FOR IMMEDIATE RELEASE
April 4, 2013
Paper endorsed by American Academy of Pediatrics
April 4, 2013, Silver Spring, MD – The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)—an organization that seeks to improve patient care by advancing the science and practice of clinical nutrition and metabolism.—today published online in the Journal of Parenteral and Enteral Nutrition (JPEN) a critical malnutrition paper entitled Defining Pediatric Malnutrition: A Paradigm Shift Toward Etiology-Related Definitions.
This paper, endorsed by the Academy of Pediatrics (AAP), builds upon A.S.P.E.N.’s continual focus on malnutrition as a high priority topic. The AAP is an organization of 60,000 pediatricians committed to the optimal physical, mental, and social health and well being for all infants, children, adolescents, and young adults.
A.S.P.E.N.’s new pediatric malnutrition definitions publication is important because it presents a uniform definition for pediatric malnutrition that can be put into practice immediately. This definition will allow future research to focus on the impact of pediatric malnutrition, explore functional outcomes, and solidify the scientific basis for evidence-based nutrition practices.
Lack of a uniform definition is responsible for under-recognition of the prevalence of malnutrition and its impact on outcomes in children. Therefore, a pediatric malnutrition definitions workgroup, led by Nilesh M. Mehta, MD, Associate Medical Director, Critical Care Medicine, Department of Anesthesiology, Pain and Perioperative Medicine, Boston Children’s Hospital, reviewed existing pediatric age group literature for relevant references related to these five domains:
- Anthropometric parameters
- Chronicity of malnutrition
- Etiology and pathogenesis
- Developmental/ functional outcomes
Based on available evidence, the multidisciplinary group included these domains in the overall construct of the new definition: Pediatric malnutrition (undernutrition) is defined as an imbalance between nutrient requirements and intake that results in cumulative deficits of energy, protein, or micronutrients that may negatively affect growth, development, and other relevant outcomes.
A.S.P.E.N.’s malnutrition paper summarizes the literature that the working group examined. And, it proposes a new classification scheme that incorporates chronicity, etiology, mechanisms of nutrient imbalance, severity of malnutrition, and its impact on outcomes. Based on its etiology, malnutrition is either illness related (secondary to 1 or more diseases/injury) or non–illness related, (caused by environmental/behavioral factors), or both.
“Malnutrition is an incredibly serious issue that affects children in all settings,” said Nilesh M. Mehta, MD, Associate Medical Director, Critical Care Medicine, Department of Anesthesiology, Pain and Perioperative Medicine, Boston Children’s Hospital. “A uniform approach to defining this condition is the first step in our efforts to ameliorate its negative impact on patient well-being and outcomes. This paper is crucial because it presents a uniform definition based on wide consensus and available literature. The comprehensive definition changes how we will research and treat pediatric malnutrition.”
For more information on this paper or to download a copy, please visit JPEN online.
The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) is dedicated to improving patient care by advancing the science and practice of nutrition support therapy and metabolism. Founded in 1976, A.S.P.E.N. is an interdisciplinary organization whose members are involved in the provision of clinical nutrition therapies, including parenteral and enteral nutrition. With more than 5,500 members from around the world, A.S.P.E.N. is a community of dietitians, nurses, nurse practitioners, pharmacists, physicians, scientists, students and other health professionals from every facet of nutrition support clinical practice, research and education. For more information about A.S.P.E.N. please visit
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