Poor assessment and definitions hide true value of medical nutrition, review reveals

By Nikki Cutler contact

- Last updated on GMT

Devonyu | Getty
Devonyu | Getty
Insufficient assessment and poor definitions are blurring our view of the value of medical nutrition for our health and economies, according to a new review of literature in Europe and the US.

'Value of Health'​, the official journal of ISPOR​ (the professional society for health economics and outcomes research), has revealed that medical nutrition terminology is not consistently defined, relevant European and US regulations are infrequently cited, and economic evaluations are infrequently conducted.

Authors of the scoping review argue that adopting standardised medical nutrition terminology is essential to develop reliable and harmonised medical nutrition advice. 

ISPOR’s Nutrition Economics Special Interest Group conducted a scoping review of scientific literature on European and US medical nutrition terminology and regulations to ascertain how medical nutrition terms are defined, relevant regulations are applied, and medical nutrition is economically evaluated in the US and Europe.

In total, 459 records were included in the analysis, of which 308 used medical nutrition terms. The review identified very few medical nutrition definitions, most of which differed from one piece of literature to the next.

The terms most frequently defined were malnutrition (58 records), enteral nutrition (9), undernutrition (7), and parenteral nutrition (5).

Relevant regulations were also infrequently cited; overall, less than 5% of the records referenced any medical nutrition regulation. Finally, just 34 of the 459 records reported some type of economic data, and only 19 contained a full or partial health economic evaluation. 

Author Karen Freijer, PhD, of Maastricht University in The Netherlands, argues the lack of consensus on medical nutrition terminology hampers research and analysis of its impact on health and economies.

“The integral role that food and nutrients play in the aetiology and progression of disease is pushing healthcare decision makers to consider the cost and value of nutrition interventions," ​she says.

“The current lack of consensus on medical nutrition terminology hampers research and analysis of its impact on health and economic outcomes in the management of disease- and condition-related nutrition therapy.

"To sustain value-based decisions within healthcare systems, establishing a common understanding of the terms and definitions surrounding medical nutrition is the critical first step to build the foundation of future nutrition economics research and evaluation of interventions.” 

The two major nutrition societies in Europe (ESPEN) and the United States (ASPEN) have prioritised, and are calling for, continuing constructive discussions to reach a consensus for the benefit of the global nutrition community.

The authors note that the ISPOR Nutrition Economics Special Interest Group fully supports this ongoing initiative and emphasises that adopting standardised medical nutrition terminology is essential to develop reliable and harmonised methodologies. 

Source: Value in Health

Published: January 2019

Medical Nutrition Terminology and Regulations in the United States and Europe—A Scoping Review: Report of the ISPOR Nutrition Economics Special Interest Group​”​ 

Authors: Freijer. K., et al

Related topics: Medical Nutrition, Regulation & Policy

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