A critical look at medical nutrition terminology and definitions,

A plethora of terms and definitions for medical nutrition has resulted in an ambiguity in the way "medical nutrition" is termed and defined across various societal levels. The terms medical nutrition, clinical nutrition, enteral nutrition, parenteral nutrition, oral nutritional supplements, medical foods, foods for special medical purposes, nutritional support, nutritional intervention and nutritional therapy are used interchangeably. To date consistent terminology/nomenclature and definitions have not emerged from the US and European medical nutrition community. The current absence of clear medical nutrition product category boundaries makes it necessary to introduce medical nutrition terminology conformance in order to reduce widespread confusion at policy; industry; healthcare; and patient level. In order to end discussion, this literature review attempts to put quantitative and qualitative clarity and continuity to the use of these terms and definitions by: (1) addressing the terminology used; (2) discussing the distinguishing features of medical nutrition in various definitions and (3) proposing a single medical nutrition term and a clear pragmatic operational definition. A scientific literature-based comparison was conducted resulting in the selection of 22 publications, describing 8 different terms with 19 definitions.Based on the terminology found in literature, the following medical nutrition terminology is proposed: medical nutrition comprises both parenteral (intravenous) as well as enteral nutrition (tube feeding and oral nutrition), which may be given via the oral route or via a tube into the gastrointestinal tract. The features found to be most important in describing medical nutrition are: route of administration; disease; supervision; composition and support/management. These features have been integrated into one operational clinical definition and resulted in the following definition: MEDICAL NUTRITION: specially formulated nutritional composition for the dietary management of patients with diseases, disorders or medical conditions that cause distinct nutritional requirements. It may consist of partial or exclusive feeding by means of oral intake, tube feeding and/or parenteral administration under healthcare professional supervision. •This review aims to put clarity and continuity to the use of medical nutrition terms and definitions.•The distinguishing features of medical nutrition are extracted from 22 publications and elaborately described.•The review concludes with a single medical nutrition term and clear pragmatic operational definition. © 2014 Elsevier Ltd