title: Adult starvation and disease-related malnutrition: a proposal for etiology-based diagnosis in the clinical practice setting from the International Consensus Guideline Committee.
abstract: OBJECTIVE
  Multiple definitions for malnutrition syndromes are found in the literature resulting in confusion. Recent 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.
  
  
  METHODS
  An International Guideline Committee was constituted to develop a consensus approach to defining malnutrition syndromes for adults in the clinical setting. Consensus was achieved through a series of meetings held at the A.S.P.E.N. and ESPEN Congresses.
  
  
  RESULTS
  It was agreed that an etiology-based approach that incorporates a current understanding of inflammatory response would be most appropriate. The Committee proposes the following nomenclature for nutrition diagnosis in adults in the clinical practice setting. "Starvation-related malnutrition", when there is chronic starvation without inflammation, "chronic disease-related malnutrition", when inflammation is chronic and of mild to moderate degree, and "acute disease or injury-related malnutrition", when inflammation is acute and of severe degree.
  
  
  CONCLUSIONS
  This commentary is intended to present a simple etiology-based construct for the diagnosis of adult malnutrition in the clinical setting. Development of associated laboratory, functional, food intake, and body weight criteria and their application to routine clinical practice will require validation.
authors.affiliation: Penn State University, University Park, PA, USA.
authors.forename: Gordon L
authors.initials: GL
authors.lastname: Jensen
authors.forename: Jay
authors.initials: J
authors.lastname: Mirtallo
authors.forename: Charlene
authors.initials: C
authors.lastname: Compher
authors.forename: Rupinder
authors.initials: R
authors.lastname: Dhaliwal
authors.forename: Alastair
authors.initials: A
authors.lastname: Forbes
authors.forename: Rafael Figueredo
authors.initials: RF
authors.lastname: Grijalba
authors.forename: Gil
authors.initials: G
authors.lastname: Hardy
authors.forename: Jens
authors.initials: J
authors.lastname: Kondrup
authors.forename: Demetre
authors.initials: D
authors.lastname: Labadarios
authors.forename: Ibolya
authors.initials: I
authors.lastname: Nyulasi
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Castillo Pineda
authors.forename: Dan
authors.initials: D
authors.lastname: Waitzberg
mesh_terms: D000208:Acute Disease; D000328:Adult; D002908:Chronic Disease; D006801:Humans; D007249:Inflammation / Q000150:complications*; D044342:Malnutrition / Q000175:diagnosis* / Q000209:etiology; D013217:Starvation / Q000150:complications* / Q000175:diagnosis; D009626:Terminology as Topic; D014947:Wounds and Injuries / Q000150:complications