ASPEN criteria for Malnutrition

Malnutrition is a simple concept. Malnutrition begins when food and nutrient intake is consistently inadequate to meet individual nutrient requirements. Over time, inadequate food and nutrient intake results in changes in weight, body composition, and physical function. At some point along the continuum that begins with inadequate nutrient intake and ends in death from starvation, increased susceptibility to disease appears.  

The diagnosis of malnutrition and its severity depends on clinical judgment, using several findings.

The Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition (ASPEN)  released a Consensus Statement regarding Characteristics Recommended for the Identification and Documentation of Adult Malnutrition and Undernutrition: 

- Insufficient energy intake; 

- weight loss; 

- loss of muscle mass; 

- loss of subcutaneous fat; 

- localized or generalized fluid accumulation that may sometimes mask weight loss; 

- diminished functional status as measured by hand grip strength represent the most relevant findings in malnutrition.

No particular finding is required or definitive. Biochemical markers should be considered with caution because many other conditions, especially inflammatory states, acute illness and trauma, may cause acutely low biomarkers.