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Contribution of body composition to nutritional assessment at hospital admission in 995 patients: a controlled population study

Published online by Cambridge University Press:  09 March 2007

Ursula G. Kyle ,
Alfredo Morabia ,
Daniel O. Slosman ,
Nouri Mensi ,
Pierre Unger  and
Claude Pichard
Ursula G. Kyle
Affiliation:
Clinical Nutrition and Diet Therapy, Geneva University Hospital, 1211 Geneva, Switzerland
Alfredo Morabia
Affiliation:
Clinical Epidemiology, Geneva University Hospital, 1211 Geneva, Switzerland
Daniel O. Slosman
Affiliation:
Nuclear Medicine, Geneva University Hospital, 1211 Geneva, Switzerland
Nouri Mensi
Affiliation:
Central Clinical Laboratory, Geneva University Hospital, 1211 Geneva, Switzerland
Pierre Unger
Affiliation:
Emergency Department, Geneva University Hospital,1211 Geneva, Switzerland
Claude Pichard*
Affiliation:
Clinical Nutrition and Diet Therapy, Geneva University Hospital, 1211 Geneva, Switzerland
*
*Corresponding author: Dr Claude Pichard, fax +41 22 372 9363, email pichard@cmu.unige.ch
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Abstract

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Body weight, weight changes and BMI are easily obtainable indicators of nutritional status, but they do not provide information on the amount of fat-free and fat masses. The purpose of the present study was to determine if fat-free mass (FFM) and fat mass were depleted in patients with normal BMI or serum albumin at hospital admission. A group of 995 consecutive patients were evaluated for malnutrition by BMI, serum albumin, and 50 kHz bioelectrical impedance analysis and compared with 995 healthy adults, matched for age and height, and then compared with FFM and fat mass percentiles previously determined in 5225 healthy adults. A BMI of ≤20 kg/m2 was noted in 17·3 % of patients and serum albumin of ≤35 g/l was found in 14·9 % of patients. In contrast, 31 % of all patients were below the tenth percentile for FFM, compared with 10·1 % of controls (χ2, P=0·0001), while 73 % of patients with BMI ≤20 kg/m2 and 31 % of patients with BMI 20–24·9 kg/m2 fell below the tenth percentile for FFM. Furthermore, the FFM was lower in patients than controls and the differences with age in FFM (lower) and fat mass (higher) were greater in patients than in controls. BMI and albumin significantly underestimated the prevalence of malnutrition in patients at hospital admission compared with body composition measurements. Optimal nutritional assessment should therefore include objective measurement of FFM and fat mass.

Keywords

MalnutritionBioelectrical impedance analysisFat-free massFat massAlbumin
Type
Research Article
Information
British Journal of Nutrition , Volume 86 , Issue 6 , December 2001 , pp. 725 - 731
Copyright
Copyright © The Nutrition Society 2001

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