Addressing malnutrition in hospitalized adults.

Established guidelines and standardized protocols exist to assist clinicians in effectively addressing disease-related malnutrition in hospitalized adults. The goals of this treatment vary according to the disease state and the severity of the malnutrition. In starvation-related malnutrition, the goal of nutrition therapy is to restore healthy levels of lean body mass and body fat. For chronic disease-related malnutrition, the goals of treatment are to maintain and improve lean body mass and body fat. In acute-disease-related malnutrition, the goals of nutrition therapy are to support vital organ function and preserve the host response through the acute episode. The success of addressing malnutrition in hospitalized patients depends not just on the nutrition therapy selected, but also on the timely and appropriate application of guidelines and protocols by the clinicians dedicated to caring for malnourished patients. Coordination of nutrition care among providers is highly desirable, and usually includes a multidisciplinary team of clinicians typically comprising a physician, nurse, dietitian, and pharmacist. For greatest success, this attention to recognizing and addressing malnutrition begins at admission and continues beyond discharge to the community. When addressing malnutrition in hospitalized patients, oral feeding through diet enrichment or oral nutrition supplementation (ONS) is the first line of defense. ONS has consistently been demonstrated to provide nutrition, clinical, functional, and economic benefits to malnourished patients in both individual trials and meta-analyses. In an era when the cost of healthcare is rising as the population ages, addressing malnutrition in hospitalized patients is an important priority.