Decreased food intake during hospital stays is an independent risk factor for hospital mortality

New and universally applicable definitions of malnutrition are published in the current issue of Clinical Nutrition. These are the result of a major international collaboration that has been endorsed by ESPEN and the American nutrition society ASPEN. The importance of the work is emphasised by the unusual step that has been taken in arranging dual publication in Clinical Nutrition and the ASPEN journal JPEN. It is expected that these definitions will take precedence in much future work.

Prompted by the recognition that generally agreed definitions of malnutrition have been lacking, and the need to distinguish between uncomplicated starvation and disease-related malnutrition, a distinguished group of authors from around the world has provided a simple and yet inclusive set of aetiology-based proposals. The affected adult is assigned to one of three forms of malnutrition: starvation-related, chronic disease-related or acute disease/injury-related. The simplicity and anticipated prognostic significance of this approach is expected to lead to improved diagnosis and to the development of validated confirmatory tools, whether in the form of laboratory tests, anthropometric or functional measures.

The international working party included experts from all continents and reached its conclusions through a structured approach to consensus which was unanimously agreed and is independent of any commercial influence.