Gastroenterology and hepatology
Malnutrition and refeeding syndrome
Screening and GLIM diagnosis of malnutrition, choosing oral, enteral or parenteral support, and preventing and treating refeeding syndrome under the 2025 AuSPEN consensus and NICE CG32.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Malnutrition affects about a third of Australian medical inpatients and is missed in most of them. It lengthens stay and raises complications, falls, readmission and death.
- Screen everyone on admission with a validated tool (MST, MUST, MNA-SF), then diagnose with GLIM or SGA.
- Feed by the gut where it works: food first, then oral supplements, then tube feeding. Parenteral nutrition is for a gut that can't be used.
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Sources
- The Australasian Society of Parenteral and Enteral Nutrition: consensus statements on refeeding syndromeAU/NZNutrition & Dietetics (Matthews-Rensch et al., 2025;82:128-42), 2025
- GLIM criteria for the diagnosis of malnutrition: a consensus report from the global clinical nutrition communityClinical Nutrition (Cederholm et al.), 2019
- The GLIM consensus approach to diagnosis of malnutrition: a 5-year updateClinical Nutrition (2025;49:11-20), 2025
- Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition (CG32)National Institute for Health and Care Excellence, 2006, updated 2017
- ASPEN consensus recommendations for refeeding syndromeAmerican Society for Parenteral and Enteral Nutrition (da Silva et al., Nutr Clin Pract 2020;35:178-95), 2020
- ESPEN practical guideline: clinical nutrition and hydration in geriatricsEuropean Society for Clinical Nutrition and Metabolism (Clin Nutr 2022;41:958-89), 2022
- ESPEN guidelines on nutritional support for polymorbid internal medicine patientsEuropean Society for Clinical Nutrition and Metabolism (Clin Nutr 2018;37:336-53), 2018
- Individualised nutritional support in medical inpatients at nutritional risk (EFFORT)Lancet (Schuetz et al., 2019;393:2312-21), 2019
- Restricted versus continued standard caloric intake during the management of refeeding syndrome in critically ill adultsAU/NZLancet Respiratory Medicine (Doig et al., 2015;3:943-52), 2015
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy