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Publications

Journal Article Ahead of print

PubMed: 41734418 DOI: 10.1016/j.clnu.2026.106595

Phenotype profiling of disease-related malnutrition with inflammation: Document elaborated by the ESPEN special interest group (SIG) ''cachexia-anorexia in chronic wasting diseases''.

Clin Nutr 59:106595

Authors: Alessio Molfino, Giovanni Imbimbo, Elisabet Rothenberg, Ingvar Bosaeus, Harriët Jager-Wittenaar, Stéphane Schneider, Gianni Biolo, Tommy Cederholm, Jann Arends, Maurizio Muscaritoli

Affiliations

  • Department of Translational and Precision Medicine, Sapienza University of Rome, Italy; Department of Interdisciplinary Studies on WellBeing, Health and Environmental Sustainability (BeSSA), Sapienza University of Rome, Italy.
  • Department of Translational and Precision Medicine, Sapienza University of Rome, Italy.
  • Department of Nursing and Integrated Health Sciences, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden.
  • University of Gothenburg, Gothenburg, Sweden.
  • Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands; Department of Gastroenterology and Hepatology, Dietetics, Radboud University Medical Center, Nijmegen, the Netherlands; Research Unit Experimental Anatomy, Faculty of Physical Education and Physiotherapy, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium.
  • Gastroenterology and Nutrition, Nice University Hospital, Université Côte d'Azur, Nice, France.
  • Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
  • Department of Public Health and Caring Sciences, Uppsala University, Sweden.
  • Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.
  • Department of Translational and Precision Medicine, Sapienza University of Rome, Italy.

Abstract

In the ESPEN SIG meetings the similarities and differences between cachexia and disease-related malnutrition (DRM) were previously analyzed, as well as the role of inflammation in DRM. In the years 2023-2025, the SIG moving forward emphasized the relevance of the evolution of the cachexia definition and the advantage of considering DRM with chronic inflammation and cachexia as synonyms. We focused on the evidence regarding: i) the impact of DRM phenotypes and grade of inflammation on the efficacy of nutritional treatments, ii) the distinction between cachexia and end-of-life conditions, and iii) the identification of the barriers, facilitators and solutions for the implementation of the DRM definition among experts and non-experts in the field of nutrition. We underlined the importance of phenotyping those patients with DRM with inflammation to identify the most appropriate nutritional and metabolic interventions. Based on the role of inflammation in chronic and acute diseases, we discussed the impact of inflammation on the effectiveness of nutritional interventions. We discussed the differences between DRM with inflammation/cachexia and "end-of-life" conditions and the limited evidence on the efficacy of nutritional therapies in a palliative setting. Finally, the SIG discussed the barriers to the implementation of the concept of DRM, and suggested solutions. We emphasize the need for primary care training programs, to identify and address DRM early, and advocate for evidence-based interdisciplinary treatment strategies. The SIG recommends to enhance primary care nutritional and dietetic services, to support general practitioners and improve patient care through increased healthcare system engagement in clinical nutrition.

MeSH

Anorexia, Malnutrition, Wasting Syndrome, Phenotype, Solutions, Therapeutics, Enteral Nutrition, Cachexia