Recorded Conference Session May 2017 - Malnutrition as a phenotype vs Malnutrition due to insufficient intake
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Loss of body tissues resulting in wasting is a common phenotype for several different conditions which can be caused by a combination of reduced food intake, excessive requirements, altered metabolism, sepsis, trauma, ageing and inactivity. They have been referred to loosely as 'malnutrition' but not all will respond to simply providing nutrients. This symposia will provide a review of phenotypes (e.g. sarcopenia, malnutrition, cachexia), their common features and the differences as they relate to cause and response to treatment. The spectrum ranges from the 85 year-old Marathon Runner with a BMI of 16.5 to the obese patient with pancreatitis who is unable to eat or drink for the past 10 days. The former is a Phenotype that does not require nutritional support and the latter is malnourished and should be given nutritional support. The only way of correctly identifying the need for nutritional support in both instances is by using the Subjective Global Assessment. Three case histories will be presented and assessed by the different major tools to show how Subjective Global Assessment avoids misclassification associated with tools which score using anthropometric parameters.
Dr. Khursheed Jeejeebhoy
Malnutrition as a phenotype vs Malnutrition due to insufficient intake
Loss of body tissues resulting in wasting is a common phenotype for several different conditions which can be caused by a combination of reduced food intake, excessive requirements, altered metabolism, sepsis, trauma, ageing and inactivity. They have been referred to loosely as malnutrition but in not all will respond to simply providing nutrients. In this review the common features and the differences as they relate to cause and response to treatment are discussed.
Can we diagnose malnutrition without considering the nutrient intake history?
In the health care setting, the clinician provides care to a growing number of elderly people. Malnutrition and sarcopenia are two well-known conditions existing in this population. A manifestation common to both malnutrition and sarcopenia is muscle wasting. Further challenging the clinician seeking to define nutritional status and determine the need for nutrition care intervention, is the overlapping of some of the criteria to diagnose wasting conditions proposed in the different consensus guidelines. This affirms the importance of making an overall evaluation of the patient's condition and relying on clinical judgment as proposed by the Subjective Global Assessment to diagnose malnutrition. When we refer to the diagnosis of malnutrition, should we not expect a link between the inadequate nutrient intake (and/or absorption) history and the physical examination?
At the end of this presentation, the participant will be able to:
1. Understand the key concept that is fundamental in the diagnosis of malnutrition
2. Make a distinction between malnutrition and the wasting conditions, such as sarcopenia.
3. Identify which tool is the most highly validated and work the best in terms of identifying people who are not getting enough nutrition and would benefit from nutritional therapy.
***Original Source: "2017 Annual Conference", Saturday, May 27, 2017
Last Updated: June 26, 2017
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