PDF(Pubmed)
Abstract：
During the last two decades, the definition, diagnosis, and management of malnutrition have significantly evolved. Malnutrition is generally defined as deficiencies, excesses, or imbalances in a person\'s intake of energy and/or nutrients. While malnutrition is associated with a significantly increased risk of morbidity, mortality, and healthcare cost, it is often underdiagnosed both in healthcare and community settings. One contributing factor is the lack of a consensus on its definition and appropriate diagnostic indicators. In the current article, we review the evolution of frameworks for the diagnosis of malnutrition. Recently published consensuses by prominent clinical nutrition societies have established a trajectory for the uniform global diagnosis of malnutrition. Limiting the use of body mass index (BMI) as a diagnostic criterion while emphasizing the use of muscle mass enables a more consistent and accurate diagnosis of malnutrition in the clinical setting. Guidance for the unified methodology and terminology for diagnosing malnutrition, such as the one proposed in the current article will enable policy makers to systematically address the two faces of malnutrition, starvation- and disease-related malnutrition applicable to both pediatric and adult populations. Policies and programs that could address issues of food insecurity and scarcity as well as early diagnosis and management of disease-related malnutrition will empower better care of community nutrition.
摘要：
在过去的二十年里，定义,诊断,营养不良的管理也有了很大的发展。营养不良通常被定义为缺乏，过度,或一个人的能量和/或营养摄入的不平衡。虽然营养不良与发病风险显著增加有关，死亡率,和医疗保健成本，在医疗保健和社区环境中，它经常被低估。一个促成因素是对其定义和适当的诊断指标缺乏共识。在当前的文章中，我们回顾了营养不良诊断框架的演变。最近，著名的临床营养学会发表的共识为全球统一的营养不良诊断奠定了基础。限制使用体重指数（BMI）作为诊断标准，同时强调使用肌肉质量，可以在临床环境中对营养不良进行更一致和准确的诊断。诊断营养不良的统一方法和术语指南，例如本文中提出的建议，将使决策者能够系统地解决营养不良的两个方面，饥饿和疾病相关的营养不良适用于儿童和成人人群。可以解决粮食不安全和稀缺问题以及疾病相关营养不良的早期诊断和管理的政策和计划将增强对社区营养的更好护理。
