Nutrition In Clinical Practice[JOURNAL]
Sun
200 papers
A dynamic online nomogram based on the Global Leadership Initiative on Malnutrition criteria for predicting 30-day mortality in patients with severe stroke.
Li J, Yang J, Gong W … +1 more , Wang Y
Nutr Clin Pract · 2026 Apr · PMID 40783807 · Publisher ↗
BACKGROUND: The Global Leadership Initiative on Malnutrition (GLIM) has released new criteria for diagnosing and grading malnutrition. However, their validation in patients with severe stroke has not been thoroughly docu...
BACKGROUND: The Global Leadership Initiative on Malnutrition (GLIM) has released new criteria for diagnosing and grading malnutrition. However, their validation in patients with severe stroke has not been thoroughly documented. This study aims to investigate the application of GLIM criteria in nutrition assessment and mortality prediction among patients with severe stroke. METHODS: This prospective study included 281 patients with severe stroke from our hospital (July 2021 to July 2023) and a validation set of 121 patients (August 2023 to March 2024). Nutrition status was assessed using Subjective Global Assessment (SGA) and GLIM criteria. The association between nutrition status and 30-day mortality was analyzed using the Kaplan-Meier method and a Cox model. A dynamic nomogram incorporating GLIM and other prognostic variables was developed. The Concordance Index, receiver operating characteristic curve, and calibration curve were used to evaluate predictive accuracy. RESULTS: GLIM-defined malnutrition was found in 19.93% of the development set and 20.66% of the validation set. Using SGA as a reference tool to evaluate the diagnostic agreement of the GLIM criteria, the GLIM criteria demonstrated good agreement in identifying malnutrition, with a kappa value of 0.669. Patients with GLIM-defined moderate (hazard ratio [HR]: 2.526, P < 0.001) and severe malnutrition (HR: 5.626, P < 0.001) had significantly higher mortality risk than those identified by SGA. The nomogram accurately predicted 30-day mortality. CONCLUSIONS: The GLIM criteria effectively assess malnutrition and predict 30-day mortality in patients with severe stroke. The developed dynamic nomogram provides accurate prognosis prediction.
Bar code scanning of ready-to-feed enteral nutrition formulas improves patient safety and reduces risk of misadministration in pediatric patients ages 1-18: A quality improvement project in a single children's hospital.
Steele C, Albert D
Nutr Clin Pract · 2025 Dec · PMID 40783803 · Publisher ↗
The safe use of enteral nutrition (EN) for patients of all ages in the healthcare setting is often taken for granted. However, an increasing body of literature highlights potential failure points even when using ready-to...
The safe use of enteral nutrition (EN) for patients of all ages in the healthcare setting is often taken for granted. However, an increasing body of literature highlights potential failure points even when using ready-to-feed (RTF) enteral formulas. Potential risks include administering a wrong, expired, or recalled formula which could result in patient harm including under or over nutrition, allergic reactions, gastrointestinal intolerance, metabolic or electrolyte disturbances, and/or consequences related to contamination. This quality improvement project reviewed the frequency of having the wrong RTF EN formula scanned for the wrong individual (defined as a near miss) in pediatric patients 1-18 years of age. During the time of this evaluation, a total of 48,044 RTF EN formula feeding attempts were recorded. Of those attempts, 46,648 were successful, with the RTF EN formula matching the patient's EN order when the patient's armband and EN bar code were scanned. The remaining 1396 attempts represented near misses in which the product being scanned was not the correct product for the patient (a rate of 2.9%). Although this rate may seem low, the number of near misses during this time frame means that, on average, 48 times per month or 1.6 times per day, the bar code scanning system is preventing a pediatric patient from receiving the wrong EN formula. The data from this performance improvement initiative support the organization's decision to scan EN formulas at the time of administration and underscores the importance of following protocols to ensure that scanning occurs every time when administering formulas to reduce risk of error.
Short bowel syndrome-associated intestinal failure patient experience: A mixed-method study leveraging an online patient community.
Chen BP, Feldman J, Gower M … +4 more , Kirby M, Terreri B, McCue M, Mundi MS
Nutr Clin Pract · 2025 Oct · PMID 40772483 · Full text
BACKGROUND: Patients with short bowel syndrome-associated intestinal failure (SBS-IF) require complex, personalized, and multidisciplinary care; however, there are disparities in access. This study measured the impact of...
BACKGROUND: Patients with short bowel syndrome-associated intestinal failure (SBS-IF) require complex, personalized, and multidisciplinary care; however, there are disparities in access. This study measured the impact of unmet needs and treatment burden among patients and their caregivers. METHODS: This cross-sectional, mixed-method study included US adults self-reporting SBS-IF and receiving home parenteral nutrition for ≥6 months and their caregivers. One-hour interviews informed the development of a 30-min survey administered to participants from an online health community. RESULTS: Among 68 patients, the mean age was 42 years, 79% were female, and 88% were White. Most of the 16 caregivers were female (69%), and younger than 45 years (69%). Of 32 patients (47%) receiving care from an SBS specialist, only 19 (59%) were referred after diagnosis; in 58% of these, referral occurred >6 months after diagnosis. Depression was reported in 44 patients (65%), with 54% not receiving professional mental health care. Financial concerns were common, with 44 patients (65%) unable to work and 40 patients (59%) reporting annual household income of <$50,000. Of 32 patients reporting difficulty paying medical bills, 22 (32%) could not fill prescriptions and 19 (28%) canceled/delayed healthcare provider visits. Social determinant of health challenges were reported by 44 patients (65%). Caregivers' responsibilities impacted their ability to work (50%) and future outlook (63%). CONCLUSION: Patients with SBS-IF face difficulties accessing specialized healthcare, and are at risk of adverse healthcare outcomes, financial hardships, and poor quality of life. Mental health and work/financial issues were common among both patients and caregivers.
Oral health in children with rare diseases and gastrostomy tubes: A retrospective database cohort study.
Magnéli AN, Sabel N, Krekmanova L … +1 more , Robertson A
Nutr Clin Pract · 2025 Oct · PMID 40762370 · Full text
BACKGROUND: The purpose was to investigate oral health in children with rare diseases and gastrostomy tubes (GTs). METHODS: This is a retrospective review of oral health in children with rare diseases and GTs 3-16 years...
BACKGROUND: The purpose was to investigate oral health in children with rare diseases and gastrostomy tubes (GTs). METHODS: This is a retrospective review of oral health in children with rare diseases and GTs 3-16 years of age who were registered in a database. The children were divided into three cohorts: 1995-2002 (cohort I), 2003-2010 (cohort II), and 2011-2018 (cohort III) with a control group of children with rare diseases without GTs. The presence of gingivitis, calculus, caries, and oral hypersensitivity were obtained from a standardized observation schedule. Frequencies of vomiting and dental visits were obtained from questionnaires completed by legal guardians. RESULTS: A total of 263 out of 2470 children had a GT. The control group consisted of 2208 children. The presence of gingivitis was significantly lower in cohort III compared with both cohorts I and II. There was no significant difference between calculus and hypersensitivity between the cohorts. The presence of gingivitis, calculus, oral hypersensitivity, and frequency of vomiting were higher in the study group, compared with that of the controls. The study groups showed statistically significant fewer caries in children <12 years of age compared with those without a g-tube. CONCLUSIONS: Ten percent of the children with rare diseases had a gastrostomy. Children with GTs displayed poorer oral health than children without, except for caries. All children with GTs displayed oral hypersensitivity and a higher frequency of vomiting. Gingivitis decreased when comparing cohort I to cohort III.
Associations between body mass index categories and geriatric assessment tests among older adults with chronic kidney disease: A prospective study.
Bildaci YD, Heybeli C, Smith L … +3 more , Rahmati M, Yon DK, Soysal P
Nutr Clin Pract · 2026 Jun · PMID 40757393 · Publisher ↗
BACKGROUND: The optimal body mass index (BMI) among older adults with chronic kidney disease (CKD) in geriatric assessment tests has not been studied. This study investigates the relationship between BMI and Comprehensiv...
BACKGROUND: The optimal body mass index (BMI) among older adults with chronic kidney disease (CKD) in geriatric assessment tests has not been studied. This study investigates the relationship between BMI and Comprehensive Geriatric Assessment (CGA) parameters among older adults with CKD. METHODS: A total of 319 older adults with CKD were included. Demographic and laboratory data and geriatric assessment tests of patients within different BMI categories (18.5-24.9, 25.0-29.9, 30.0-34.9, and >35.0 kg/m) were compared. Logistic regression analysis was used to determine associations between CGA and BMI categories. RESULTS: The mean age was 84 ± 7 years, the mean glomerular filtration rate was 47 ± 8 ml/min/1.73 m, and 236 patients (74%) were women. BMI categories of <25.0, 25.0-29.9, 30.0-34.9, and >35.0 included 51 (16%), 119 (37.3%), 88 (27.6%), and 61 (19.1%) patients. A BMI range of 25-35 showed the most favorable results, according to CGA scores for basic and instrumental activities of daily living, the Tinetti scale, Mini Nutritional Assessment (MNA), and the Geriatric Depression Scale (GDS) among BMI groups. Patients with a BMI of 30.0-34.9 had better scores in Mini Mental State Examination, GDS, and MNA than those with a BMI of 25.0-29.9, whereas other measures were comparable between these two categories. CONCLUSION: The optimum range of BMI levels for nutrition and cognitive health and mood status in older adults with CKD is 30.0-34.9.
Nutrition assessment of hospitalized very preterm infants: Best practices for accurate anthropometry in neonatal intensive care unit settings.
Pepin H, Ellard D, Roytek S … +5 more , Bell KA, Foster L, Steele T, Ramel SE, Belfort MB
Nutr Clin Pract · 2025 Dec · PMID 40755285 · Full text
Hospitalized very preterm infants, those born at <32 weeks of gestation, represent a nutritionally vulnerable population. Anthropometry is used widely in neonatal intensive care unit (NICU) clinical and research settings...
Hospitalized very preterm infants, those born at <32 weeks of gestation, represent a nutritionally vulnerable population. Anthropometry is used widely in neonatal intensive care unit (NICU) clinical and research settings to facilitate nutrition assessment. This approach involves measuring an infant's body weight, length, and head circumference and plotting them on a growth chart to assess current nutrition status and monitor changes over time. Anthropometric measurements are prone to error owing to the challenges of measuring sick infants who frequently require respiratory support and other medical equipment and a lack of standardized approaches. In this paper, we describe our standardized approach to anthropometry in hospitalized very preterm infants in the NICU with a focus on addressing the specific challenges that arise in this environment. Our overall goal is to provide a tool for clinicians and researchers who want to enhance the quality of anthropometric data, improve decision-making about diet-based care in the NICU, and strengthen the conclusions and impact of research involving very preterm infants.
Swallow screen and education in patients following endotracheal extubation: A pre- and postintervention study.
Lai SY, Lin LC, Shih YH … +3 more , Wu SC, Chang YC, Chen CC
Nutr Clin Pract · 2026 Feb · PMID 40754670 · Publisher ↗
BACKGROUND: Patients with hemorrhagic stroke often have dysphagia and delayed oral feeding after extubation. Fewer than 33% of intensive care units (ICUs) implement swallow screens, with limited evidence-based early oral...
BACKGROUND: Patients with hemorrhagic stroke often have dysphagia and delayed oral feeding after extubation. Fewer than 33% of intensive care units (ICUs) implement swallow screens, with limited evidence-based early oral feeding protocols. We evaluated a nurse-administered "swallow screen and education" (SSE) program on oral feeding status, pneumonia incidence, and weight trajectory. METHODS: A pre-post intervention study with matched historical controls was conducted in a neurosurgical ICU. Twenty-eight consecutive patients with hemorrhagic stroke (aged ≥20 years) received the SSE program 24-h after extubation. Twenty-eight matched controls received the usual care. Outcomes included 24-h and 7-day nothing by mouth (NBM) rates, 30-day pneumonia incidence, and 4-week weight trajectory. RESULTS: The SSE group showed lower 24-h NBM rates vs controls (42.86% vs 78.57%; odds ratio [OR] = 0.21; 95% CI, 0.063-0.661; P = 0.006). By day 7, differences persisted but were not statistically significant (28.57% vs 38.46%). The SSE group exhibited lower pneumonia incidence (3.57% vs 17.86%). After adjusting for confounders, SSE independently predicted reduced pneumonia risk (adjusted OR = 0.029; 95% CI, 0.001-0.708; P = 0.030). Weight decreased significantly in both groups (week 3: -2.681 kg, P < 0.001; week 4: -2.965 kg, P = 0.008). CONCLUSION: Our preliminary findings suggest that the SSE program was associated with lower 24-h NBM rates after extubation and reduced pneumonia risk without affecting weight trajectories in this small hemorrhagic stroke cohort. This pragmatic intervention demonstrates potential clinical utility and scalability in neurosurgical ICUs. Future research should include larger randomized controlled trials with instrumental swallowing assessments while addressing weight loss in this vulnerable population.
Regression of intestinal failure-associated liver disease by alteration of lipid emulsion regime in home parenteral nutrition: A case report.
Mohamed SA, Gamage M, Parker R … +2 more , Brown RM, Cooper SC
Nutr Clin Pract · 2025 Oct · PMID 40740021 · Full text
Up to 65% of patients receiving parenteral nutrition (PN) have intestinal failure-associated liver disease (IFALD) and ~25% will have fibrosis on biopsy. First-generation lipid injectable emulsions (ILEs) are considered...
Up to 65% of patients receiving parenteral nutrition (PN) have intestinal failure-associated liver disease (IFALD) and ~25% will have fibrosis on biopsy. First-generation lipid injectable emulsions (ILEs) are considered a greater risk factor for IFALD compared with newer formulations. We describe a case report of an adult patient with intestinal failure receiving PN who had improvement of liver function tests (LFTs) and regression of fibrosis on liver biopsy following a switch from 100% soybean oil (SO) ILE to SO, medium-chain triglyceride, olive oil, and fish oil ILE. This supports the only other existing adult case report in the literature to date, which showed histological improvement but no improvements in LFTs.
Micronutrient deficiencies after pancreatico-duodenectomy: A narrative review of the literature and recommendations for clinical practice.
Phillips ME, Livingstone C, Frampton AE … +1 more , Hart KH
Nutr Clin Pract · 2025 Oct · PMID 40736420 · Full text
Micronutrient uptake is impaired after pancreatico-duodenectomy (PD) because of malabsorption, reduced absorptive capacity, and poor oral intake. Biochemical depletion is reported in cohort studies, but deficiency states...
Micronutrient uptake is impaired after pancreatico-duodenectomy (PD) because of malabsorption, reduced absorptive capacity, and poor oral intake. Biochemical depletion is reported in cohort studies, but deficiency states are predominantly reported in case reports, making it difficult to assess occurrence rates. Although national guidelines recommend monitoring of micronutrients, there are no guidelines on what this should consist of. We undertook a narrative review to explore the incidence of deficiency and make recommendations for clinical management using data from randomized controlled trials, cohort studies, and case reports. We established that iron, zinc, and vitamin D deficiencies are common. Fat-soluble vitamin deficiencies are rare and occurred in patients who discontinued pancreatic enzymes but are otherwise nutritionally well, whereas trace element and B vitamin deficiencies occurred as part of a more generalized malnutrition state. We make recommendations for identification and treatment of micronutrient deficiencies and recommend routine assessment of iron, zinc, and vitamin D status and bone density in all patients who have undergone curative treatment and take pancreatic enzyme replacement therapy (PERT) or have benign disease. In those with malnutrition or not taking PERT, additional screening for vitamins A, E, and K; selenium; copper; and magnesium should be undertaken. A pragmatic approach should be taken for those with limited long-term survival, with a focus on iron status, as this will impact quality of life.
Construction and verification of discharge preparation and guidance checklist for patients requiring home enteral nutrition: A randomized control trial.
Chen C, Xu X, Jin T … +2 more , Yang Y, Zhu D
Nutr Clin Pract · 2025 Dec · PMID 40714882 · Publisher ↗
BACKGROUND: To develop, implement, and evaluate a structured discharge preparation and guidance checklist for patients requiring home enteral nutrition (HEN). METHODS: The HEN discharge preparation and guidance checklist...
BACKGROUND: To develop, implement, and evaluate a structured discharge preparation and guidance checklist for patients requiring home enteral nutrition (HEN). METHODS: The HEN discharge preparation and guidance checklist was developed through a multiphase process by literature review, qualitative interview, and Delphi consultation. A randomized controlled trial was conducted with 90 patients (45 intervention, 45 control) requiring HEN at a tertiary hospital in China. The intervention group received checklist-assisted discharge education, whereas the control group received conventional verbal instructions. Outcomes were assessed using validated tools: Quality of Discharge Teaching Scale (QDTS), Readiness for Hospital Discharge Scale (RHDS), Patient Satisfaction Questionnaire-18 (PSQ-18), NutriQoL, Self-Rating Anxiety Scale (SAS), 30-day unplanned readmission rates, and patient-initiated inquiries. RESULTS: The intervention group demonstrated significant improvements in QDTS total scores (P < 0.001), content received (P < 0.001), and delivery skills and effects (P = 0.007). RHDS scores for personal status, knowledge, perceived coping ability, and expected support were significantly higher in the intervention group (all P < 0.05). PSQ-18 (P < 0.001) and daily life and social activity domains of NutriQoL (P = 0.036) also improved. However, no significant differences were observed in physical functioning domains of NutriQoL (P = 0.217), SAS (P = 0.160), or unplanned readmission rates (P = 0.343). The intervention group reported fewer online searches for HEN management (P = 0.035). CONCLUSION: The HEN discharge preparation and guidance checklist effectively standardized discharge education, enhanced patient preparedness, and improved satisfaction. Although short-term physiological and psychological outcomes showed limited effects, the tool addresses critical gaps in transitional care. Future studies should explore long-term impacts and integrate financial/psychosocial support.
Treatment outcomes in pediatric intestinal failure patients with ambulatory Candida central line-associated bloodstream infections with and without central venous line removal: A retrospective case series.
Khan HH, Jump CS, Bauer J … +3 more , Wu Q, Thacker S, Eckard AR
Nutr Clin Pract · 2025 Oct · PMID 40714873 · Full text
BACKGROUND: Lack of central venous line (CVL) sites is a common indication for intestinal transplantation in intestinal failure (IF) patients. For treatment of central line-associated bloodstream infections (CLABSIs), ma...
BACKGROUND: Lack of central venous line (CVL) sites is a common indication for intestinal transplantation in intestinal failure (IF) patients. For treatment of central line-associated bloodstream infections (CLABSIs), many pediatric gastroenterologists preserve CVL access, but line removal is typically recommended for Candida sp CLABSI due to high risk of systemic complications. However, no data exist on outcomes for IF patients treated for Candida sp CLABSI. This study aims to assess if CVL preservation increases the risk of complications or recurrence. MATERIALS AND METHODS: A retrospective chart review was conducted for children <18 years of age with IF and Candida sp CLABSI between 2012 and 2023. Patients with blood cultures positive for Candida sp from the CVL were included. Each CLABSI event was analyzed for key variables. RESULTS: Twelve patients were included, with 18 events (median age 6.4 years). Candida species identified included C albicans (33.3%) and C parapsilosis (38.9%). Antifungal therapy exceeded 14 days in all events, and ethanol lock therapy (70% concentration) was used in 72%. CVL was removed in 44.4% of events. Five patients had multiple events, with Candida species identified in subsequent infections. No secondary site seeding or long-term sequelae occurred, and no patients died. CONCLUSION: Our data suggest that CVL preservation in pediatric IF patients with Candida sp CLABSI is feasible without increased complications or mortality. Limitations include small sample size and retrospective design.
Dietary recommendations for pediatric and adolescent patients utilizing GLP-1 receptor agonists for weight management: A narrative review of current literature.
Kennedy C, Moyer K, Herdes RE
Nutr Clin Pract · 2026 Feb · PMID 40714863 · Publisher ↗
Glucagon-like peptide-1 (GLP-1) receptor agonists are becoming an increasingly important tool in addressing obesity in the US, with burgeoning use in pediatric and adolescent populations. Although their use is expanding,...
Glucagon-like peptide-1 (GLP-1) receptor agonists are becoming an increasingly important tool in addressing obesity in the US, with burgeoning use in pediatric and adolescent populations. Although their use is expanding, there is a notable gap in the literature regarding optimal dietary guidelines for these patients. This review synthesizes current evidence on dietary recommendations for patients using GLP-1 receptor agonists for weight management, with particular emphasis on strategies for pediatric and adolescent populations. Key strategies include prioritizing protein in the diet to help maintain lean body mass, gradually increasing fiber content to minimize gastrointestinal side effects, focusing on nutrient-dense meals in smaller, more frequent portions, and monitoring micronutrients to prevent deficiencies. Successful implementation of these dietary guidelines relies on an interdisciplinary approach to optimize both short- and long-term success.
Fish oil intravenous fat emulsion monotherapy and essential fatty acid requirements.
Otis AS, Pettersen-Coulombe F, Demers E
Nutr Clin Pract · 2025 Oct · PMID 40682340 · Publisher ↗
Abstract loading — click title to view on PubMed.
Considerations in nutrition support for long-term bariatric surgery care.
Tewksbury C, Mahoney L, Shover R … +1 more , Schiavone PA
Nutr Clin Pract · 2025 Oct · PMID 40682338 · Publisher ↗
Bariatric surgery remains a highly effective treatment for severe obesity and its related comorbidities, but long-term nutrition management poses significant challenges for a small minority of post-bariatric surgery pati...
Bariatric surgery remains a highly effective treatment for severe obesity and its related comorbidities, but long-term nutrition management poses significant challenges for a small minority of post-bariatric surgery patients. Patients may require specialized nutrition support, including exclusive parenteral nutrition or enteral nutrition, owing to complications such as malabsorption, perforated ulceration, or severe nutrient deficiencies. This narrative review outlines the best practices for assessing, implementing, and monitoring exclusive parenteral nutrition or enteral nutrition in postbariatric patients, emphasizing individualized care and the management of psychosocial factors such as weight stigma. The article highlights future directions in technology and personalized medicine to optimize outcomes in this complex population.
Evaluation of malnutrition status and associated clinical indicators in Chinese patients with autoimmune rheumatic diseases: A cross-sectional study.
Chen C, Qiu Q, Kong W … +3 more , Huang S, Zhang Z, Chen X
Nutr Clin Pract · 2026 Jun · PMID 40682326 · Publisher ↗
BACKGROUND: We aimed to investigate the prevalence and impact of malnutrition in Chinese patients with autoimmune rheumatic diseases (ARDs) and to explore the associated risk factors. METHODS: This study evaluated the nu...
BACKGROUND: We aimed to investigate the prevalence and impact of malnutrition in Chinese patients with autoimmune rheumatic diseases (ARDs) and to explore the associated risk factors. METHODS: This study evaluated the nutrition status of 205 Chinese patients with ARDs. Participants' characteristics, nutrition measurements, activities of daily living (ADL), and clinical outcomes were collected. Body composition was measured by bioelectrical impedance analysis. Malnutrition was defined according to Global Leadership Initiative on Malnutrition criteria. RESULTS: In the study, 29.8% of the 205 patients with ARDs were diagnosed with malnutrition. Patients with malnutrition exhibited lower body mass index, fat-free mass index, and fat mass index as well as decreased levels of serum albumin, prealbumin, and 25-hydroxyvitamin D. High use of glucocorticoids (odds ratio [OR] = 4.65; 95% CI, 1.383-15.650; P = 0.013) and dysphagia (OR = 15.750; 95% CI, 1.504-164.905; P = 0.021) were independent risk factors of malnutrition in patients with ARDs. The patients with ARDs and malnutrition exhibited prolonged hospitalization, increased hospital costs declined ADL, and a higher 6-month rehospitalization rate. Furthermore, in female patients, malnutrition (OR = 2.210; 95% CI, 1.078-4.531; P = 0.030) increased the risk of 6-month rehospitalization rather than male patients. CONCLUSION: Malnutrition was associated with poor ADL and clinical outcomes. High use of glucocorticoids and dysphagia were independent risk factors of malnutrition in Chinese patients with ARDs.
Untold stories of the genesis and dissemination of PEN and ASPEN.
Barrocas A
Nutr Clin Pract · 2025 Oct · PMID 40682325 · Publisher ↗
Abstract loading — click title to view on PubMed.
Improving hospital nutrition care through "Indigenous cultural safety" of menu options: Results of a cross-sectional survey of Indigenous people in Western Canada.
Conklin AI, Tian D, Janzen V … +4 more , Spears A, Johnson N, Kaufman C, Feeney S
Nutr Clin Pract · 2026 Feb · PMID 40682323 · Full text
BACKGROUND: Hospital nutrition services rarely offer Indigenous-specific menu options, an essential element of delivering "Indigenous cultural safety" in nutrition care to Indigenous patients. METHODS: Indigenous partici...
BACKGROUND: Hospital nutrition services rarely offer Indigenous-specific menu options, an essential element of delivering "Indigenous cultural safety" in nutrition care to Indigenous patients. METHODS: Indigenous participants (n = 370) completed a semistructured Indigenous Food Ways survey (paper-based and online) from 2021 to 2022 as part of continuous healthcare quality improvement. Descriptive statistics summarized cultural/traditional foods respondents wanted to see or did not want to see as options on hospital menus. RESULTS: A majority of respondents (83%) agreed that a menu option for cultural/traditional foods was important, with 716 unique items reported. Seafood and meat/alternatives were common cultural/traditional items for menu options, specifically salmon (22%), traditional meat (14%), moose (12%), and venison (12%). Grain items reported were mostly Bannock (22%). Nearly 20% of the sample listed traditional foods, medicine, or tea as options for hospital menus. Respondents identified 254 items they did not want to see on hospital menus, which were commonly energy-dense/processed foods (16%) or poorly prepared/flavored items (13%), as well as peas and carrots (7%). Notably, some foods (eg, Bannock, salmon, fish eggs) were listed among both desired and not desired menu options. CONCLUSION: Results showed that offering cultural or traditional foods on hospital menus is considered important by Indigenous people, and that a wide range of foods would be desired. Specific cultural foods to include on menus were salmon, traditional meats, or traditional teas. Foods not to include were also identified. Improving future nutrition care and services will require menu modifications to provide culturally safe options for Indigenous patients.
Malnutrition prevalence at hospital admission and discharge based on the two-step Global Leadership Initiative on Malnutrition: A prospective observational study in Malawian adult patients.
Mphwanthe G, Columbus T, Wasambo L … +5 more , Koster H, Mndoliro L, Mtande F, Burr H, Weatherspoon L
Nutr Clin Pract · 2025 Jul · PMID 40653752 · Publisher ↗
OBJECTIVE: To assess the prevalence of malnutrition at hospital admission and discharge and examine factors associated with malnutrition at discharge among adult patients. STUDY DESIGN: A prospective observational study...
OBJECTIVE: To assess the prevalence of malnutrition at hospital admission and discharge and examine factors associated with malnutrition at discharge among adult patients. STUDY DESIGN: A prospective observational study was conducted at two public referral hospitals in Malawi, targeting adult patients aged 18-65 years (n = 418). Within 24-48 h of hospital admission, patients were screened for malnutrition risk using the Malnutrition Screening Tool and diagnosed with malnutrition using the Global Leadership Initiative on Malnutrition (GLIM) criteria. Patients (n = 229) with a length of stay (LOS) of ≥7 days were rescreened and reassessed at discharge. RESULTS: According to the GLIM criteria, at admission, 74.3% (n = 150) of the patients were diagnosed with malnutrition, of which 71.3% (n = 107) were moderately malnourished and 28.7% (n = 43) were severely malnourished. At discharge (≥7-day LOS), 81.5% (n = 101) were malnourished, with 35.6% (n = 36) and 64.4% (n = 65) being moderately and severely malnourished, respectively. Among patients who were severely malnourished at discharge (≥7-day LOS), 63.1% (n = 41) and 61.5% (n = 40) exhibited three of the GLIM phenotypic and two of the etiologic characteristics, respectively. Malnutrition at discharge (≥7-day LOS) was associated with a longer LOS (adjusted odds ratio [AOR], 1.206; 95% CI, 1.062-1.370; P = 0.004) and a history of previous hospital admission within the past 6 months (AOR, 4.146; 95% CI, 1.192-14.418; P = 0.025). CONCLUSION: Malnutrition at admission and discharge is a serious concern in Malawi, necessitating tailored nutrition/dietetic interventions in the hospital, at discharge, and after discharge.
Navigating the ethical landscape of parenteral nutrition: Balancing care and moral principles.
Tabone T, Ellul P, Azzopardi N … +1 more , Agius E
Nutr Clin Pract · 2025 Dec · PMID 40652386 · Publisher ↗
Parenteral nutrition (PN) is a life-sustaining therapy for patients unable to meet nutrition needs via enteral routes, but its use presents significant ethical complexity. This narrative review provides clinicians with a...
Parenteral nutrition (PN) is a life-sustaining therapy for patients unable to meet nutrition needs via enteral routes, but its use presents significant ethical complexity. This narrative review provides clinicians with a practical, principle-based framework to navigate the ethical dilemmas inherent in PN across diverse clinical contexts. Grounded in the four pillars of medical ethics-autonomy, beneficence, nonmaleficence, and justice-the review explores decision-making challenges in vulnerable populations, long-term PN, and end-of-life care. Clinically relevant scenarios are examined, including initiation or withdrawal of PN in terminal illness, informed consent in cognitively impaired patients, and balancing parental wishes with a child's best interests in pediatric care. The ethical tension between prolonging life and enhancing quality of life is critically appraised, particularly in oncology and palliative settings. The review also addresses disparities in PN access and resource allocation, with actionable insights for clinicians practicing in low-resource settings. Key take-home strategies include using structured ethical frameworks such as the Four-Quadrant and Shared Decision-Making models, involving ethics committees in complex cases, and prioritizing transparent, compassionate communication. Clinicians are encouraged to consider both the clinical utility and psychosocial burden of PN, and to integrate multidisciplinary perspectives into care planning. Ultimately, this review underscores the need for ethically attuned, patient-centered PN decisions that align with individual goals, values, and context. It provides structured guidance to assist nutrition support teams in translating ethical principles into clinical practice, thereby ensuring that PN is administered judiciously, safely, and in accordance with the patient's best interests.
Differences in practice on parenteral nutrition filter use: Could we be missing something?
Klang MG, Ferrie S
Nutr Clin Pract · 2025 Aug · PMID 40635445 · Publisher ↗
Abstract loading — click title to view on PubMed.
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