Nutrition Screening Pediatrics

Nutrition Screening Pediatrics

Welcome to the Nutrition Screening Pediatrics Systematic Review 
In the pediatric population, optimal nutritional status is crucial to ensure appropriate growth and development. Nutrition screening exists as an important precursor to dietitian notification that a nutrition problem may exist, thus sending a patient into the first step of the Nutrition Care Process. Use of valid and reliable nutrition screening tools that are appropriate for age and practice setting are important components of the screening process.

The scope of this project was to determine the validity and reliability of 14 pediatric nutrition screening tools to identify risk of malnutrition related to under- or over-nutrition and to determine if results varied according to users of the tools. Validity and reliability of mid-arm muscle circumference (MUAC) as a single screening indicator to detect risk of undernutrition in developed countries was also examined. Finally, the association between food insecurity and under- or over-nutrition was explored in order to determine if this factor should be considered during nutrition screening.

Key Findings
  • The most frequently examined tools were:  Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP), Screening Tool for Risk on Nutritional status and Growth (STRONGkids) (13 studies each) and Paediatric Yorkhill Malnutrition Score (PYMS) (9 studies).
  • The workgroup concluded that tools with moderate to high validity and reliability that were based on Grade I (Strong) or Grade II (Fair) evidence were: STAMP, STRONGkids and PYMS in the inpatient setting, and the Nutrition Screening Tool for Cystic Fibrosis (NRST for CF) in the specialty/outpatient setting. No tools met these criteria in the community setting.
  • Differences in validity and reliability among different users of the tools were found, but the relevance of these findings is unclear. Grade II evidence.
  • MUAC demonstrated a low degree of validity and high reliability, based on Grade III (Limited) evidence.
  • The preponderance of evidence suggested no association between food insecurity status and underweight or overweight/obesity in the pediatric population in the US, though evidence was mixed with some suggestion of increased overweight/obesity with food insecurity compared to food security. Grade II evidence.
Use the links on the left to view tool components and descriptions; validity and reliability criteria, definitions; and the evidence analysis. Expand the section below titled Project Team and Disclosures for a listing of individuals who contributed to the development of the systematic review, disclosures and project funding information.

  • Project Team and Disclosures (2018)
    The following individuals contributed their valuable time and expertise to this project:

    Workgroup Members
    • Patricia J. Becker, MS, CSP, CNSC, RDN, Chair
      Pediatric Dietitian, Dayton Children’s Hospital, Cincinnati, OH, USA
    • Sarah G. Bellini, PhD, CD, RDN
      Assistant Professor, Brigham Young University, Provo, UT, USA
    • Mark R. Corkins, MD, CNSC
      Professor of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, USA
    • Bonnie A. Spear, PhD, MS, RDN, FAND
      Professor Pediatrics Emeritus, University of Alabama at Birmingham, Birmingham, AL, USA
    • Elizabeth Spoede, MS, CSP, RD, LD
      Clinical Nutrition Specialist & Pediatric Dietitian, Texas Children’s Hospital, Houston, TX, USA
    • Molly R. Wong Vega, MS, RDN, CSP, CSSD, LD
      Senior Dietitian, Texas Children’s Hospital; Memorial Hermann IRONMAN Sports Medicine Institute, Houston, TX, USA
    Project Leaders
    • Tami A. Piemonte, MS, RDN, LDN, Project Manager
      Independent Contractor, St. Petersburg, FL, USA
    • Mary Katherine Hoy, EdD, RD, Lead Analyst
      Nutritionists, ARS-USDA, Beltsville, MD, USA
    • Mary Rozga, PhD, RD, Academy Staff  
      Nutrition Researcher, Academy of Nutrition and Dietetics, Chicago, IL, USA
    • Deepa Handu, PhD, RN, Methodologist
      Senior Scientist, Academy of Nutrition and Dietetics, Chicago, IL, USA
    Evidence Analysts
    • Lisa A. Davis, MS, RD
      Dietitian/Nutritionist, University of Wisconsin Hospital & Clinics, Madison, WI, USA
    • Sharon Foley, PhD, RDN
      Assistant Professor, Rush University, Chicago, IL, USA
    • Namibia Lebron-Torres, MS
      MPH Candidate, Tufts University School of Medicine, Boston, MA, USA
    • Christiane L.  Meireles, PhD, RDN, LD
      Clinical Assistant Professor, University of Texas Health San Antonio, San Antonio, TX, USA
    • Keiy C. Murofushi, MS, RDN
      Executive Director, Cedars Sinai Medical Center, Beverly Hills, CA, USA
    • Jessica Soldavini, MPH, RD, LDN
      Graduate Research Assistant, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
    • Amy Yahiro, RD, LDN
      Clinical Dietitian, Edward Hines Jr. Veterans Affairs Hospital, Chicago, IL, USA
    Financial Contributors
    • Commission on Dietetic Registration
    • Academy of Nutrition and Dietetics

    Disclosures of Potential Conflicts of Interest: In the interest of full disclosure, the Academy has adopted the policy of revealing relationships workgroup members have with companies that sell products or services that are relevant to this topic. Workgroup members are required to disclose potential conflicts of interest by completing the Academy Conflict of Interest Form. It should not be assumed that these financial interests will have an adverse impact on the content, but they are noted here to fully inform readers.
    • Patricia Becker: Provided consultant services to The Cincinnati Children’s Home; received compensation from Abbott Nutrition for speaking services
    • Bonnie Spear: Received grant funding from Bureau of Maternal and Child Health