PEN eNews 11(3) March 2021

Nutrition Assessment and Malnutrition - What is the Latest?

What nutrition assessment process can be used to diagnose malnutrition in adults admitted to hospital?

There is no gold standard for the assessment of nutritional status and no tool can replace a clinician’s judgment in interpreting information obtained from history, physical examination, anthropometric measurements and laboratory data; however, standardized processes are desired to promote consistency in the diagnosis of malnutrition.

The GLIM criteria, a consensus from the Global Clinical Nutrition Community, recommends that a diagnosis of malnutrition be made on the presence of at least one phenotypic criteria and one etiologic criteria. The phenotypic criteria include non-volitional weight loss, low BMI and reduced muscle mass. The etiologic criteria include reduced food intake/assimilation and disease burden/inflammation. These clinical measures are included in a range of existing tools designed to diagnose malnutrition. The phenotypic criteria can be used to classify the severity of malnutrition. The groups recommend that any diagnosis of malnutrition be followed with a comprehensive nutrition assessment.

There are a range of tools that have been validated for nutrition assessment in many individual studies. The above GLIM criteria are incorporated into many existing validated tools used to diagnose malnutrition in adults, such as the Subjective Global Assessment (SGA).

See PEN Calculator: Nutrition Screening and Assessment Tools: Assessment Tools.

Country-specific Recommendations

The ICD-10-Australian Modification definition for malnutrition is regularly used for diagnosis and coding of malnutrition in Australian hospitals.

The Canadian Malnutrition Task Force recommends the use of the Subjective Global Assessment as the gold standard for diagnosing malnutrition.

The U.K. National Institute for Health and Care Excellence (NICE) Guidelines defines a person who is malnourished as meeting any of these criteria: BMI <18.5kg/m², unintentional weight loss of more than 10% within the preceding three to six months or a BMI <20 kg/m² combined with unintentional weight loss of more than 5% within the preceding three to six months.

To see the full practice question, including the Evidence Summary, Remarks, Evidence Statements, Comments and References, click here.

Looking for information on malnutrition and screening? See: What screening process can be used to identify adults at risk of malnutrition admitted to hospital?

Want to know what else is new and updated? Bookmark these pages:
New Knowledge Pathway Content (Knowledge Pathways, Practice Questions, Summary of Recommendations and Evidence, Practice Guidance Toolkits, Backgrounds)
Tools and Resources.

The Gastrointestinal System – Pediatrics/Paediatrics Knowledge Pathway is Updated!

• What are the recommendations for rehydration and nutritional management of acute gastroenteritis among children?
• What is the safety and efficacy of the use of supplemental zinc in the management of acute gastroenteritis among children?
• What is the safety and efficacy of the use of probiotics in the management of acute gastroenteritis among children?
• What is the safety and efficacy of the use of probiotics in the prevention of antibiotic-associated diarrhea and Clostridium difficile-associated diarrhea among children?

• 25 Knowledge Pathways
• 197 Practice Questions
• 95 Handouts.

• Celiac Disease
• Infant Nutrition - Infant Formula
• Multivitamin/mineral Supplements and Chronic Disease
• Postoperative Feeding
• Probiotics - Pediatric Gastroesophageal Reflux Disease
• Research Methods
• Weight/Obesity - Bariatric Surgery.

• Does involvement in food preparation and cooking improve nutrition knowledge, skills, attitudes and dietary quality?
• What are the best practices for the effective implementation of cooking and food skills training programs/interventions?
• What enablers and barriers should be considered when promoting food preparation involvement?

Open Access to COVID-19 Content Continues

• COVID-19
  • COVID-19 and Nutrition Background
  • COVID-19 Related Tools and Resources
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• PEN eNews.

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Raising Our Healthy Kids Videos 

Raising Our Healthy Kids is a series of free, short and snappy 1-2 minute videos providing information to parents and care providers on the healthy growth and development of children up to 12 years of age. The videos provide information on general nutrition, active play, healthy growth and development, including positive body image and understanding how marketing affects choices and food intake.

These award winning videos can be freely shared and used as teaching resources and discussion generators. You can:

• show them in a waiting room or clinic area 
• add them to hospital/agency TV channels and/or websites, and 
• email them to your clients.

Highlights:

• There are 70 videos in total on a variety of healthy living topics.
• Twenty-six videos are specifically related to nutrition, with 25 of these translated into French.
• The videos were created by health professionals, are evidence-based and national in scope.

What topic areas do the videos cover?
The videos cover a number of topic areas and they have been divided into 11 channels:

You can access the videos from:

• PEN: Practice-based Evidence in Nutrition^®: 
  • Infant Nutrition 
  • Preschool Nutrition 
  • Media Literacy and Food Marketing 
  • School Age Nutrition 
  • Play and Physical Activity
• Dietitians of Canada Unlockfood.ca 
• Vimeo website (contains all 70 videos)

FAQs
As a professional, do I need permission to use and distribute the videos?
You are free to use these videos in any way you can to help families live healthier lives. They are free from branding and bias. You do not need to ask permission to use them, nor do you need to write any form of acknowledgement. The videos were created to be used to help families with children with the ‘red tape’ removed for easy use and dissemination.

The content of the videos is national in scope and is consistent with messages from Health Canada, Public Health Agency of Canada, Alberta Health Services, and nutrition messages are consistent with PEN: Practice-based Evidence in Nutrition^®.

Who developed the videos?
The videos were developed by a multi-stakeholder group including Dietitians of Canada and Alberta Health Services and with input from a pediatrician and community stakeholders across Canada.

Where did the funding come from?
Funding was provided by the Government of Alberta, Calgary Health Trust and Canadian Institutes of Health Research; and the videos were produced by Shadow Light Productions. Financial support for French translations was provided by EatRight Ontario.