F.A.Q. | Clinical Nutrition LAM Initiative

F.A.Q.

Find Answers to Some of the Most Commonly Asked Questions.

What is the objective of “United for clinical nutrition”?

“United for clinical nutrition” was created to raise awareness of disease-related malnutrition. This initiative is focused on the problem of disease-related malnutrition and the serious impact it has on patients’ physical health, increased complications, and extended recovery from illness and surgery. We want to work hand-in-hand supporting health care professionals in the early detection of disease-related malnutrition by screening these patients and providing adequate nutritional therapy. We share the mutual goal of reducing patient hospital stays and hospital readmissions through optimizing clinical nutrition therapy.

To read more about “United for clinical nutrition”, please click here.

What is disease-related malnutrition?

Disease-related malnutrition is defined as under-nutrition resulting from disease, inflammation, impaired absorption and/or poor dietary intake. An International Guideline Committee, held at the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) and the European Society for Clinical Nutrition and Metabolism (ESPEN) Congresses, categorized malnutrition for adults in the clinical setting as follows: chronic disease-related malnutrition and acute disease or injury-related malnutrition.1

To read more about disease-related malnutrition, please click here.

  • 1. Jensen GL, Mirtallo J, Compher C et al. Adult starvation and disease-related malnutrition: a proposal for etiology-based diagnosis in the clinical practice setting from the International Consensus Guideline Committee. JPEN 2010;34(2):156-159.

Why is fighting disease-related malnutrition so important?

Studies indicate that disease-related malnutrition is highly prevalent in hospital patients around the world. According to the British Association for Parenteral and Enteral Nutrition (BAPEN), one in four patients is at risk of malnutrition.1,2,3 The prevalence of disease-related malnutrition is even higher in Latin America with up to 50 percent of hospital patients.4

Fighting disease-related malnutrition is important to reduce the significantly negative impacts on patient outcomes and care costs. Disease-related malnutrition affects people of all ages, but those over 65 are at a 40 percent greater risk.2 Malnutrition has been associated with increased morbidity and mortality.5 Malnourished patients are also prone to complications such as infections6 and longer hospital stays.7

  • 1. Russell C, Elia M. Nutrition screening survey in the UK. Redditch, BAPEN 2008.
  • 2. a. b. Russell C, Elia M. Nutrition screening survey in the UK. Redditch, BAPEN 2009.
  • 3. Russell C, Elia M. Nutrition screening survey in the UK. Redditch, BAPEN 2011.
  • 4. Waitzberg DL, Caiaffa WT, Correia MITD. Hospital malnutrition: the Brazilian national survey (Ibranutri): a study of 4000 patients. Nutrition 2001;17(7-):573-580.
  • 5. Norman K, Pichard C, Lochs H et al. Impact of disease-related malnutrition. Clin Nutr 2008;27:5-15.
  • 6. Sorensen J, Kondrup J, Prokopwicz J et al. EuroOOPS: an international, multicentre study to implement nutritional risk screening and evaluate clinical outcome. Clin Nutr 2008;27(3);340-349.
  • 7. Elia M, Stratton RJ. A cost-benefit analysis of oral nutritional supplements in preventing ulcers in hospital. Clin Nutr 2005;24:640-641.

What is clinical nutrition and why is it important?

Clinical nutrition is the proper management of a patient’s energy balance, providing sufficient amounts of proteins, fluids, vitamins and minerals, which is fundamental for health and resistance to disease. In the majority of patients, an adequate dietary intake can be ensured by providing normal, good quality hospital food. In case nutritional requirements cannot be met with regular oral hospital diet, clinical nutrition support involving oral supplementation, enteral tube feeding and/or parenteral nutrition becomes indispensable.1

To read more about clinical nutrition, please click here.

  • 1. National Collaborating Centre for Acute Care (UK). Nutrition Support for Adults Oral Nutrition Support, Enteral Tube Feeding and Parenteral Nutrition. NICE Clinical Guidelines, No. 32 London 2006.

What is parenteral nutrition?

Parenteral nutrition (PN) is the intravenous infusion of nutrients directly into the systemic circulation, bypassing the gastrointestinal (GI) tract.1 Administration of PN is usually reserved for situations in which no other means of providing nutrients is possible, which is especially important for critically ill patients. Supplemental PN provided to the critically ill receiving less than 60 percent of their energy target via the enteral route from day four after ICU admission typically result in a 30 percent relative risk reduction for nosocomial infections, less antibiotic days and earlier weaning from mechanical ventilation.2

To read more about parenteral nutrition, please click here.

  • 1. National Collaborating Centre for Acute Care (UK). Nutrition Support for Adults Oral Nutrition Support, Enteral Tube Feeding and Parenteral Nutrition. NICE Clinical Guidelines, No. 32 London 2006.
  • 2. Heidegger CP, Berger MM, Graf S et al. Optimisation of energy provision with supplemental parenteral nutrition in critically ill patients: A randomized controlled clinical trial. Lancet 2013;381(9864):385-393.

What are the other forms of clinical nutrition?

Oral administration is preferred whenever the patient has a functioning gastrointestinal (GI) tract and can swallow safely. Enteral nutrition, which includes oral nutritional supplements (ONS) and sip or tube feed via the GI-tract, is typically used in cases where nutritional support is limited.

Why focus on Latin America?

Around the world one in four hospital patients is at risk of disease-related malnutrition.1,2,3 In Latin America in particular, up to 50 percent of hospitalized patients are malnourished, which negatively impacts outcomes and increases long-term costs.4 The statistics point out a need to support health care professionals in the region with training and improved clinical nutrition education to jointly fight the high frequency of disease-related malnutrition.

  • 1. Russell C, Elia M. Nutrition screening survey in the UK. Redditch, BAPEN 2008.
  • 2. Russell C, Elia M. Nutrition screening survey in the UK. Redditch, BAPEN 2009.
  • 3. Russell C, Elia M. Nutrition screening survey in the UK. Redditch, BAPEN 2011.
  • 4. Waitzberg DL, Caiaffa WT, Correia MITD. Hospital malnutrition: the Brazilian national survey (Ibranutri): a study of 4000 patients. Nutrition 2001;17(7-):573-580.

What if I am not in the regions listed on the website? Will this information still be relevant?

While the content on this website is tailored specifically toward health care professionals in Latin America, the general topic and information contained here is applicable anywhere in the world.

Why is Fresenius Kabi engaged to fight against disease-related malnutrition?

“United for clinical nutrition” was created by Fresenius Kabi to partner with health care professionals and authorities, and help identify disease-related malnutrition, particularly in Latin American countries. As a leading provider of enteral and parenteral nutrition, Fresenius Kabi is in a unique position to support the fight against disease-related malnutrition.

Have any peer review groups endorsed the content on this site?

The information contained on this website has come from industry reports, leading health care journals and relevant international nutritional societies, including American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) and the European Society for Clinical Nutrition and Metabolism (ESPEN), as well as clinical best practices developed by Fresenius Kabi.

What if I need more information than is available here?

If you have questions about any of the information contained on this website, or have inquires about additional topics, please contact us here. We will do our best to answer your questions or refer you to source experts who can.

Do I need permission to link to/or share content found on this site?

You are welcome to share any content you find on this website with colleagues. Our mission is to work with health care professionals and authorities in the fight against disease-related malnutrition. We share your determination to create better outcomes for patients.

Can I use the logo?

Use of the “United for clinical nutrition” logo is limited to our program partners and will be granted on a case by case. Please use our contact form for further information.

How can I offer suggestions to improve or expand the site?

We are interested in hearing your thoughts on how we can improve or expand the information contained here to make it as relevant and helpful as possible. Feel free to contact us with your ideas, suggestions and feedback on this website.

Downloads

Dr. Roger Riofrio sitting in front of a United for clinical nutrition roll-up during ESPEN Congress.

Dr. Roger Riofrio

(mp4, 33.63 MB)
Dr. Dan Linetzky Waitzberg

Dr. Mario Ignacio Perman

(mp4, 64.25 MB)
Dr. Karin Papapietro sitting in front of a United for clinical nutrition roll-up during ESPEN Congress

Dr. Karin Papapietro

(mp4, 32.2 MB)