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Journal of Parenteral and Enteral Nutrition
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Invited Commentary

Malnutrition Syndromes: A Conundrum vs Continuum

Gordon L. Jensen, MD, PhD1, Bruce Bistrian, MD, PhD2, Ronenn Roubenoff, MD, MHS3 and Douglas C. Heimburger, MD, MS4

From the 1 Department of Nutritional Sciences, the Pennsylvania State University, University Park, PA;2 Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA;3 Immunology Medical Research, Biogen Idec, Inc, Cambridge, MA; and 4 Departments of Nutrition Sciences and Medicine, University of Alabama at Birmingham, Birmingham, AL.

Address correspondence to: Gordon L. Jensen, MD, PhD, Professor and Head, Department of Nutritional Sciences, 110 Chandlee Lab, The Pennsylvania State University, University Park, PA 16802; e-mail: GLJ1{at}psu.edu.

This provocative commentary critically examines historic definitions for adult malnutrition syndromes as they apply to developed countries with modern healthcare. To stimulate further discussion, the authors propose an updated approach that incorporates current understanding of the systemic inflammatory response to help guide assessment, diagnosis, and treatment. An appreciation of a continuum of inflammatory response in relation to malnutrition syndromes is described. This discussion serves to highlight a research agenda to address deficiencies in diagnostics, biomarkers, and therapeutics of inflammation in relation to malnutrition.

Key Words: malnutrition • cachexia • kwashiorkor • marasmus • protein-energy malnutrition

Journal of Parenteral and Enteral Nutrition, Vol. 33, No. 6, 710-716 (2009)
DOI: 10.1177/0148607109344724
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