Valid food intake measures of adult patients for use within the GLIM framework: a scoping review.

BACKGROUND: Reduced food intake is one of the etiologic criteria proposed by the Global Leadership Initiative on Malnutrition (GLIM). Various tools for the assessment of food intake exist, however, to diagnose malnutrition, as in GLIM, they should be validated against established reference standards, and quick and easy to complete by various members of the health care team. AIM: This scoping review synthesizes the current evidence related to validated assessment measures of food intake for adult patients in healthcare settings and reports on the application of these measures within the GLIM diagnostic framework. METHODS: A comprehensive search strategy was performed using four bibliographic databases. To be included, studies needed to be conducted on adults in a healthcare setting, have a dietary intake assessment component (i.e. index method) that can be completed by various healthcare staff members, with minimal training and in a short time period, and make comparison of this method to an established dietary assessment reference. Studies needed to report energy and protein intake data and provide appropriate validation statistics. Two reviewers independently reviewed all abstracts and relevant full-text articles, and extracted data. RESULTS: After duplicate removal, 7866 abstracts were screened; 51 articles were eligible for full article review, 13 articles fulfilled the inclusion criteria and one further article was obtained from grey literature, for a total of 14 articles included in the scoping review. Food weighing before and after consumption was used as a reference method by most studies. For index methods, four different measurement tools, with variations, were used. This included visual estimation methods (VEM) using a 1-10-point scale without any pictorials (2 studies); VEM based on plate-model pictures (8 studies); VEM based on plate-models with associated defined nutritional values (4 studies) and digital technology (2 studies). Various levels of accuracy were found, with accuracy increasing when more options are provided and when employing digital technology. Index methods could be completed by participants themselves, nurses, food service workers and dietitians. Adequate training on completion of the tools is associated with improved results. CONCLUSION: Index methods to assess food intake accurately for energy and protein intake can determine inadequate intake as compared to the reference method. Yet, a further step is required to interpret food intake relative to the patient's energy requirement to determine sufficiency of that intake for determination of the GLIM criterion. However, visual estimation methods identified in this review can be used by diverse clinicians with confidence to determine patient food intake.

Duke Scholars

Author Krista Lynn Haines Trauma, Acute, and Critical Care Surgery