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Priority: Prevent, Identify, Treat Malnutrition

Published:December 19, 2018DOI:https://doi.org/10.1016/j.jand.2018.10.024
      Malnutrition is one of the most challenging health problems facing our country and the world. Hunger, food insecurity, and malnutrition exist in people of all ages and social demographics and may not be immediately visible. Academy members, leaders, our Headquarters Team, and partner organizations in the United States and globally are collaborating to diagnose, treat, and—as possible—prevent malnutrition in communities, schools, health care settings, and workplaces. We are making significant progress. For example, the Academy’s work on managing malnutrition among seniors has been increasingly visible as the Malnutrition Quality Improvement Initiative (MQii) (http://mqii.defeatmalnutrition.today/) has expanded over the past 5 years.

      Education and Advocacy

      Our September spotlight on malnutrition emphasized that members must identify and treat malnutrition and demonstrate leadership in this endeavor in all settings. In October, the Food & Nutrition Conference & Expo (FNCE) dedicated an educational track to malnutrition. Immediately following FNCE, more than 1,400 members attended the Academy’s largest-ever Public Policy Workshop to encourage members of Congress to include the diagnosis and treatment of malnutrition as a component of high-quality health care. In a Capitol Hill rally (see photo above) and in visits to congressional offices, members emphasized the vital roles of registered dietitian nutritionists (RDNs) and nutrition and dietetics technicians, registered (NDTRs) in comprehensive malnutrition care.

      Identify and Intervene

      I asked two Academy members who are recognized experts in malnutrition to share what members need to know and do to successfully address this issue.
      “Know the definition of malnutrition and what the validated malnutrition screening tools are,” says Patricia J. Becker, MS, RDN, CSP, CNSC, pediatric nutrition specialist at Dayton (OH) Children’s Hospital Medical Center and chair of the Pediatric Nutrition dietetic practice group. “Read the new adult and pediatric Evidence Analysis Library nutrition screening projects and learn the recommended indicators for identification and documentation of malnutrition. Communicate your findings and diagnosis to your health care team and educate them on the recommended indicators. You can investigate being a site for the Malnutrition Clinical Characteristic Validation Study (www.eatrightpro.org/research/projects-tools-and-initiatives/nutrition-research-network/nutrition-research-network-projects), collect data on the prevalence of malnutrition, and publish your data.”
      According to Terese Scollard, MBA, RDN, LD, FAND, regional clinical nutrition manager at Providence Health & Services in Portland, OR, and chair of the Clinical Nutrition Managers DPG: “Dietitians must learn and intervene in the causes and consequences of malnutrition, be leaders and collaborators in finding and fixing inconsistencies, and address gaps that miss prevention opportunities or make undernutrition and malnutrition worse. It is not acceptable to wait for 20-, 30- or 40-pound weight loss in ill people, when timely and early interventions with minimal costs can reduce or prevent a nutritional crisis. We need to share these harm stories so others will understand and help us change and improve the paradigm.”

      Prepare the Profession

      Through education and experience, we are positioning RDNs as key participants on interdisciplinary teams in the United States. and abroad in addressing malnutrition. Myriad learning opportunities provided by the Academy ensure that food and nutrition professionals are prepared to handle prevention, identification, and treatment of malnutrition in real-life situations. From FNCE to Public Policy Workshops to hands-on Nutrition-Focused Physical Exam trainings and more, the Academy is ensuring that members are the recognized experts who lead the fight against malnutrition.