Cederholm T, Barazzoni R, Austin P, Ballmer P, Biolo G, Bischoff SC, Compher C, Correia I, Higashiguchi T, Holst M, Jensen GL, Malone A, Muscaritoli M, Nyulasi I, Pirlich M, Rothenberg E, Schindler K, Schneider SM, de van der Schueren MA, Sieber C, Valentini L, Yu JC, Van Gossum A, Singer P, et al.
Clinical nutrition (Edinburgh, Scotland). Date of publication 2017 Feb 1;volume 36(1):49-64.
1. Clin Nutr. 2017 Feb;36(1):49-64. doi: 10.1016/j.clnu.2016.09.004. Epub 2016 Sep
14.
ESPEN guidelines on definitions and terminology of clinical nutrition.
Cederholm T(1), Barazzoni R(2), Austin P(3), Ballmer P(4), Biolo G(5), Bischoff
SC(6), Compher C(7), Correia I(8), Higashiguchi T(9), Holst M(10), Jensen GL(11),
Malone A(12), Muscaritoli M(13), Nyulasi I(14), Pirlich M(15), Rothenberg E(16),
Schindler K(17), Schneider SM(18), de van der Schueren MA(19), Sieber C(20),
Valentini L(21), Yu JC(22), Van Gossum A(23), Singer P(24).
Author information:
(1)Departments of Geriatric Medicine, Uppsala University Hospital and Public
Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala
University, Uppsala, Sweden. Electronic address: tommy.cederholm@pubcare.uu.se.
(2)Department of Medical, Surgical and Health Sciences, University of Trieste,
Trieste, Italy. Electronic address: barazzon@units.it.
(3)Pharmacy Department, Oxford University Hospitals NHS Foundation Trust, United
Kingdom; Pharmacy Department, University Hospital Southampton NHS Foundation
Trust, United Kingdom. Electronic address: peter.austin@uhs.nhs.uk.
(4)Department of Medicine, Kantonsspital Winterthur, Winterthur, Switzerland.
Electronic address: peter.ballmer@ksw.ch.
(5)Institute of Clinical Medicine, University of Trieste, Trieste, Italy.
Electronic address: biolo@units.it.
(6)Institute of Nutritional Medicine, University of Hohenheim, Stuttgart,
Germany. Electronic address: bischoff.stephan@uni-hohenheim.de.
(7)School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.
Electronic address: compherc@nursing.upenn.edu.
(8)Department of Surgery, Federal University of Minas Gerais, Belo Horizonte,
Brazil. Electronic address: isabel_correia@uol.com.br.
(9)Department of Surgery and Palliative Medicine, Fujita Health University,
School of Medicine, Toyoake, Japan. Electronic address:
t-gucci30219@herb.ocn.ne.jp.
(10)Center for Nutrition and Bowel Disease, Department of Gastroenterology,
Aalborg University Hospital, Aalborg, Denmark. Electronic address:
mette.holst@rn.dk.
(11)The Dean's Office and Department of Medicine, The University of Vermont
College of Medicine, Burlington, VT, USA. Electronic address:
gordon.jensen@med.uvm.edu.
(12)Pharmacy Department, Mount Carmel West Hospital, Columbus, OH, USA.
Electronic address: ainsleym@nutritioncare.org.
(13)Department of Clinical Medicine, Sapienza University of Rome, Italy.
Electronic address: maurizio.muscaritoli@uniroma1.it.
(14)Nutrition and Dietetics, Alfred Health, Melbourne, Australia. Electronic
address: i.nyulasi@alfred.org.au.
(15)Department of Internal Medicine, Elisabeth Protestant Hospital, Berlin,
Germany. Electronic address: matthias.pirlich@pgdiakonie.de.
(16)Department of Food and Meal Science, Kristianstad University, Kristianstad,
Sweden. Electronic address: elisabet.rothenberg@vgregion.se.
(17)Department of Internal Medicine III, Division of Endocrinology and
Metabolism, Medical University Vienna, Vienna, Austria. Electronic address:
karin.schindler@meduniwien.ac.at.
(18)Department of Gastroenterology and Clinical Nutrition, Archet Hospital,
University of Nice Sophia Antipolis, Nice, France. Electronic address:
stephane.schneider@unice.fr.
(19)Department of Nutrition and Dietetics, Internal Medicine, VU University
Medical Center, Amsterdam, The Netherlands; Department of Nutrition, Sports and
Health, Faculty of Health and Social Studies, HAN University of Applied Sciences,
Nijmegen, The Netherlands. Electronic address: m.devanderschueren@vumc.nl.
(20)Institute for Biomedicine of Ageing, Friedrich-Alexander University
Erlangen-Nürnberg, Hospital St. John of Lord, Regensburg, Germany. Electronic
address: cornel.sieber@fau.de.
(21)Department of Agriculture and Food Sciences, Section of Dietetics, University
of Applied Sciences, Neubrandenburg, Germany. Electronic address:
valentini@hs-nb.de.
(22)Department of General Surgery, Peking Union Medical College Hospital, Chinese
Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Electronic address: yu-jch@163.com.
(23)Department of Gastroenterology, Clinic of Intestinal Diseases and Nutritional
Support, Hopital Erasme, Free University of Brussels, Brussels, Belgium.
Electronic address: Andre.VanGossum@erasme.ulb.ac.be.
(24)Department of Critical Care, Institute for Nutrition Research, Rabin Medical
Center, Sackler School of Medicine, Tel Aviv University, Petah Tikva 49100
Israel. Electronic address: pierre.singer@gmail.com.
Comment in
Clin Nutr. 2017 Oct;36(5):1451.
Clin Nutr. 2017 Dec;36(6):1725-1726.
BACKGROUND: A lack of agreement on definitions and terminology used for
nutrition-related concepts and procedures limits the development of clinical
nutrition practice and research.
OBJECTIVE: This initiative aimed to reach a consensus for terminology for core
nutritional concepts and procedures.
METHODS: The European Society of Clinical Nutrition and Metabolism (ESPEN)
appointed a consensus group of clinical scientists to perform a modified Delphi
process that encompassed e-mail communication, face-to-face meetings, in-group
ballots and an electronic ESPEN membership Delphi round.
RESULTS: Five key areas related to clinical nutrition were identified: concepts;
procedures; organisation; delivery; and products. One core concept of clinical
nutrition is malnutrition/undernutrition, which includes disease-related
malnutrition (DRM) with (eq. cachexia) and without inflammation, and
malnutrition/undernutrition without disease, e.g. hunger-related malnutrition.
Over-nutrition (overweight and obesity) is another core concept. Sarcopenia and
frailty were agreed to be separate conditions often associated with malnutrition.
Examples of nutritional procedures identified include screening for subjects at
nutritional risk followed by a complete nutritional assessment. Hospital and care
facility catering are the basic organizational forms for providing nutrition.
Oral nutritional supplementation is the preferred way of nutrition therapy but if
inadequate then other forms of medical nutrition therapy, i.e. enteral tube
feeding and parenteral (intravenous) nutrition, becomes the major way of nutrient
delivery.
CONCLUSION: An agreement of basic nutritional terminology to be used in clinical
practice, research, and the ESPEN guideline developments has been established.
This terminology consensus may help to support future global consensus efforts
and updates of classification systems such as the International Classification of
Disease (ICD). The continuous growth of knowledge in all areas addressed in this
statement will provide the foundation for future revisions.
Copyright © 2016 European Society for Clinical Nutrition and Metabolism.
Published by Elsevier Ltd.. All rights reserved.
DOI: 10.1016/j.clnu.2016.09.004
PMID: 27642056 [Indexed for MEDLINE]
