MiOA: Executive Summary of Recommendations (2023)
Executive Summary of Recommendations
Below are the recommendations and ratings for the Academy of Nutrition and Dietetics Adult Weight Management (AWM) 2022 Evidence-Based Nutrition Practice Guideline. Use the links on the left to view the Guideline Introduction. Detailed recommendations, including the evidence supporting these recommendations, is available from the Guideline Recommendations and Supporting Evidence tab.
Each recommendation was developed from specific systematic review questions. Please download the "Relationship between PICO Questions and Recommendations" table (PDF) for details.
- For a description of the Academy Recommendation Rating scheme (Strong, Fair, Weak, Consensus, Insufficient Evidence), click here.
- For a description of the GRADE Recommendation Rate scheme (Level 1 (1A, 1B, 1C, 1D), Level 2 (2A, 2B, 2C, 2D), click here
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Nutrition Assessment
MiOA: Long-Term Care Mini-Nutritional Assessment
We suggest that registered dietitian nutritionists use the Mini-Nutritional Assessment (MNA) for malnutrition assessment in older adults living in long-term care. The MNA is a valid tool that can identify older adults that are malnourished and may predict mortality.
MiOA: Long-Term Care Subjective Global Assessment and Patient-Generated Subjective Global Assessment
We suggest that registered dietitian nutritionists consider using the Subjective Global Assessment (SGA) or Patient Generated Global Assessment (PGA-SGA) if use of the Mini-Nutritional Assessment (MNA) is not feasible for malnutrition assessment in older adults living in long-term care. The SGA and PG-SGA may be valid tools that can identify older adults with malnutrition, although more evidence is needed.
MiOA: Community Mini-Nutritional Assessment
We suggest that registered dietitian nutritionists use the Mini-Nutritional Assessment (MNA) for malnutrition assessment in older adults living in the community. The MNA is a valid and reliable tool that can identify older adults that are malnourished and may predict mortality.
MiOA: Community Subjective Global Assessment
We suggest that registered dietitian nutritionists consider use of the Subjective Global Assessment (SGA) if the Mini-Nutritional Assessment (MNA) is not feasible for malnutrition assessment in older adults living in the community. The SGA may be a valid and reliable tool that can identify older adults with malnutrition, although more evidence is needed.
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Nutrition Intervention
MiOA: Oral Nutrition Supplements in Long-Term Care
Healthcare practitioners should recommend oral nutrition supplements (ONS) for older adults with malnutrition or at risk for malnutrition living in long-term care. ONS intake 1–2 times per day to meet caloric, and protein deficit is associated with increased calorie and protein intake, weight gain, and improved nutrition status.
MiOA: Oral Nutrition Supplements in the Community
Healthcare practitioners should consider oral nutrition supplements (ONS) as part of an individualized and comprehensive nutrition intervention for older adults with malnutrition or at risk for malnutrition living in the community. ONS intake of 1–2 servings per day is likely to increase calorie and protein intake.
MiOA: Oral Nutrition Supplements when Discharged From Acute Care to the Community
Healthcare practitioners should consider oral nutrition supplements (ONS) as part of an individualized and comprehensive nutrition intervention for older adults with malnutrition or at risk for malnutrition discharged from acute care to the community. ONS intake of 1–2 servings per day is likely to increase calorie and protein intake and improve nutrition status.
MiOA: Dietitian Effectiveness in the Community
Older adults living in the community and considered malnourished or at risk of malnutrition should receive nutrition interventions from a dietitian. Dietitian interventions are associated with weight maintenance or desired gain, and improved calorie and protein intake.
MiOA: Dietitian Effectiveness Post-Discharge
Older adults discharged from acute care to the community and considered malnourished or at risk for malnutrition should receive nutrition interventions from a dietitian. Dietitian interventions are associated with increased calorie and protein intake, weight maintenance or desired gain, and improved nutrition status.
MiOA: Food Fortification in Long-Term Care
Healthcare practitioners may consider food fortification as part of a comprehensive nutrition intervention for older adults with malnutrition or at risk of malnutrition living in long-term care. Food fortification is commonly used and is a feasible nutrition intervention to improve calorie and protein intake.
MiOA: Food Fortification in the Community
Healthcare practitioners may consider food fortification as part of a comprehensive nutrition intervention for older adults with malnutrition or at risk of malnutrition living in the community. Food fortification is commonly used and is a feasible nutrition intervention to improve calorie and protein intake.
MiOA: Home Delivered Meals and Congregate Meals
Older adults living in the community, especially those considered malnourished or at risk for malnutrition, should be referred to home-delivered and congregate meal services to improve calorie and protein intake and reduce incidence and risk of malnutrition.
