Abstract Muscle ultrasound (mUS) is an emerging and increasingly utilized tool for assessing body composition. Bedside mUS can provide reliable measurements of skeletal muscle and adipose tissue that can strengthen nutrition assessment. As current malnutrition diagnostic frameworks emphasize the evaluation of lean body mass, mUS offers a practical, radiation‐free, serial, and accessible method for quantifying muscle status in real time. This review summarizes the existing literature on mUS‐based body composition assessment, introduces the technical skills needed for high‐quality image acquisition, describes the measurements that may be useful in the assessment of malnutrition, and outlines the need for skills‐based training programs. Key parameters include muscle layer thickness, cross‐sectional area, echo intensity, pennation angle, and fascicle length. Normative reference values and longitudinal changes are reviewed, as each can help clinicians identify low muscle mass and track meaningful changes over time. Despite the advantages of mUS, adoption within routine nutrition practice remains inconsistent. Limited standardization of acquisition protocols and insufficient access to structured, hands‐on operator training continue to hinder reproducibility across clinical settings. Further implementation studies are needed to ensure high‐quality measurements are conducted and incorporated into nutritional assessment.
Nutrition clinicians need to recognize the importance of establishing meaningful connections with their patients and family members. In this manuscript, we discuss skills for making these connections and possibly reducing the risk of nutrition-related ethical dilemmas. American Society for Parenteral and Enteral Nutrition leaders have stressed the importance of clinician-patient connections. Insights from Jonathan Rhoads, who was a developer of parenteral nutrition, indicated that availability and affability are important traits for nutrition clinicians, not just ability. These qualities reflect a patient-centered approach grounded in compassion, empathy, and effective communication. We present two examples of teaching tools designed to develop these skills in nutrition clinicians. (1) A nutrition clinician play performed at the ASPEN Clinical Nutrition Week 2015 that used spoken words and nonverbal communication to demonstrate approaches to connecting with a patient's family members. (2) A module developed for graduate nutrition students in 2025 that uses an artificial intelligence-generated role-play simulation to provide practice engaging in conversations with patients and caregivers involving crucial issues about the use of artificially administered nutrition and hydration.
Abstract Background Malnutrition is prevalent among inpatients with neurological conditions and is associated with adverse outcomes. This study identified determinants of phase angle (PhA) and its association with prolonged length of stay (LOS). Methods This cross‐sectional study enrolled 365 inpatients with neurological conditions. Bioelectrical impedance analysis‐derived PhA was measured at admission. Nutritional status was assessed using Nutritional Risk Screening 2002 (NRS‐2002) and Subjective Global Assessment. PhA was categorized (<6° vs ≥6°) for description and modeled as continuous in regression. Linear regression identified PhA determinants. Logistic regression assessed the association between PhA and prolonged LOS (≥19 days). Receiver operating characteristic analysis compared discrimination of PhA and NRS‐2002. Results The cohort comprised 365 patients (65.2% male; median age, 56.00 years). Median PhA was 4.50°. Independent PhA determinants included age, sex, NRS‐2002 score, serum albumin, lean body mass, and neutrophil‐to‐lymphocyte ratio (adjusted R 2 = 0.440, P < 0.001). PhA below the reference range (<6°) was associated with prolonged LOS ( P = 0.043). After adjusting for age, sex, and disease category, lower PhA was independently associated with prolonged LOS (OR = 0.810 per 1° increase; 95% CI, 0.680–0.966; P = 0.019); however, this association was no longer significant in the fully adjusted model or in the sensitivity analysis using continuous LOS. The NRS‐2002 showed better discrimination for prolonged LOS (AUC = 0.626; P < 0.001). Conclusion Lower PhA was associated with prolonged hospitalization in the partially adjusted model, but not in the fully adjusted model or sensitivity analyses. PhA may complement existing screening approaches such as the NRS‐2002.
Abstract Nutritional management is fundamental in Prader–Willi syndrome (PWS), but longitudinal data from routine pediatric practice are limited. We describe a 3‐year nutritional follow‐up of a boy with PWS complicated by obesity, insulin resistance, dyslipidemia, hyperuricemia, and fatty liver. Management consisted of an energy‐restricted, nutritionally balanced diet, structured meal timing, portion control, family‐based supervision, exercise guidance, and serial monitoring of anthropometry, body composition, metabolic markers, liver enzymes, growth, and pubertal development. Weight and metabolic status improved initially, but weight later showed a U‐shaped trajectory during puberty, likely related to slower growth, delayed pubertal progression, and reduced adherence after school transition. These findings support the need for ongoing, developmentally tailored nutritional monitoring in children with PWS.
