Illness-associated undernutrition (DAU) was widespread in hospitalized children. It was well known to be related to poor disease outcomes, making appropriate diagnosis and assessment critical in caring for the sick child. However, various obstacles exist to regular screening, evaluation, and treatment of unwell children with poor nutritional status or DAU, including insufficient resources, a lack of nutritional awareness, and a lack of established nutrition policy. Researchers recommended that all pediatric facilities implement procedures for identifying children with (at risk of) DAU, including nutritional screening, criteria for further assessment to establish DAU diagnosis and follow-up, assessing weight and height in all children as a minimum, and allowing children at risk to be assessed by a hospital dietitian. “Undernutrition is a condition resulting from imbalanced nutrition or abnormal utilization of nutrients that causes clinically meaningful adverse effects on tissue function and/or body size/composition with subsequent impact on health outcomes,” according to an updated descriptive definition of pediatric DAU.
To facilitate data comparison, it was recommended that, in addition to commonly used undernutrition criteria such as z score <−2 for weight-for-age, weight-for-length, or body mass index <−2, an unintentional decline of >1 in these z scores over time be considered as an indicator requiring further assessment to establish DAU diagnosis. Because the etiology of DAU is multifaceted, clinical examination and anthropometry should ideally be supplemented by body composition measures, nutritional intake, needs, and losses, and consideration of illness-specific variables.
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