ESPEN guidelines on definitions and terminology of clinical nutrition

T. Cederholm, R. Barazzoni, P. Austin, P. Ballmer, G. Biolo, S. C. Bischoff, C. Compher, I. Correia, Takashi Higashiguchi, M. Holst, G. L. Jensen, A. Malone, M. Muscaritoli, I. Nyulasi, M. Pirlich, E. Rothenberg, K. Schindler, S. M. Schneider, M. A.E. de van der Schueren, C. SieberL. Valentini, J. C. Yu, A. Van Gossum, P. Singer

Research output: Contribution to journalArticle

235 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)49-64
Number of pages16
JournalClinical Nutrition
Volume36
Issue number1
DOIs
Publication statusPublished - 01-01-2017

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Terminology
Malnutrition
Guidelines
Consensus
Nutrition Therapy
Enteral Nutrition
Sarcopenia
Cachexia
Nutrition Assessment
Group Processes
Hunger
Parenteral Nutrition
Postal Service
International Classification of Diseases
Research
Obesity
Communication
Organizations
Inflammation
Food

All Science Journal Classification (ASJC) codes

  • Nutrition and Dietetics
  • Critical Care and Intensive Care Medicine

Cite this

Cederholm, T., Barazzoni, R., Austin, P., Ballmer, P., Biolo, G., Bischoff, S. C., ... Singer, P. (2017). ESPEN guidelines on definitions and terminology of clinical nutrition. Clinical Nutrition, 36(1), 49-64. https://doi.org/10.1016/j.clnu.2016.09.004
Cederholm, T. ; Barazzoni, R. ; Austin, P. ; Ballmer, P. ; Biolo, G. ; Bischoff, S. C. ; Compher, C. ; Correia, I. ; Higashiguchi, Takashi ; Holst, M. ; Jensen, G. L. ; Malone, A. ; Muscaritoli, M. ; Nyulasi, I. ; Pirlich, M. ; Rothenberg, E. ; Schindler, K. ; Schneider, S. M. ; de van der Schueren, M. A.E. ; Sieber, C. ; Valentini, L. ; Yu, J. C. ; Van Gossum, A. ; Singer, P. / ESPEN guidelines on definitions and terminology of clinical nutrition. In: Clinical Nutrition. 2017 ; Vol. 36, No. 1. pp. 49-64.
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abstract = "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.",
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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, MAE, Sieber, C, Valentini, L, Yu, JC, Van Gossum, A & Singer, P 2017, 'ESPEN guidelines on definitions and terminology of clinical nutrition', Clinical Nutrition, vol. 36, no. 1, pp. 49-64. https://doi.org/10.1016/j.clnu.2016.09.004

ESPEN guidelines on definitions and terminology of clinical nutrition. / Cederholm, T.; Barazzoni, R.; Austin, P.; Ballmer, P.; Biolo, G.; Bischoff, S. C.; Compher, C.; Correia, I.; Higashiguchi, Takashi; Holst, M.; Jensen, G. L.; Malone, A.; Muscaritoli, M.; Nyulasi, I.; Pirlich, M.; Rothenberg, E.; Schindler, K.; Schneider, S. M.; de van der Schueren, M. A.E.; Sieber, C.; Valentini, L.; Yu, J. C.; Van Gossum, A.; Singer, P.

In: Clinical Nutrition, Vol. 36, No. 1, 01.01.2017, p. 49-64.

Research output: Contribution to journalArticle

TY - JOUR

T1 - ESPEN guidelines on definitions and terminology of clinical nutrition

AU - Cederholm, T.

AU - Barazzoni, R.

AU - Austin, P.

AU - Ballmer, P.

AU - Biolo, G.

AU - Bischoff, S. C.

AU - Compher, C.

AU - Correia, I.

AU - Higashiguchi, Takashi

AU - Holst, M.

AU - Jensen, G. L.

AU - Malone, A.

AU - Muscaritoli, M.

AU - Nyulasi, I.

AU - Pirlich, M.

AU - Rothenberg, E.

AU - Schindler, K.

AU - Schneider, S. M.

AU - de van der Schueren, M. A.E.

AU - Sieber, C.

AU - Valentini, L.

AU - Yu, J. C.

AU - Van Gossum, A.

AU - Singer, P.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - 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.

AB - 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.

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Cederholm T, Barazzoni R, Austin P, Ballmer P, Biolo G, Bischoff SC et al. ESPEN guidelines on definitions and terminology of clinical nutrition. Clinical Nutrition. 2017 Jan 1;36(1):49-64. https://doi.org/10.1016/j.clnu.2016.09.004