[Health Council of the Netherlands underestimates interactions in undernutrition in the elderly]

The Health Council of the Netherlands has recently published a report on undernutrition in the elderly. Undernutrition is a huge problem associated with negative health outcomes, especially in the frail elderly. Although its review of the recent literature is useful, the report does not contribute anything to clinical practice. The point is that evidence for firm conclusions is still lacking, and that most of all more research is needed to really define undernutrition and that RCTs in homogeneous groups of elderly should yield evidence on the most effective treatment strategies in the different populations in old age. This reductionist viewpoint neglects the fact that undernutrition in the elderly is a geriatric syndrome, which is mainly explained by multifactorial aetiology. Therefore, the only way forward is to study and treat undernutrition in older adults by using a broad geriatric perspective, without aiming for the holy grail of the single best evidenced definition or treatment.