Disease associated malnutrition in pediatrics - what is new?

Koen F Joosten, Koen Huysentruyt, Jessie M Hulst, Konstantinos Gerasimidis

Journal: Current opinion in clinical nutrition and metabolic care 2025;28(3):289-296

PMID: 39964737

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Abstract

PURPOSE OF REVIEW

Disease associated malnutrition (DAM) remains an important concern in the care of hospitalized children and children with a chronic disease. This review focused on pediatric literature published since 2023 on the prevalence, assessment and treatment of DAM in different settings.

RECENT FINDINGS

The prevalence of DAM depends on a variety of factors. Studies focused on the relationship between different assessment methods of DAM and sarcopenia in hospitalized children and children with an underlying disease and clinical outcomes. Several papers focused on exploring the interplay between nutritional management and the evolving metabolic phases of critically ill children. Some studies explored feeding intolerance and barriers to administering enteral nutrition, micronutrient assessment and whether continuous versus intermittent feeding was superior in pediatric intensive care.

SUMMARY

In hospitalized children and chronically ill children, nutritional assessment and assessment of frailty and/or sarcopenia is best done using a comprehensive approach integrating anthropometrics, nutrition focused history and physical examination. Adequate nutritional support for critically ill children is challenging and needs to be tailored to the specific phases of critical illness. Intermittent feeding may offer potential advantages in inducing ketosis and circadian rhythm alignment but requires careful management to prevent nutritional deficits.

Address: Department of Pediatric Gastroenterology, UZ Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium.; Department of Pediatrics, Division of Gastroenterology, Hepatology & Nutrition, The Hospital for Sick Children, Toronto, Canada.; Department of Pediatrics & Nutritional Sciences, University of Toronto, Toronto, Canada.; Human Nutrition, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.; Division of Pediatric Intensive Care, Department of Neonatal and Pediatric Intensive Care, Erasmus MC, Sophia Children's Hospital, Rotterdam, The Netherlands.

DOI: 10.1097/MCO.0000000000001115

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MeSH Terms: Humans, Child, Malnutrition, Nutrition Assessment, Critical Illness, Sarcopenia, Nutritional Support, Child Nutrition Disorders, Child, Preschool, Prevalence, Nutritional Status, Chronic Disease, Child, Hospitalized