The strategy and role of clinical nutrition in chronic disease management

At present, the number of patients with various chronic diseases in China is rapidly increasing and becoming younger, and the treatment compliance rate is low, and the disease control effect is not satisfactory, which undoubtedly increases the economic and mental burden of the people

Low nutritional support rate in actual clinical practice

'Six shifts' needed to be achieved

The clinical nutrition action in the National Nutrition Plan (2017-2030) serves as a general framework and guides, and sorts out four important directions: First, establish nutrition risk screening, nutrition assessment, malnutrition diagnosis, nutrition treatment and efficacy monitoring , an integrated and standardized clinical nutritional support treatment path

These four things are mutually reinforcing and related.

From the survey of 25 domestic centers, it can be seen that the nutritional support rate in actual clinical practice is very low, and the current overall standardized path and support program have not been fully established

Globally, through surveys of many patients with chronic diseases, it is found that the core problem in the management of chronic diseases is diet and nutrition

Therefore, there is still a lot of room for improvement in the weight and status of clinical nutrition in the minds of patients in the management of chronic diseases

Under the new historical conditions, clinical nutrition needs to realize "six transformations": first, from simple chronic disease management to both disease prevention and epidemic prevention and control; second, from special physiological periods such as pregnant women, infants and young children, to The whole life cycle nutrition management transformation; the third is the transformation from specific disease groups, such as the elderly disease group, to the general population; the fourth is the transformation from pure nutrition treatment to the overall lifestyle adjustment; the fifth is the transformation from hospital nutrition management to hospital community family nutrition management The sixth is to transform from the traditional nutrition model to the networked remote nutrition management model

Establish the concept of "big nutrition"

Extend tentacles beyond the hospital

After 20 years of efforts, nutritional support has evolved from simply improving nutritional status to enabling patients to obtain real clinical benefits by improving nutritional status

In order to achieve the goal, it is necessary to use the national strategy of Modern Healthy China, standardize the clinical nutrition diagnosis and treatment process, establish (improve) various clinical nutrition quality control standards, establish the concept of "big nutrition" and a multidisciplinary team nutrition management model, and deepen the tentacles from the hospital.

Specifically, on the one hand, nutritional screening, nutritional assessment-malnutrition diagnosis, nutritional intervention, and monitoring of abnormally complete and standardized pathways need to be established

The tentacles of nutritional support have to be extended beyond the hospital.