Growing evidence suggests that varying degrees of acute or chronic inflammation are key contributing factors in the pathophysiology of malnutrition that is associated with disease or injury. Historic nutrition assessment parameters have been revealed to be impacted by inflammatory response. The presence of inflammation can also blunt favorable responses to nutrition therapies.
We have proposed a new etiology-driven approach to nutrition diagnosis for adults in the clinical practice setting that has been adopted by A.S.P.E.N. and the Academy of Nutrition and Dietetics. These malnutrition syndromes include starvation-related malnutrition, in which there is chronic starvation without inflammation, chronic disease-related malnutrition, in which inflammation is chronic and of mild to moderate degree, and acute disease- or injury-related malnutrition, in which inflammation is acute and of severe degree.
A systematic approach to nutrition assessment will be shared for the diagnosis of malnutrition with practical indicators of malnutrition and inflammation that include medical/surgical history and clinical diagnosis, clinical signs, and physical examination, anthropometric data, laboratories, dietary assessment, and functional outcomes. Feasibility and validity testing of malnutrition markers and characteristics will be discussed. Opportunities for modulation of inflammation to promote improved outcomes will be explored. Inflammation can be a good thing…let’s try to keep it that way.
Senior Associate Dean for Research Emeritus; Professor of Medicine and Nutrition Emeritus,
Larner College of Medicine University of Vermont, Burlington, VT