Defining malnutrition in persons with spinal cord injury – does the Global Criteria for Malnutrition work?

Food & Nutrition Research, 2024 · DOI: http://dx.doi.org/10.29219/fnr.v68.9989 · Published: March 25, 2024

Spinal Cord Injury Nutrition & Dietetics Rehabilitation

Simple Explanation

This study assesses malnutrition in patients with spinal cord injury (SCI) using global criteria (GLIM). It finds a high prevalence of malnutrition among subacute SCI patients. Loss of fat-free mass, a natural result of SCI, contributes to malnutrition diagnoses, potentially questioning the GLIM criteria's validity in SCI patients. The study questions if SCI itself induces a malnourished state, and the GLIM criteria's applicability, suggesting further investigation into clinical implications.

Study Duration

October 2018 to March 2023

Participants

66 patients with SCI

Evidence Level

Cross-sectional study

Key Findings

1
62% of subacute SCI patients were malnourished according to the GLIM criteria.
2
The MUST screening tool showed moderate agreement with GLIM but missed malnutrition risk in some patients.
3
Low fat-free mass index (FFMI) was a key factor in GLIM malnutrition diagnoses, even when MUST screening indicated low risk.

Research Summary

This study assessed malnutrition in SCI patients using GLIM criteria, finding a high prevalence of malnutrition. The MUST screening tool showed moderate agreement but failed to identify all malnourished patients, particularly those with low FFMI. The study highlights the need for an international consensus on malnutrition criteria for SCI and further validation of FFM estimation methods.

Practical Implications

Nutritional Screening Improvement

Enhance malnutrition screening tools for SCI patients to better identify those at risk, especially considering fat-free mass loss.

Personalized Nutritional Plans

Develop individualized nutrition plans that account for the metabolic changes and muscle atrophy associated with SCI to prevent malnutrition and promote recovery.

GLIM Criteria Evaluation

Evaluate and potentially adapt the GLIM criteria to better suit the unique nutritional needs and body composition changes in individuals with SCI.

Study Limitations

1
Self-reported height data may introduce bias in BMI assessment.
2
Fluid imbalances in SCI patients may affect the accuracy of BIA measurements for FFM estimation.
3
The MUST tool is not specific to SCI, potentially affecting the accuracy of malnutrition risk screening.

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