Disease-related malnutrition and nutritional assessment in clinical practice

Malnutrition has been defined as “a state resulting from lack of intake or uptake of nutrition that leads to altered body composition (decreased fat-free mass) and body cell mass leading to diminished physical and mental function and impaired clinical outcome from disease”. The prevalence of malnutrition in hospital populations is reported to vary between 11-45%. To prevent or treat malnutrition, early recognition of the (risk for) malnutrition is necessary. The prevalence of malnutrition, its characteristics, and the subsequent necessary interventions may vary in different patient populations. This thesis aimed to provide new insights with regard to the (risk) assessment of disease-related malnutrition and its implications for healthcare professionals in order to improve their care for patients in daily clinical practice. This thesis shows that a substantial part of the patients prior to vascular surgery, or patients with COPD following a pulmonary rehabilitation program, is malnourished or at risk for malnutrition, whereas these patients may be unrecognized and thus not treated. Therefore screening and assessment are important, and should be performed in such a way that all domains of malnutrition are represented, as well as the underlying factors that give guidance to interventions. Insight in what motivates people to eat healthy and new methods to measure body composition can be helpful to the nutrition care process. This is important as (risk for) malnutrition is a predictor of worse clinical outcome and is associated with frailty. To improve recognition of malnutrition and nutrition-related disorders, more knowledge and awareness is needed