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The underappreciated role of low muscle mass in the management of malnutrition

Deutz, Nicolaas E.P.
Ashurst, Ione
Ballesteros, Maria D.
Bear, Danielle E.
Cruz-Jentoft, Alfonso J.
Landi, Francesco
Laviano, Alessandro
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Published in Journal of the American Medical Directors Association. 2019, vol. 20, no. 1, p. 22-27
Abstract Preserving muscle is not only crucial for maintaining proper physical movement, but also for its many metabolic and homeostatic roles. Lowmusclemass has been shown to adversely affect health outcomes in a variety of disease states (eg, chronic obstructive pulmonary disease, cancer, cardiovascular disease) and leads to an increased risk for readmission andmortality in hospitalized patients. Lowmusclemass is now included in themost recent diagnostic criteria for malnutrition. Currentmanagement strategies for malnutrition may not prioritize the maintenance and restoration of muscle mass. This likely reflects the challenge of identifying and measuring this body composition compartment in clinical practice and the lack of awareness by health care professionals of the importance that muscle plays in patient health outcomes. As such, we provide a reviewof current approaches andmake recommendations formanaging lowmusclemass and preventing muscle loss in clinical practice. Recommendations to assist the clinician in the optimalmanagement of patients at risk of lowmusclemass include the following: (1) placemuscle mass at the core of nutritional assessment andmanagement strategies; (2) identify and assess lowmuscle mass; (3) develop amanagement pathway for patients at risk of lowmusclemass; (4) optimize nutrition to focus on muscle mass gain versus weight gain alone; and (5) promote exercise and/or rehabilitation therapy to help maintain and build muscle mass. The need to raise awareness of the importance of screening andmanaging ‘at risk’ patients so it becomes routine is imperative for change to occur. Health systems need to drive clinicians to treat patients with this focused approach, and the economic benefits
Keywords Muscle functionMuscle massMalnutritionBody compositionNutritional supplement
PMID: 30580819
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Research group Nutrition clinique (597)
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DEUTZ, Nicolaas E.P. et al. The underappreciated role of low muscle mass in the management of malnutrition. In: Journal of the American Medical Directors Association, 2019, vol. 20, n° 1, p. 22-27. doi: 10.1016/j.jamda.2018.11.021 https://archive-ouverte.unige.ch/unige:125923

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Deposited on : 2019-11-12

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