Nutritional Therapy along the Continuum of Care

About this Research Topic

Background

At the 2022 ESPEN conference, the International Declaration on the Human Right to Nutritional Care was presented, stating the ethical obligation to ensure optimal nutritional care. Still, in our aging populations, patients often present with a range of chronic conditions that, in combination with poor lifestyle choices and other factors such as polypharmacy, affect their nutritional status. Often hidden behind adipose tissue, their muscle mass is decreased, and intakes of essential nutrients are low, while inflammatory levels are chronically increased.

Consequently, patients often enter the hospital malnourished, they continue to lose muscle mass during the stay, and they fail to recover it after discharge. Decrease in food intake due to factors such as lack of exercise, stress caused by the hospital stay and metabolic changes as a result of their medical condition, surgery, or drugs, further aggravates the micronutrient deficiencies. All of this affects their clinical prognosis and the increase in frailty puts them at risk of further health problems, leading to a vicious cycle of malnutrition, ill health, and frailty.

As such, the aim of this Research Topic is to highlight the effect of nutritional therapies on patients' clinical prognosis and quality of life, as well as the cost for society. Potential solutions to improve nutritional interventions along the continuum of care will be discussed and substantiated with data from clinical trials. Effectiveness of nutritional interventions post-discharge, in institutions and in the community are encouraged, to demonstrate the beneficial effect for patients. Data on cost-effectiveness will also help to highlight the beneficial effect of nutritional interventions (for example, oral nutritional supplements) on healthcare cost. In addition, as the Vienna declaration discusses patient empowerment as a critical factor to ensure improved nutritional care, practical examples of how this can be achieved will also be presented, alongside ethical concerns of failing to incorporate nutritional care into our medical practice.

This Research Topic will therefore serve as a call for action to discuss and address gaps in our understanding of these problems, and for implementation of initiatives to optimize nutritional therapies along the continuum of care. Evidence for programs on nutritional interventions, education, and other relevant initiatives for optimal nutritional care along all stages of the patient’s journey will be presented, including data on the prevalence and consequences of malnutrition in patients. As a multidisciplinary approach is essential, we will bring together experts from different specialties along the continuum of care to present promising approaches in their respective fields, helping to make the Vienna declaration on the human right to nutritional care a reality for patients.

We welcome submissions including but not limited to the following:
• Observational data on the prevalence of malnutrition and its consequences for patient prognosis (e.g., mortality, morbidity, length of stay, readmission, quality of life);
• Original data from nutritional intervention trials with specialized products (e.g., dietary supplements, oral nutritional supplements tube feed, parenteral nutrition), specific foods or fortified foods (or a mix between the different types), on nutritional status, clinical outcomes, and other relevant parameters from hospitals, post-discharge in institutions or the community;
• Health economic data on the impact of malnutrition and/or nutritional interventions on healthcare cost;
• Examples for initiatives on patient empowerment to improve nutritional care, and discussion on their application in clinical practice.

Original research (observational studies and clinical trials), meta-analysis and systematic reviews, and policy and practice reviews are welcomed, as are opinion papers on ethical considerations and the role of the Vienna declaration

Keywords: Malnutrition, Clinical nutrition, Nutritional therapy, Rehabilitation, Pre-habilitation, Frailty

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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