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Diagnosing undernutrition children and adults: new French criteria. Why, for what and for whom? A joint statement of the French National Authority for Health and French Federation of Nutrition

Abstract : Abstract The objective was to establish new diagnostic criteria for undernutrition for the French population, concordant for children aged < 18 years and adults aged < 70 years, easy to use by health professionals, and applicable whatever the situation (in - and outpatients). A multi-disciplinary working and a reading group were involved. The procedure was divided into 4 phases: 1) systematic review and synthesis of the literature; 2) writing of the initial version of the guidelines; 3) reading; 4) finalization. The literature search included international guidelines, meta-analyses, systematic reviews, and randomized control trials from January 2007 to July 31, 2018. A two-step approach was selected: diagnosing undernutrition, and then grading its severity. For diagnosis at least one phenotypic criterion associated with at least one etiologic criterion were required for both children and adults. Phenotypic criteria for children were: weight loss, body mass index (BMI) < International Obesity Task Force curve 18.5, weight stagnation, reduction of muscle mass/function; for adults: weight loss, BMI < 18.5, reduction of muscle mass/function. Etiological criteria for children and adults were: reduction in dietary intake, reduced absorption, and hypercatabolism. Phenotypic metrics were used in both children and adults for grading severity (moderate or severe). These new French recommendations integrate the proposals of recent international recommendations combining etiologic with phenotypic criteria, but for the first time, they are concordant for children and adults. The World Health Organization threshold of 18.5 for BMI was kept as phenotypic criteria because epidemiologic data show an increased mortality for that threshold.
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https://hal.inrae.fr/hal-03237374
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Submitted on : Wednesday, May 26, 2021 - 3:52:47 PM
Last modification on : Friday, June 4, 2021 - 2:40:26 PM

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Jacques Delarue, Jean-Claude Desport, Béatrice Dubern, Francisca Joly, Emmanuel Mas, et al.. Diagnosing undernutrition children and adults: new French criteria. Why, for what and for whom? A joint statement of the French National Authority for Health and French Federation of Nutrition. British Journal of Nutrition, Cambridge University Press (CUP), 2021, pp.1-38. ⟨10.1017/S0007114521001471⟩. ⟨hal-03237374⟩

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