Diagnostic criteria for malnutrition - An ESPEN Consensus Statement

Area of Science:

• Clinical Nutrition
• Medical Diagnostics
• Public Health

Background:

• Malnutrition diagnosis lacks standardized criteria across clinical settings and etiologies.
• International terminology for malnutrition is inconsistent, hindering effective communication and care.

Purpose of the Study:

• To establish a consensus-based minimum set of criteria for diagnosing malnutrition.
• To standardize international terminology for malnutrition.
• To create criteria applicable across all clinical settings and etiologies.

Main Methods:

• A modified Delphi process was employed by a European Society of Clinical Nutrition and Metabolism (ESPEN) appointed group.
• The process included e-mail communications, face-to-face meetings, questionnaires, and ballots among ESPEN members.

Main Results:

• ESPEN recommends screening for malnutrition risk and appropriate assessment/treatment.
• Two diagnostic options for malnutrition were agreed upon: BMI <18.5 kg/m² or unintentional weight loss combined with reduced BMI or low fat-free mass index (FFMI).
• Specific cut-offs for BMI, weight loss, and FFMI (age and sex-specific) were defined, with over 75% member agreement.

Conclusions:

• Malnutrition diagnosis in at-risk individuals should utilize either a low BMI (<18.5 kg/m²) or a combination of weight loss with age-specific reduced BMI or sex-specific low FFMI.
• The new criteria aim to unify international terminology and application across diverse clinical contexts.