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Wunderle, C., Gomes, F., Schuetz, P., Stumpf, F., Austin, P., Ballesteros-Pomar, M. D., . . . Bischoff, S. C. (2024). ESPEN practical guideline: Nutritional support for polymorbid medical inpatients. Clinical Nutrition, 43(3), 674-691
Open this publication in new window or tab >>ESPEN practical guideline: Nutritional support for polymorbid medical inpatients
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2024 (English)In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 43, no 3, p. 674-691Article in journal (Refereed) Published
Abstract [en]

Background: Disease-related malnutrition in polymorbid medical inpatients is a highly prevalent syndrome associated with significantly increased morbidity, disability, short- and long-term mortality, impaired recovery from illness, and healthcare costs.

Aim: As there are uncertainties in applying disease-specific guidelines to patients with multiple conditions, our aim was to provide evidence-based recommendations on nutritional support for the polymorbid patient population hospitalized in medical wards.

Methods: The 2023 update adheres to the standard operating procedures for ESPEN guidelines. We undertook a systematic literature search for 15 clinical questions in three different databases (Medline, Embase and the Cochrane Library), as well as in secondary sources (e.g., published guidelines), until July 12th, 2022. Retrieved abstracts were screened to identify relevant studies that were used to develop recommendations (including SIGN grading), which was followed by submission to Delphi voting. Here, the practical version of the guideline is presented which has been shortened and equipped with flow charts for patients care.

Results: 32 recommendations (7x A, 11x B, 10x O and 4x GPP), which encompass different aspects of nutritional support were included from the scientific guideline including indication, route of feeding, energy and protein requirements, micronutrient requirements, disease-specific nutrients, timing, monitoring and procedure of intervention. Here, the practical version of the guideline is presented which has been shortened and equipped with flow charts for patients care.

Conclusions: Recent high-quality trials have provided increasing evidence that nutritional support can reduce morbidity and other complications associated with malnutrition in polymorbid patients. The timely screening of patients for risk of malnutrition at hospital admission followed by individualized nutritional support interventions for at-risk patients should be part of routine clinical care and multimodal treatment in hospitals worldwide. Use of this updated practical guideline offers an evidencebased nutritional approach to polymorbid medical inpatients and may improve their outcomes.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Guideline, Polymorbid, Multimorbidity, Nutritional support, Hospitalized patients
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:uu:diva-525901 (URN)10.1016/j.clnu.2024.01.008 (DOI)001181768500001 ()38309229 (PubMedID)
Available from: 2024-04-04 Created: 2024-04-04 Last updated: 2024-04-04Bibliographically approved
Muñoz-Fernandez, S. S., Garcez, F. B., Alencar, J. C. G., Bastos, A. A., Morley, J. E., Cederholm, T., . . . Ribeiro, S. M. L. (2024). Gut microbiota disturbances in hospitalized older adults with malnutrition and clinical outcomes. Nutrition (Burbank, Los Angeles County, Calif.), 122, Article ID 112369.
Open this publication in new window or tab >>Gut microbiota disturbances in hospitalized older adults with malnutrition and clinical outcomes
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2024 (English)In: Nutrition (Burbank, Los Angeles County, Calif.), ISSN 0899-9007, E-ISSN 1873-1244, Vol. 122, article id 112369Article in journal (Refereed) Published
Abstract [en]

Objective

Malnutrition is one of the most threatening conditions in geriatric populations. The gut microbiota has an important role in the host's metabolic and muscular health: however, its interplay with disease-related malnutrition is not well understood. We aimed to identify the association of malnutrition with the gut microbiota and predict clinical outcomes in hospitalized acutely ill older adults.

Methods

We performed a secondary longitudinal analysis in 108 geriatric patients from a prospective cohort evaluated at admission and 72 h of hospitalization. We collected clinical, demographic, nutritional, and 16S rRNA gene-sequenced gut microbiota data. Microbiota diversity, overall composition, and differential abundance were calculated and compared between patients with and without malnutrition. Microbiota features associated with malnutrition were used to predict clinical outcomes.

Results

Patients with malnutrition (51%) had a different microbiota composition compared to those who were well-nourished during hospitalization (ANOSIM R = 0.079, P = 0.003). Patients with severe malnutrition showed poorer α-diversity at admission (Shannon P = 0.012, Simpson P = 0.018) and follow-up (Shannon P = 0.023, Chao1 P = 0.008). Differential abundance of Lachnospiraceae NK4A136 group, Subdoligranulum, and Faecalibacterium prausnitzii were significantly lower and inversely associated with malnutrition, while Corynebacterium, Ruminococcaceae Incertae Sedis, and Fusobacterium were significantly increased and positively associated with malnutrition. Corynebacterium, Ruminococcaceae Incertae Sedis, and the overall composition were important predictors of critical care in patients with malnutrition during hospitalization.

Conclusion

Older adults with malnutrition, especially in a severe stage, may be subject to substantial gut microbial disturbances during hospitalization. The gut microbiota profile of patients with malnutrition might help us to predict worse clinical outcomes.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Acute disease, Critical care, Gut microbiota, GLIM criteria, Malnutrition, Older adults
National Category
Nutrition and Dietetics Geriatrics
Identifiers
urn:nbn:se:uu:diva-527984 (URN)10.1016/j.nut.2024.112369 (DOI)001208456200001 ()38422755 (PubMedID)
Available from: 2024-05-15 Created: 2024-05-15 Last updated: 2024-05-15Bibliographically approved
Borda, M. G., Samuelsson, J., Cederholm, T., Baldera, J. P., Perez-Zepeda, M. U., Barreto, G. E., . . . Aarsland, D. (2024). Nutrient Intake and Its Association with Appendicular Total Lean Mass and Muscle Function and Strength in Older Adults: A Population-Based Study. Nutrients, 16(4), Article ID 568.
Open this publication in new window or tab >>Nutrient Intake and Its Association with Appendicular Total Lean Mass and Muscle Function and Strength in Older Adults: A Population-Based Study
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2024 (English)In: Nutrients, E-ISSN 2072-6643, Vol. 16, no 4, article id 568Article in journal (Refereed) Published
Abstract [en]

Treatment options for sarcopenia are currently limited, and primarily rely on two main therapeutic approaches: resistance-based physical activity and dietary interventions. However, details about specific nutrients in the diet or supplementation are unclear. We aim to investigate the relationship between nutrient intake and lean mass, function, and strength. Data were derived from the Gothenburg H70 birth cohort study in Sweden, including 719,70-year-olds born in 1944 (54.1% females). For independent variables, the diet history method (face-to-face interviews) was used to estimate habitual food intake during the preceding three months. Dependent variables were gait speed (muscle performance), hand grip strength (muscle strength), and the appendicular lean soft tissue index (ALSTI). Linear regression analyses were performed to analyze the relationship between the dependent variables and each of the covariates. Several nutrients were positively associated with ALSTI, such as polyunsaturated fatty acids (DHA, EPA), selenium, zinc, riboflavin, niacin equivalent, vitamin B12, vitamin D, iron, and protein. After correction for multiple comparisons, there were no remaining correlations with handgrip and gait speed. Findings of positive correlations for some nutrients with lean mass suggest a role for these nutrients in maintaining muscle volume. These results can be used to inform clinical trials to expand the preventive strategies and treatment options for individuals at risk of muscle loss and sarcopenia.

Place, publisher, year, edition, pages
MDPI, 2024
Keywords
sarcopenia, body composition, aging, diet, walking speed, muscle strength
National Category
Geriatrics Nutrition and Dietetics
Identifiers
urn:nbn:se:uu:diva-525076 (URN)10.3390/nu16040568 (DOI)001172347500001 ()38398892 (PubMedID)
Available from: 2024-03-19 Created: 2024-03-19 Last updated: 2024-03-19Bibliographically approved
Kirk, B., Cawthon, P. M., Arai, H., Avila-Funes, J. A., Barazzoni, R., Bhasin, S., . . . Cruz-Jentoft, A. J. (2024). The Conceptual Definition of Sarcopenia: Delphi Consensus from the Global Leadership Initiative in Sarcopenia (GLIS). Age and Ageing, 53(3), Article ID afae052.
Open this publication in new window or tab >>The Conceptual Definition of Sarcopenia: Delphi Consensus from the Global Leadership Initiative in Sarcopenia (GLIS)
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2024 (English)In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 53, no 3, article id afae052Article in journal (Refereed) Published
Abstract [en]

Importance Sarcopenia, the age-related loss of muscle mass and strength/function, is an important clinical condition. However, no international consensus on the definition exists. Objective The Global Leadership Initiative in Sarcopenia (GLIS) aimed to address this by establishing the global conceptual definition of sarcopenia. Design The GLIS steering committee was formed in 2019-21 with representatives from all relevant scientific societies worldwide. During this time, the steering committee developed a set of statements on the topic and invited members from these societies to participate in a two-phase International Delphi Study. Between 2022 and 2023, participants ranked their agreement with a set of statements using an online survey tool (SurveyMonkey). Statements were categorised based on predefined thresholds: strong agreement (>80%), moderate agreement (70-80%) and low agreement (<70%). Statements with strong agreement were accepted, statements with low agreement were rejected and those with moderate agreement were reintroduced until consensus was reached. Results 107 participants (mean age: 54 +/- 12 years [1 missing age], 64% men) from 29 countries across 7 continents/regions completed the Delphi survey. Twenty statements were found to have a strong agreement. These included; 6 statements on 'general aspects of sarcopenia' (strongest agreement: the prevalence of sarcopenia increases with age (98.3%)), 3 statements on 'components of sarcopenia' (muscle mass (89.4%), muscle strength (93.1%) and muscle-specific strength (80.8%) should all be a part of the conceptual definition of sarcopenia)) and 11 statements on 'outcomes of sarcopenia' (strongest agreement: sarcopenia increases the risk of impaired physical performance (97.9%)). A key finding of the Delphi survey was that muscle mass, muscle strength and muscle-specific strength were all accepted as 'components of sarcopenia', whereas impaired physical performance was accepted as an 'outcome' rather than a 'component' of sarcopenia. Conclusion and relevance The GLIS has created the first global conceptual definition of sarcopenia, which will now serve to develop an operational definition for clinical and research settings.

Place, publisher, year, edition, pages
Oxford University Press, 2024
Keywords
older people, conceptual, definitions, sarcopenia, GLIS
National Category
Geriatrics
Identifiers
urn:nbn:se:uu:diva-526386 (URN)10.1093/ageing/afae052 (DOI)001190159300001 ()38520141 (PubMedID)
Available from: 2024-04-12 Created: 2024-04-12 Last updated: 2024-04-12Bibliographically approved
Visser, M., Mendonca, N., Avgerinou, C., Cavdar, S., Cederholm, T., Cruz-Jentoft, A. J., . . . Volkert, D. (2023). A Core Outcome Set for nutritional intervention studies in older adults with malnutrition and those at risk: a study protocol. BMC Geriatrics, 23(1), Article ID 221.
Open this publication in new window or tab >>A Core Outcome Set for nutritional intervention studies in older adults with malnutrition and those at risk: a study protocol
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2023 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 23, no 1, article id 221Article in journal (Refereed) Published
Abstract [en]

Background: Malnutrition (i.e., protein-energy malnutrition) in older adults has severe negative clinical consequences, emphasizing the need for effective treatments. Many, often small, randomized controlled trials (RCTs) testing the effectiveness of nutritional interventions for the treatment of malnutrition showed mixed results and a need for meta-analyses and data pooling has been expressed. However, evidence synthesis is hampered by the wide variety of outcomes and their method of assessment in previous RCTs. This paper describes the protocol for developing a Core Outcome Set (COS) for nutritional intervention studies in older adults with malnutrition and those at risk.

Methods: The project consists of five phases. The first phase consists of a scoping review to identify frequently used outcomes in published RCTs and select additional patient-reported outcomes. The second phase includes a modified Delphi Survey involving experienced researchers and health care professionals working in the field of malnutrition in older adults, followed by the third phase consisting of a consensus meeting to discuss and agree what critical outcomes need to be included in the COS. The fourth phase will determine how each COS outcome should be measured based on a systematic literature review and a second consensus meeting. This will be followed by a dissemination and implementation phase. Patient and Public Involvement (PPI) representatives will contribute to study design, oversight, consensus, and dissemination.

Conclusions: The result of this project is a COS that should be included in any RCT evaluating the effect of nutritional interventions in older adults with malnutrition and those at risk. This COS will facilitate comparison of RCT results, will increase efficient use of research resources and will reduce bias due to measurement of the outcome and publication bias. Ultimately, the COS will support clinical decision making by identifying the most effective approaches for treating and preventing malnutrition in older adults.

Place, publisher, year, edition, pages
BioMed Central (BMC)BMC Geriatrics, 2023
Keywords
Endpoint determination, Core Outcome Set, Aged, Malnutrition, Randomized controlled trials, Meta-analysis, Review, Delphi technique
National Category
Nutrition and Dietetics Nursing
Identifiers
urn:nbn:se:uu:diva-502679 (URN)10.1186/s12877-023-03832-2 (DOI)000963484900002 ()37024825 (PubMedID)
Available from: 2023-05-31 Created: 2023-05-31 Last updated: 2024-01-15Bibliographically approved
Larsson, L. E., Wang, R., Cederholm, T., Wiggenraad, F., Ryden, M., Hagman, G., . . . Thunborg, C. (2023). Association of Sarcopenia and Its Defining Components with the Degree of Cognitive Impairment in a Memory Clinic Population. Journal of Alzheimer's Disease, 96(2), 777-788
Open this publication in new window or tab >>Association of Sarcopenia and Its Defining Components with the Degree of Cognitive Impairment in a Memory Clinic Population
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2023 (English)In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 96, no 2, p. 777-788Article in journal (Refereed) Published
Abstract [en]

Background: Sarcopenia and cognitive impairment are two leading causes of disabilities. Objective: The objective was to examine the prevalence of sarcopenia and investigate the association between sarcopenia diagnostic components (muscle strength, muscle mass, and physical performance) and cognitive impairment in memory clinic patients.

Methods: 368 patients were included (age 59.0 +/- 7.25 years, women: 58.7%), displaying three clinical phenotypes of cognitive impairments, i.e., subjective cognitive impairment (SCI, 57%), mild cognitive impairment (MCI, 26%), and Alzheimer's disease (AD, 17%). Sarcopenia was defined according to diagnostic algorithm recommended by the European Working Group on Sarcopenia in Older People. Components of sarcopenia were grip strength, bioelectrical impedance analysis, and gait speed. They were further aggregated into a score (0-3 points) by counting the numbers of limited components. Multi-nominal logistic regression was applied.

Results: Probable sarcopenia (i.e., reduced grip strength) was observed in 9.6% of the patients, and 3.5% were diagnosed with sarcopenia. Patients with faster gait speed showed less likelihood of MCI (odds ratio [OR]: 0.24, 95% confidence interval [CI]: 0.06-0.90) and AD (OR: 0.12, 95% CI: 0.03-0.60). One or more limited sarcopenia components was associated with worse cognitive function. After adjusting for potential confounders, the association remained significant only for AD (OR 4.29, 95% CI 1.45-11.92).

Conclusions: The results indicate a connection between the sarcopenia components and cognitive impairments. Limitations in the sarcopenia measures, especially slow walking speed, were related to poorer cognitive outcomes. More investigations are required to further verify the causal relationship between sarcopenia and cognitive outcomes.

Place, publisher, year, edition, pages
IOS Press, 2023
Keywords
Alzheimer's disease, body composition, cognitive function, gait speed, hand grip strength, outpatients, sarcopenia
National Category
Geriatrics Neurology
Identifiers
urn:nbn:se:uu:diva-518790 (URN)10.3233/JAD-221186 (DOI)001099536400028 ()37899056 (PubMedID)
Funder
Swedish Research Council, 2022-01404Knowledge Foundation, 2018-0151Knowledge Foundation, 2021-0002Knowledge Foundation, 2022-0202Karolinska InstituteAlzheimerfondenRegion StockholmKnut and Alice Wallenberg FoundationKonung Gustaf V:s och Drottning Victorias Frimurarestiftelse
Available from: 2024-01-02 Created: 2024-01-02 Last updated: 2024-01-02Bibliographically approved
Barazzoni, R., Cederholm, T., Zanetti, M. & Cappellari, G. G. (2023). Defining and diagnosing sarcopenia: Is the glass now half full?. Metabolism: Clinical and Experimental, 143, Article ID 155558.
Open this publication in new window or tab >>Defining and diagnosing sarcopenia: Is the glass now half full?
2023 (English)In: Metabolism: Clinical and Experimental, ISSN 0026-0495, E-ISSN 1532-8600, Vol. 143, article id 155558Article, review/survey (Refereed) Published
Abstract [en]

Low muscle mass and function exert a substantial negative impact on quality of life, health and ultimately survival, but their definition, identification and combination to define sarcopenia have suffered from lack of universal consensus. Methodological issues have also contributed to incomplete agreement, as different approaches, techniques and potential surrogate measures inevitably lead to partly different conclusions. As a consequence: 1) awareness of sarcopenia and implementation of diagnostic procedures in clinical practice have been limited; 2) patient identification and evaluation of therapeutic strategies is largely incomplete. Significant progress has however recently occurred after major diagnostic algorithms have been developed, with common features and promising perspectives for growing consensus. At the same time, the need for further refinement of the sarcopenia concept has emerged, to address its increasingly recognized clinical heterogeneity. This includes potential differential underlying mechanisms and clinical features for age-and disease-driven sarcopenia, and the emerging challenge of sarcopenia in persons with obesity. Here, we will review existing algorithms to diagnose sarcopenia, and major open methodological issues to assess skeletal muscle mass and function under different clinical conditions, in order to highlight similarities and differences. Potential for consensus on sarcopenia diagnosis as well as emerging new challenges will be discussed.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Sarcopenia, Diagnostic criteria, Algorithm
National Category
Geriatrics
Identifiers
urn:nbn:se:uu:diva-510505 (URN)10.1016/j.metabol.2023.155558 (DOI)001042664500001 ()37031950 (PubMedID)
Available from: 2023-08-31 Created: 2023-08-31 Last updated: 2023-08-31Bibliographically approved
Muscaritoli, M., Imbimbo, G., Jager-Wittenaar, H., Cederholm, T., Rothenberg, E., Girolamo, F. G., . . . Molfino, A. (2023). Disease-related malnutrition with inflammation and cachexia. Clinical Nutrition, 42(8), 1475-1479
Open this publication in new window or tab >>Disease-related malnutrition with inflammation and cachexia
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2023 (English)In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 42, no 8, p. 1475-1479Article in journal (Refereed) Published
Abstract [en]

In 2010, the definition of cachexia was jointly developed by the European Society for Clinical Nutrition and Metabolism (ESPEN) Special Interest Groups (SIG) "Cachexia-anorexia in chronic wasting diseases" and "Nutrition in geriatrics". Cachexia was considered as a synonym of disease-related malnutrition (DRM) with inflammation by the ESPEN guidelines on definitions and terminology of clinical nutrition. Starting from these concepts and taking into account the available evidence the SIG "Cachexia-anorexia in chronic wasting diseases" conducted several meetings throughout 2020-2022 to discuss the similarities and differences between cachexia and DRM, the role of inflammation in DRM, and how it can be assessed. Moreover, in line with the Global Leadership Initiative on Malnutrition (GLIM) framework, in the future the SIG proposes to develop a prediction score to quantify the individual and combined effect(s) of multiple muscle and fat catabolic mechanisms, reduced food intake or assimilation and inflammation, which variably contribute to the cachectic/malnourished phenotype. This DRM/cachexia risk prediction score could consider the factors related to the direct mechanisms of muscle catabolism separately from those related to the reduction of nutrient intake and assimilation. Novel perspectives in the field of DRM with inflammation and cachexia were identified and described in the report.& COPY; 2023 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Place, publisher, year, edition, pages
Elsevier BV, 2023
Keywords
Disease related malnutrition, Cachexia, Inflammation, Anorexia, Special Interest Group, ESPEN
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:uu:diva-510142 (URN)10.1016/j.clnu.2023.05.013 (DOI)001047497100001 ()37302879 (PubMedID)
Available from: 2023-08-24 Created: 2023-08-24 Last updated: 2023-08-24Bibliographically approved
Wunderle, C., Gomes, F., Schuetz, P., Stumpf, F., Austin, P., Ballesteros-Pomar, M. D., . . . Bischoff, S. C. (2023). ESPEN guideline on nutritional support for polymorbid medical inpatients. Clinical Nutrition, 42(9), 1545-1568
Open this publication in new window or tab >>ESPEN guideline on nutritional support for polymorbid medical inpatients
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2023 (English)In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 42, no 9, p. 1545-1568Article in journal (Refereed) Published
Abstract [en]

Background: Disease-related malnutrition in polymorbid medical inpatients is a highly prevalent syndrome associated with significantly increased morbidity, disability, short- and long-term mortality, impaired recovery from illness, and cost of care.

Aim: As there are uncertainties in applying disease-specific guidelines to patients with multiple conditions, our aim was to provide evidence-based recommendations on nutritional support for the polymorbid patient population hospitalized in medical wards.

Methods: This update adheres to the standard operating procedures for ESPEN guidelines. We did a systematic literature search for 15 clinical questions in three different databases (Medline, Embase and the Cochrane Library), as well as in secondary sources (e.g. published guidelines), until July 12th. Retrieved abstracts were screened to identify relevant studies that were used to develop recommendations (incl. SIGN grading), which was followed by submission to Delphi voting.

Results: From a total of 3527 retrieved abstracts, 60 new relevant studies were analyzed and used to generate a guideline draft that proposed 32 recommendations (7x A, 11x B, 10x O and 4x GPP), which encompass different aspects of nutritional support including indication, route of feeding, energy and protein requirements, micronutrient requirements, disease-specific nutrients, timing, monitoring and procedure of intervention. The results of the first online voting showed a strong consensus (agreement of >90%) on 100% of the recommendations. Therefore, no final consensus conference was needed.

Conclusions: Recent high-quality trials have provided increasing evidence that nutritional support can reduce morbidity and other complications associated with malnutrition in polymorbid patients. The timely screening of patients for risk of malnutrition at hospital admission followed by individualized nutritional support interventions for at-risk patients should be part of routine clinical care and multimodal treatment in hospitals worldwide. Use of this updated guideline offers an evidence-based nutritional approach to the polymorbid medical inpatients and may improve their outcomes.& COPY; 2023 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).

Place, publisher, year, edition, pages
Elsevier BV, 2023
Keywords
Guideline, Polymorbidity, Multimorbidity, Nutritional support, Hospitalized patients
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:uu:diva-510717 (URN)10.1016/j.clnu.2023.06.023 (DOI)001046077000001 ()37478809 (PubMedID)
Available from: 2023-09-04 Created: 2023-09-04 Last updated: 2023-09-04Bibliographically approved
Silva, M. Z., Cederholm, T., Gonzalez, M. C., Lindholm, B. & Avesani, C. M. (2023). GLIM in chronic kidney disease: What do we need to know?. Clinical Nutrition, 42(6), 937-943
Open this publication in new window or tab >>GLIM in chronic kidney disease: What do we need to know?
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2023 (English)In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 42, no 6, p. 937-943Article in journal (Refereed) Published
Abstract [en]

The lack of consensus on diagnostic criteria for malnutrition has hampered developments in research and clinical practice pertaining to nutrition. This opinion paper describes the applicability and other aspects of using the Global Leadership Initiative on Malnutrition (GLIM) criteria for diagnosing malnu-trition in patients with chronic kidney disease (CKD). We examine the purpose of GLIM, the particu-larities of CKD that can affect the nutritional and metabolic status and the diagnosis of malnutrition. In addition, we make an appraisal of previous studies that used GLIM in the context of CKD and discuss the value and relevance of using the GLIM criteria in patients with CKD.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Chronic kidney disease, Dialysis, Nutritional assessment, Glim, Malnutrition, Global leadership initiative on malnutrition
National Category
Nutrition and Dietetics Urology and Nephrology
Identifiers
urn:nbn:se:uu:diva-503243 (URN)10.1016/j.clnu.2023.04.019 (DOI)000986939700001 ()37099985 (PubMedID)
Available from: 2023-06-14 Created: 2023-06-14 Last updated: 2023-06-14Bibliographically approved
Projects
Nutrition and ageing - epidemiological and experimental studies [2009-03880_VR]; Uppsala UniversitySarcopenia – novel understanding of occurrence, mechanisms and treatment of an emerging threat to independent living at old age [2011-01166_Forte]; Uppsala UniversityNutrition and ageing - epidemiological, expermental and clinical studies [2012-02799_VR]; Uppsala UniversitySarcopenia in old age and chronic disease - epidemiology, mechanisms and interventions [2015-02338_VR]; Uppsala University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-3705-0725

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