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Kathleen Harrison

Wed, 02/06/2019 - 17:18

Thanks George! Great review, as this was a really interesting talk.

Relating to Asish and Ruaa's comments, there appears to be an issue of relatively little information regarding objective diagnosis of malnutrition, and thus difficulty in providing evidence-based dietary intervention. Empirical diagnosis of malnutrition is often confounded by disease co-morbidities; as how could physicians employ normative biomarkers (i.e. molecular serum albumin, or imaging calf muscle to adipose ratio) in the non-normative context of acute illness?

Second, I think it would be great to expand evidence-based education, and thus effective medical treatment, for malnutrition in various contexts. WHO definition of 'malnutrition' includes; Undernutrition (i.e. inadequacy of muscle mass and/or vitamins and mineral intake), Obesity (i.e. excess of mass, usually adipose), and Diet-related noncommunicable diseases (i.e. cardiovascular disease related to poor diet). This would include ICD-9/OHIP codes 263-278, and then some!
It would be great to have additional information regarding best-practice guidelines to assist physicians in treatment of the malnourished patient (i.e. In a septic patient, meeting full caloric requirements is not advised, as described in the "International Guidelines for Management of Severe Sepsis and Septic Shock".)

Kathleen Harrison

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