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Asia Pac J Clin Nutr. 2017 Mar;26(2):202-211. doi: 10.6133/apjcn.022016.04.

Taking action against malnutrition in Asian healthcare settings: an initiative of a Northeast Asia Study Group.

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Fujita Health University School of Medicine, Department of Surgery and Palliative Medicine, Toyoake, Japan. Email:
National Center for Geriatrics and Gerontology, Center for Gerontology and Social Science, Obu, Japan.
Abbott Nutrition, Research and Development, Singapore.
Nagoya University Graduate School of Medicine, Department of Community Healthcare and Geriatrics, Nagoya, Japan.
Hyogo College of Medicine, Department of Emergency, Disaster and Critical Care Medicine, Nishinomiya, Japan.
National Taipei University of Nursing and Health Sciences, Graduate Institute of Long-Term Care; National Taiwan University Hospital (Bei-Hu), Department of Community and Family Medicine, Taipei, Taiwan.
Geneva Medical University, Honorary in Department of Medicine, Geneva, Switzerland.
Kumamoto Daiichi Hospital, Diabetes and Endocrinology, Kumamoto, Japan.
Jinling Hospital, Research Institute of General Surgery, Jinling, China.


Malnutrition is common in Asia, especially among people who are critically ill and/or older. Study results from China, Japan, and Taiwan show that malnutrition or risk of malnutrition is found in up to 30% of communitydwelling people and as much as 50% of patients admitted to hospitals-with prevalence even higher among those older than 70 years. In Asia, malnutrition takes substantial tolls on health, physical function, and wellbeing of people affected, and it adds huge financial burdens to healthcare systems. Attention to nutrition, including protein intake, can help prevent or delay disease- and age-related disabilities and can speed recovery from illness or surgery. Despite compelling evidence and professional guidelines on appropriate nutrition care in hospital and community settings, patients' malnutrition is often overlooked and under-treated in Asian healthcare, as it is worldwide. Since the problem of malnutrition continues to grow as many Asian populations become increasingly "gray", it is important to take action now. A medical education (feedM.E.) Global Study Group developed a strategy to facilitate best-practice hospital nutrition care: screen-intervene-supervene. As members of a newly formed feedM.E. Northeast Asia Study Group, we endorse this care strategy, guiding clinicians to screen each patient's nutritional status upon hospital admission or at initiation of care, intervene promptly when nutrition care is needed, and supervene or follow-up routinely with adjustment and reinforcement of nutrition care plans, including post-discharge. To encourage best-practice nutrition in Asian patient care settings, our paper includes a simple, stepwise Nutrition Care Pathway (NCP) in multiple languages.

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