs can distort the apparent dietary adequacy, mask nutrient deficiencies, precipitate metabolic imbalances, or modify the expected response to nutritional interventions.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

The identification of clinical signs associated with nutrient deficiencies remains essential.

“Similarly, the identification of clinical signs associated with nutrient deficiencies remains essential.”

May combine two claims.

Overall evidence on the effectiveness of integrating genotyping into nutritional counseling remains limited and of variable quality.

“However, overall evidence on the effectiveness of integrating genotyping into nutritional counseling remains limited and of variable quality [141].”

• cites [141] Ellis, 2021, Effect of Incorporating Genetic Testing Results into Nutrition Counseling and Care on Health Outcomes: An Evidence Analysis Center Systematic Review-Part II, J. Acad. Nutr. Diet. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

Genomic insights contribute to long-term risk reduction strategies by informing preventive nutrition approaches that account for inherited predispositions to chronic diseases.

“Additionally, genomic insights contribute to long-term risk reduction strategies by informing preventive nutrition approaches that account for inherited predispositions to chronic diseases.”

May combine two claims.

Current findings highlight promising opportunities but are not yet sufficient to draw firm conclusions about the clinical effectiveness of the ABCDEFG framework.

“Current findings highlight promising opportunities but are not yet sufficient to draw firm conclusions about its clinical effectiveness.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

The ABCDEFG framework represents a conceptual evolution beyond traditional assessment models and aligns with contemporary advances in precision nutrition and integrative health.

“The ABCDEFG framework represents a conceptual evolution beyond traditional assessment models and aligns with contemporary advances in precision nutrition and integrative health.”

• AssumptionRests on an assumption: The classical ABCD model presents limitations when addressing contemporary challenges such as the double burden of malnutrition, aging populations, and the rise in chronic diseases.

Probably not a substantial claim: may not pass S2 (checkable).

The broader ABCDEFG framework has the potential to support more individualized and context-specific approaches to care.

“This broader framework has the potential to support more individualized and context-specific approaches to care.”

Classified as probably not a substantial claim.

Some components of the ABCDEFG model, particularly the ecological (microbiota) and genomic-nutrigenomic dimensions, still require standardized methodologies, reference values, and cost-effective tools to facilitate their routine use in professional practice.

“Some of its components-particularly the ecological (microbiota) and genomic-nutrigenomic dimensions-still require standardized methodologies, reference values, and cost-effective tools to facilitate their routine use in professional practice.”

Classified as probably not a substantial claim.

The proposed ABCDEFG model has not yet undergone full validation in diverse clinical and community contexts.

“Additionally, the proposed ABCDEFG model has not yet undergone full validation in diverse clinical and community contexts.”

May combine two claims.

The study design did not follow a systematic review protocol, so the selection of articles may have been influenced by publication bias and the authors' judgment.

“First, although a comprehensive literature search was conducted across major databases, the study design did not follow a systematic review protocol; therefore, the selection of articles may have been influenced by publication bias and the authors' judgment.”

Probably not a substantial claim: may not pass S4 (based). May combine two claims.

The expanded ABCDEFG model incorporates additional dimensions that allow for a more comprehensive and integrative evaluation, linking traditional indicators with environmental, physiological, and molecular domains.

“The expanded ABCDEFG model incorporates additional dimensions that allow for a more comprehensive and integrative evaluation, linking traditional indicators with environmental, physiological, and molecular domains.”

Classified as probably not a substantial claim. May combine two claims.

The evidence supporting improvements in prevention, early diagnosis, and management remains preliminary and should be interpreted with caution.

“Nevertheless, the evidence supporting improvements in prevention, early diagnosis, and management remains preliminary and should be interpreted with caution.”

May combine two claims.

The systems-oriented perspective of the ABCDEFG framework enables more nuanced diagnostic reasoning and supports personalized nutritional decision-making, particularly in complex scenarios such as aging, chronic disease, and metabolically heterogeneous populations.

“This systems-oriented perspective enables more nuanced diagnostic reasoning and supports personalized nutritional decision-making, particularly in complex scenarios such as aging, chronic disease, and metabolically heterogeneous populations.”

May combine two claims.

The genomic-nutrigenomic dimension adds explanatory power to nutritional variability but still requires methodological standardization and robust clinical validation before routine incorporation into nutritional care.

“Altogether, the genomic-nutrigenomic dimension adds explanatory power to nutritional variability but still requires methodological standardization and robust clinical validation before routine incorporation into nutritional care.”