Clinical applications of body composition and functional status tools for nutrition assessment of hospitalized adults: A Systematic Review

Luke O. Smith, Joanne F. Olieman, Kirsten A. Berk, Gerdien C. Ligthart-Melis, Carrie P. Earthman*

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

3 Citations (Scopus)


Background: No global consensus exists on diagnostic criteria for malnutrition. Muscular deficits and functional impairments are major components of available malnutrition diagnostic frameworks because these facets of nutrition status significantly impact outcomes. The purpose of this review is to explore which body composition assessment (BCA) and functional status assessment (FSA) tools are being used for nutrition assessment (NA) and monitoring the response to nutrition interventions (RNIs) in adult inpatients. Methods: A literature search of Embase, Medline (Ovid), Web of Science, and Cochrane Central was performed to identify studies that used BCA and/or FSA tools for NA (along with an accepted NA diagnostic framework) and/or for monitoring RNI in adult inpatients. Results: The search yielded 3667 articles; 94 were included in the review. The number of studies using BCA and/or FSA tools for NA was 47 and also 47 for monitoring RNI. Seventy-nine percent of studies used bioimpedance for BCA, and 97% that included FSA utilized handgrip strength. When compared against sets of diagnostic criteria, many of the BCA and FSA tools showed promising associations with nutrition status. Conclusion: Bioimpedance methods are the most widely used bedside BCA tools, and handgrip strength is the most widely used FSA tool; however, these methods are being used with a variety of protocols, algorithms, and interpretation practices in heterogeneous populations. To create a standardized nutrition status assessment process there is a need for validation studies on bedside methods and the development of globally standardized assessment protocols in clinical inpatient settings.

Original languageEnglish
Pages (from-to)11-29
Number of pages19
JournalJournal of Parenteral and Enteral Nutrition
Issue number1
Early online date29 Aug 2022
Publication statusPublished - Jan 2023

Bibliographical note

Funding Information:
The authors wish to thank Wichor Bramer, PhD and Marjolein Udo, MSc from the Erasmus MC Medical Library for developing and updating the search strategies and Elles van der Louw, PhD, RD for her contributions to the design and final review of the manuscript.

Publisher Copyright:
© 2022 American Society for Parenteral and Enteral Nutrition.


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