Unsatisfactory knowledge and use of terminology regarding malnutrition, starvation, cachexia and sarcopenia among dietitians

Lies ter Beek, Erika Vanhauwaert, Frode Slinde, Ylva Orrevall, Christine Henriksen, Madelene Johansson, Carine Vereecken, Elisabet Rothenberg, Harriët Jager-Wittenaar

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Clinical signs of malnutrition, starvation, cachexia and sarcopenia overlap, as they all imply muscle wasting to a various extent. However, the underlying mechanisms differ fundamentally and therefore distinction between these phenomena has therapeutic and prognostic implications. We aimed to determine whether dietitians in selected European countries have ‘sufficient knowledge’ regarding malnutrition, starvation, cachexia and sarcopenia, and use these terms in their daily clinical work.MethodsAn anonymous online survey was performed among dietitians in Belgium, the Netherlands, Norway and Sweden. ‘Sufficient knowledge’ was defined as having mentioned at least two of the three common domains of malnutrition according to ESPEN definition of malnutrition (2011): ‘nutritional balance’, ‘body composition’ and ‘functionality and clinical outcome’, and a correct answer to three cases on starvation, cachexia and sarcopenia. Chi-square test was used to analyse differences in experience, work place and number of malnourished patients treated between dietitians with ‘sufficient knowledge’ vs. ‘less sufficient knowledge’. Results712/7186 responded to the questionnaire, of which data of 369 dietitians were included in the analysis (5%). The term ‘malnutrition’ is being used in clinical practice by 88% of the respondents. Starvation, cachexia and sarcopenia is being used by 3%, 30% and 12% respectively. The cases on starvation, cachexia and sarcopenia were correctly identified by 58%, 43% and 74% respectively. 13% of the respondents had ‘sufficient knowledge’. 31% of the respondents identified all cases correctly. The proportion of respondents with ‘sufficient knowledge’ was significantly higher in those working in a hospital or in municipality (16%, P < 0.041), as compared to those working in other settings (7%). The results of our survey among dietitians in four European countries show that the percentage of dietitians with ‘sufficient knowledge’ regarding malnutrition, starvation, cachexia and sarcopenia is unsatisfactory (13%). The terms starvation, cachexia and sarcopenia are not often used by dietitians in daily clinical work. As only one-third (31%) of dietitians identified all cases correctly, the results of this study seem to indicate that nutrition-related disorders are suboptimally recognized in clinical practice, which might have a negative impact on nutritional treatment. The results of our study require confirmation in a larger sample of dietitians.
Original languageEnglish
Pages (from-to)1-7
JournalClinical nutrition
DOIs
Publication statusPublished - 2016

Keywords

  • nutrition disorder
  • malnutrition
  • starvation
  • cachexia
  • sarcopenia
  • dietitians

Cite this

ter Beek, Lies ; Vanhauwaert, Erika ; Slinde, Frode ; Orrevall, Ylva ; Henriksen, Christine ; Johansson, Madelene ; Vereecken, Carine ; Rothenberg, Elisabet ; Jager-Wittenaar, Harriët. / Unsatisfactory knowledge and use of terminology regarding malnutrition, starvation, cachexia and sarcopenia among dietitians. In: Clinical nutrition. 2016 ; pp. 1-7.
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title = "Unsatisfactory knowledge and use of terminology regarding malnutrition, starvation, cachexia and sarcopenia among dietitians",
abstract = "Clinical signs of malnutrition, starvation, cachexia and sarcopenia overlap, as they all imply muscle wasting to a various extent. However, the underlying mechanisms differ fundamentally and therefore distinction between these phenomena has therapeutic and prognostic implications. We aimed to determine whether dietitians in selected European countries have ‘sufficient knowledge’ regarding malnutrition, starvation, cachexia and sarcopenia, and use these terms in their daily clinical work.MethodsAn anonymous online survey was performed among dietitians in Belgium, the Netherlands, Norway and Sweden. ‘Sufficient knowledge’ was defined as having mentioned at least two of the three common domains of malnutrition according to ESPEN definition of malnutrition (2011): ‘nutritional balance’, ‘body composition’ and ‘functionality and clinical outcome’, and a correct answer to three cases on starvation, cachexia and sarcopenia. Chi-square test was used to analyse differences in experience, work place and number of malnourished patients treated between dietitians with ‘sufficient knowledge’ vs. ‘less sufficient knowledge’. Results712/7186 responded to the questionnaire, of which data of 369 dietitians were included in the analysis (5{\%}). The term ‘malnutrition’ is being used in clinical practice by 88{\%} of the respondents. Starvation, cachexia and sarcopenia is being used by 3{\%}, 30{\%} and 12{\%} respectively. The cases on starvation, cachexia and sarcopenia were correctly identified by 58{\%}, 43{\%} and 74{\%} respectively. 13{\%} of the respondents had ‘sufficient knowledge’. 31{\%} of the respondents identified all cases correctly. The proportion of respondents with ‘sufficient knowledge’ was significantly higher in those working in a hospital or in municipality (16{\%}, P < 0.041), as compared to those working in other settings (7{\%}). The results of our survey among dietitians in four European countries show that the percentage of dietitians with ‘sufficient knowledge’ regarding malnutrition, starvation, cachexia and sarcopenia is unsatisfactory (13{\%}). The terms starvation, cachexia and sarcopenia are not often used by dietitians in daily clinical work. As only one-third (31{\%}) of dietitians identified all cases correctly, the results of this study seem to indicate that nutrition-related disorders are suboptimally recognized in clinical practice, which might have a negative impact on nutritional treatment. The results of our study require confirmation in a larger sample of dietitians.",
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author = "{ter Beek}, Lies and Erika Vanhauwaert and Frode Slinde and Ylva Orrevall and Christine Henriksen and Madelene Johansson and Carine Vereecken and Elisabet Rothenberg and Harri{\"e}t Jager-Wittenaar",
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doi = "10.1016/j.clnu.2016.03.23",
language = "English",
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Unsatisfactory knowledge and use of terminology regarding malnutrition, starvation, cachexia and sarcopenia among dietitians. / ter Beek, Lies; Vanhauwaert, Erika; Slinde, Frode; Orrevall, Ylva; Henriksen, Christine; Johansson, Madelene; Vereecken, Carine ; Rothenberg, Elisabet; Jager-Wittenaar, Harriët.

In: Clinical nutrition, 2016, p. 1-7.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Unsatisfactory knowledge and use of terminology regarding malnutrition, starvation, cachexia and sarcopenia among dietitians

AU - ter Beek, Lies

AU - Vanhauwaert, Erika

AU - Slinde, Frode

AU - Orrevall, Ylva

AU - Henriksen, Christine

AU - Johansson, Madelene

AU - Vereecken, Carine

AU - Rothenberg, Elisabet

AU - Jager-Wittenaar, Harriët

PY - 2016

Y1 - 2016

N2 - Clinical signs of malnutrition, starvation, cachexia and sarcopenia overlap, as they all imply muscle wasting to a various extent. However, the underlying mechanisms differ fundamentally and therefore distinction between these phenomena has therapeutic and prognostic implications. We aimed to determine whether dietitians in selected European countries have ‘sufficient knowledge’ regarding malnutrition, starvation, cachexia and sarcopenia, and use these terms in their daily clinical work.MethodsAn anonymous online survey was performed among dietitians in Belgium, the Netherlands, Norway and Sweden. ‘Sufficient knowledge’ was defined as having mentioned at least two of the three common domains of malnutrition according to ESPEN definition of malnutrition (2011): ‘nutritional balance’, ‘body composition’ and ‘functionality and clinical outcome’, and a correct answer to three cases on starvation, cachexia and sarcopenia. Chi-square test was used to analyse differences in experience, work place and number of malnourished patients treated between dietitians with ‘sufficient knowledge’ vs. ‘less sufficient knowledge’. Results712/7186 responded to the questionnaire, of which data of 369 dietitians were included in the analysis (5%). The term ‘malnutrition’ is being used in clinical practice by 88% of the respondents. Starvation, cachexia and sarcopenia is being used by 3%, 30% and 12% respectively. The cases on starvation, cachexia and sarcopenia were correctly identified by 58%, 43% and 74% respectively. 13% of the respondents had ‘sufficient knowledge’. 31% of the respondents identified all cases correctly. The proportion of respondents with ‘sufficient knowledge’ was significantly higher in those working in a hospital or in municipality (16%, P < 0.041), as compared to those working in other settings (7%). The results of our survey among dietitians in four European countries show that the percentage of dietitians with ‘sufficient knowledge’ regarding malnutrition, starvation, cachexia and sarcopenia is unsatisfactory (13%). The terms starvation, cachexia and sarcopenia are not often used by dietitians in daily clinical work. As only one-third (31%) of dietitians identified all cases correctly, the results of this study seem to indicate that nutrition-related disorders are suboptimally recognized in clinical practice, which might have a negative impact on nutritional treatment. The results of our study require confirmation in a larger sample of dietitians.

AB - Clinical signs of malnutrition, starvation, cachexia and sarcopenia overlap, as they all imply muscle wasting to a various extent. However, the underlying mechanisms differ fundamentally and therefore distinction between these phenomena has therapeutic and prognostic implications. We aimed to determine whether dietitians in selected European countries have ‘sufficient knowledge’ regarding malnutrition, starvation, cachexia and sarcopenia, and use these terms in their daily clinical work.MethodsAn anonymous online survey was performed among dietitians in Belgium, the Netherlands, Norway and Sweden. ‘Sufficient knowledge’ was defined as having mentioned at least two of the three common domains of malnutrition according to ESPEN definition of malnutrition (2011): ‘nutritional balance’, ‘body composition’ and ‘functionality and clinical outcome’, and a correct answer to three cases on starvation, cachexia and sarcopenia. Chi-square test was used to analyse differences in experience, work place and number of malnourished patients treated between dietitians with ‘sufficient knowledge’ vs. ‘less sufficient knowledge’. Results712/7186 responded to the questionnaire, of which data of 369 dietitians were included in the analysis (5%). The term ‘malnutrition’ is being used in clinical practice by 88% of the respondents. Starvation, cachexia and sarcopenia is being used by 3%, 30% and 12% respectively. The cases on starvation, cachexia and sarcopenia were correctly identified by 58%, 43% and 74% respectively. 13% of the respondents had ‘sufficient knowledge’. 31% of the respondents identified all cases correctly. The proportion of respondents with ‘sufficient knowledge’ was significantly higher in those working in a hospital or in municipality (16%, P < 0.041), as compared to those working in other settings (7%). The results of our survey among dietitians in four European countries show that the percentage of dietitians with ‘sufficient knowledge’ regarding malnutrition, starvation, cachexia and sarcopenia is unsatisfactory (13%). The terms starvation, cachexia and sarcopenia are not often used by dietitians in daily clinical work. As only one-third (31%) of dietitians identified all cases correctly, the results of this study seem to indicate that nutrition-related disorders are suboptimally recognized in clinical practice, which might have a negative impact on nutritional treatment. The results of our study require confirmation in a larger sample of dietitians.

KW - voedingsstoornissen

KW - ondervoeding

KW - uithongering

KW - sarcopenie

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KW - nutrition disorder

KW - malnutrition

KW - starvation

KW - cachexia

KW - sarcopenia

KW - dietitians

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JO - Clinical nutrition

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SN - 0261-5614

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