Malnutrition in Clinical Settings: Research Gaps and Opportunities

Day 1: September 12, 12:00‒5:00 p.m. EDT
Adults

11:30 a.m.

Doors Open

Workshop Introduction and Overview
Christopher Lynch, PhD, Office of Nutrition Research, NIH

12:00‒12:20 p.m.

Opening Remarks and Welcome Day 1

12:20‒12:40 p.m.

Overview of Malnutrition Outside of the Hospital and Community Issues
Nancy E. Roman, Partnership for a Healthier America

12:40‒1:00 p.m.

Overview in the Medical Setting (Illness-related Malnutrition)
Gordon L. Jensen, MD, PhD, University of Vermont

Session 1: The Cost of Malnutrition in Clinical Settings
Rationale: Scope of the Problem and the Cost of Not Addressing the Problem

1:00‒1:10 p.m.

Overview of the AHRQ Report
Marion F. Winkler, PhD, RD, LDN, CNSC, Brown Medical School

1:10‒1:20 p.m.

Value Project
Peggi Guenter, PhD, RN, FAAN, FASPEN, American Society for Parenteral and Enteral Nutrition

1:20‒1:30 p.m.

Malnutrition as a Quality Measure: Health Disparities and Findings of a Quality Study 4 U.S. Hospitals
Kristi Mitchell, MPH, Health Equity Outcomes

1:30‒1:40 p.m.

Economics of Nutrition in Healthcare
Kirk W. Kerr, PhD, Abbott

1:40‒2:00 p.m.

Q&A
Moderator: Kelly Tappenden, PhD, University of Illinois Chicago

2:00‒2:15 p.m.

Break

Improving Assessment to Nutrition Care

2:15‒2:25 p.m.

Optimal Number of Registered Dietitians (RD) Needed to Address Nutrition-related Issues
Rosa K. Hand, PhD, RDN, LD, FAND, Case Western Reserve University

2:25‒2:35 p.m.

Inpatient Payment Issues
Marsha Schofield, MS, RD, LD, FAND, Consultant

2:35‒2:45 p.m.

Malnutrition Diagnosis During Adult Inpatient Hospitalizations
Kenneth G. Nepple, MD, FACS, University of Iowa

2:45‒2:55 p.m.

Outpatient Reimbursement Issues
Francisco Loya, MD, Harlingen Medical Center and Valley Baptist Medical Center-Harlingen

2:55‒3:05 p.m.

Lifestyle Medicine Reimbursement
Meagan Grega, MD, FACLM, DipABLM, Kellyn Foundation

3:05‒3:25 p.m.

Q&A
Moderator: Kelly Tappenden, PhD, University of Illinois Chicago

3:25‒3:40 p.m.

Break

Session 2: Moving Beyond the Terminology of "Malnutrition"
Malnutrition in Clinical Disease: Moving Towards Developing a Unified Definition of Malnutrition

3:40‒3:50 p.m.

Diagnosing Malnutrition in Adults: Today and Into the Future
Charlene W. Compher, PhD, RD, LDN, FASPEN, Hospital of the University of Pennsylvania

3:50‒4:00 p.m.

Addressing Food Insecurity among Overlooked Population Groups
David S. Seres, MD, ScM, PNS, FASPEN, Columbia University Irving Medical Center

4:00‒4:10 p.m.

Does a Malnutrition Diagnosis Predict Who Will Benefit from Nutrition Support?
Professor Phillip Schuetz, Kantonsspital Aarau and University of Basel, Switzerland

4:10‒4:20 p.m.

Causes, Consequences and Treatment of Micronutrient Deficiencies
Patrick Stover, PhD, Texas A&M University

4:20‒4:30 p.m.

Nutritionally Vulnerable and Hidden Hunger
Katherine Tucker, PhD, University of Massachusetts Lowell

4:30‒4:50 p.m.

Q&A
Moderator: David S. Seres, MD, ScM, PNS, FASPEN, Columbia University Irving Medical Center

4:50‒5:00 p.m.

Adjourn Day 1

Day 2: September 13, 12:00‒5:00 p.m. EDT
Adults

12:00‒12:10 p.m.

Welcome Day 2 and Day 1 Recap

Session 2: Moving Beyond the Terminology of "Malnutrition" (continued)
Defining Refractory Malnutrition: Confounders

12:10‒12:20 p.m.

Aging in Clinical Settings
Rose Ann DiMaria-Ghalili, PhD, RN, FASPEN, FAAN, FGSA, Drexel University

12:20‒12:30 p.m.

Body Composition and Nutritional Status
Carrie P. Earthman, PhD, RDN, University of Delaware

12:30‒12:40 p.m.

Renal Cachexia
Professor Joanne Reid, Queen's University Belfast

12:40‒12:50 p.m.

Cancer Cachexia: Oncology/ASCO Guidelines
Mary Platek, PhD, MS, Roswell Park Comprehensive Cancer Center

12:50‒1:10 p.m.

Q&A
Moderator: David S. Seres, MD, ScM, PNS, FASPEN, Columbia University Irving Medical Center

1:10‒1:25 p.m.

Break

Session 3: Measuring Malnutrition: Methods and Tools
Strengths and Caveats of Current Biomarkers and Tools

1:25‒1:35 p.m.

Strengths and Weaknesses of Current Visceral Protein Biomarkers and Biomarkers of Nutritional/Metabolic State
David Evans, MD, Ohio State College of Medicine

1:35‒1:45 p.m.

Physical and Composite Measurements
Alison Steiber, PhD, RD, Academy of Nutrition and Dietetics

Emerging Biomarkers and Tools

1:45‒1:55 p.m.

Deuterium-creatinine Dilution Method for Muscle Composition
Williams Evans, PhD, University of California, Berkeley

1:55‒2:05 p.m.

Nutritional Metabolomics: Potential Utility in Nutrition and Metabolic Support
Thomas Ziegler, MD, MS, Emory University

2:05‒2:15 p.m.

Metabolomics (plasma, urine) to Identify Malnutrition in Critical Illness
Kenneth B. Christopher, MD, MS, Harvard Medical School

2:15‒2:25 p.m.

Breath Analysis of Volatile Organic Compounds to Identify Malnutrition in Clinical Settings
Raed Dweik, MD, MBA, Cleveland Clinic

2:25‒2:35 p.m.

Microbiome and Malnutrition in Critical Illness
John Alverdy, MD, The University of Chicago

2:35‒3:05 p.m.

Q&A
Moderator: Gail A.M. Cresci, PhD, RD, LD, Cleveland Clinic

3:05‒3:20 p.m.

Break

Session 4: Implementations Challenges and Case Examples: Addressing Malnutrition and Reducing Health Disparities

3:20‒3:30 p.m.

Supply Chain Shortages
Jay Mirtallo, MS, RPH, BCNSP, FASHP, FASPEN, The Ohio State University  

3:30‒3:40 p.m.

Dual Burden of Overweight/Obesity and Malnutrition
Jeffrey Mechanick, MD, Mount Sinai 

3:40‒3:50 p.m.

Malabsorptive and Small Bowel Disorders: The Increased Burden of Malnutrition in GI Patients
Carolyn Newberry, MD, PNS, Weill Cornell Medicine

3:50‒4:00 p.m.

ICU Nutrition: Moving Beyond Support
Jayshil Patel, MD, Medical College of Wisconsin

4:00‒4:10 p.m.

Dementia and Enteral Feeding Needs
David S. Seres, MD, ScM, PNS, FASPEN, Columbia University Irving Medical Center

4:10‒4:20 p.m.

Nutrition and Lifestyle Medicine Services in the Nation's Largest Public Health Care System
Michelle McMacken, MD, FACP, DipABLM, NYC Health + Hospitals, NYU Grossman School of Medicine

4:20‒4:50 p.m. 

Q&A
Moderator: Alison Steiber, PhD, RD, Academy of Nutrition and Dietetics

4:50‒5:00 p.m.

Adjourn Day 2

Day 3: September 14, 12:00‒5:00 p.m. EDT
Adults

12:00‒12:10 p.m.

Welcome Day 3 and Day 2 Recap

Session 5: Training the Next Generation of Researchers: Diversity, Equity, Inclusion, and Accessibility

12:10‒12:20 p.m.

Nutrition in the Curricula of Residencies and Medical Schools
David S. Seres, MD, ScM, PNS, FASPEN, Columbia University Irving Medical Center

12:20‒12:30 p.m.

Global Perspectives on Training Clinicians
Professor Sumantra (Shumone) Ray, NNEdPro Global Centre for Nutrition & Health

12:30‒12:40 p.m.

Program to Advance the Career Development of Scientists from Diverse Backgrounds Conducting Nutrition, Obesity, Diabetes, and Related Research and Other NIH Programs
Mary Evans, PhD, National Institute of Diabetes and Digestive and Kidney Diseases, NIH

12:40‒1:00 p.m.

Barriers and Potential Solutions to Dietetics Education among Students of Diverse Backgrounds
Francoise Kazimierczuk, PhD, RD, LD, ATC, CSCS2, University of Cincinnati
Rayane Abu Sabha, PhD, RFD, Accreditation Council for Education in Nutrition and Dietetics

1:00‒2:00 p.m.

Q&A and Panel Discussion
Moderator: Charlotte Pratt, PhD, National Heart, Lung, and Blood Institute, NIH
Panelists:
Jessica D. Torro, MS, RDN, Metropolitan State University of Denver
Sharon A. Cox, MA, RDN, LDN, FAND, Tecker International Consulting
April J. Stull, PhD, RDN, FAND, Baylor University and National Organization of Blacks in Dietetics and Nutrition (NOBIDAN)
Yvonne T. Maddox, PhD, TAThorton Foundation

2:00‒3:00 p.m.

Visit the Poster Hall for Poster Session: Adults Track 1

Session 6: Moonshot Studies

3:00‒4:00 p.m.

Discussion and Breakout Sessions
Moderators:
Todd Rice, MD, Vanderbilt University Medical Center
David S. Seres, MD, ScM, PNS, FASPEN, Columbia University Irving Medical Center

4:00‒4:30 p.m.

Adult Sessions Closing and Adjourn Day 3

Day 4: September 19, 12:00‒5:00 p.m. EDT
Early Life

12:00‒12:10 p.m.

Welcome Day 4
Ashley Vargas, PhD, MPH, RDN, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH
Alison Cernich, Ph.D., Deputy Director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development
Nilesh Mehta, MD, Boston Children’s Hospital and Harvard Medical School

Session 7: Early Life Malnutrition Introduction: Definition, Burden, Epidemiology, and Screening

12:10‒12:20 p.m.

Defining Pediatric Malnutrition: New Concepts and Metrics
Mark R. Corkins, MD, The University of Tennessee Health Science Center

12:20‒12:30 p.m.

Approaches to Screening, Assessing, and Diagnosing Pediatric Malnutrition
Patricia J. Becker, MS, RDN, CSP, CNSC, Dayton Children's Hospital

12:30‒12:40 p.m.

Application of a Tool for Diagnosing Pediatric Malnutrition in U.S. Hospitals
Elizabeth Jimenez, PhD, RDN, LD, University of New Mexico Health Sciences Center

12:40‒12:50 p.m.

Preterm Infants and the Bigger Causal Picture
Tanis Fenton, PhD, University of Calgary

12:50‒1:10 p.m.

Q&A and Discussion of Lessons from Adult Malnutrition
Moderators:
Nilesh Mehta, MD, Boston Children’s Hospital and Harvard Medical School and Todd Rice, MD, Vanderbilt University Medical Center

1:10‒1:25 p.m.

Break

Session 8:  Early Life Malnutrition Research Considerations, Part 1
Unique Challenges in Early Life Research on Malnutrition

1:25‒1:35 p.m.

Opportunities to Address Challenges of Conducting Dietary Assessment during Infancy
Marie Kainoa Fialkowski Revilla PhD, RD, LDN, University of Hawaii

1:35‒1:45 p.m.

Prolonged Hospitalization Early in Life Complicates Research on Malnutrition
Barbara Medoff-Cooper, PhD, RN, FAAN, University of Pennsylvania

Complexities of Children being Dependent on Food Systems and Caregivers in Research on Malnutrition
Maureen M. Black, PhD, University of Maryland School of Medicine

A Summary of the Evidence on Malnutrition in Early Life

1:55‒2:05 p.m.

Systematic Review Summaries for Pediatric Malnutrition related to ASPEN Guidelines
Sharon Y. Irving, PhD, CRNP, FCCM, FAAN, FASPEN, University of Pennsylvania

2:05‒2:15 p.m.

Systematic Review Summaries for Pediatric Malnutrition related to the Academy Guidelines
Lisa Moloney, MS, RDN, Academy of Nutrition and Dietetics

2:15‒2:35 p.m.

Q&A
Moderator: Gail A.M. Cresci, PhD, RD, LD, Cleveland Clinic

2:35‒2:50 p.m.

Break

Disease/Condition-specific Malnutrition

2:50‒3:00 p.m.

Changes in Metabolism: DMI
Tamara S. Hannon, MD, Indiana University School of Medicine

3:00‒3:10 p.m.

Changes in Metabolism: Inborn-errors and other Metabolic Disorders
TBD

3:10‒3:20 p.m.

Changes in Metabolism: Obesity
Edmond Wickham, MD, MPH, Virginia Commonwealth University School of Medicine

3:20‒3:30 p.m.

Inability to Meet Nutrient Needs: Anorexia Nervosa
Andrea Garber, PhD, RD, University of California, San Francisco

3:30‒3:40 p.m.

Inability to Meet Nutrient Needs: Cancer
Elena J. Ladas, PhD, RD, Columbia University Irving Medical Center

3:40‒3:50 p.m.

Inability to Meet Nutrient Needs: Critical Care
Lori Bechard, PhD, RDN, Boston Children's Hospital

3:50‒4:00 p.m.

Malabsorption: IBD
David L. Suskind, MD, Seattle Children's Hospital

4:00‒4:10 p.m.

Malabsorption: IBS
Bruno Pedro Chumpitazi, MD, MPH, Texas Children's Hospital

4:10‒4:20 p.m.

Malabsorption: SBS
Alexandra Carey, MD, Boston Children's Hospital

4:20‒4:30 p.m.

Immune Related: NEC
Jalal Abu-Shaweesh, MD, Cleveland Clinic

Q&A
Moderator: Gail A.M. Cresci, PhD, RD, LD, Cleveland Clinic

Adjourn Day 4

Day 5: September 20, 12:00‒5:00 p.m. EDT
Early Life

12:00‒12:10 p.m.

Welcome Day 5 and Day 4 Recap
Nilesh Mehta, MD, Boston Children’s Hospital and Harvard Medical School

Session 9: Early Life Malnutrition Research Conderations, Part 2
Update on Malnutrition-related Measures in Pediatrics

12:10‒12:20 p.m.

Update on Body Composition Assessment in Children
Stephanie Merlino, MS, RD, LD, MetroHealth

12:20‒12:30 p.m.

Energy Needs/Expenditure
Leanne M Redman, MS, PhD, Pennington Biomedical Research Center

12:30‒12:40 p.m.

Short vs. Long Term Outcomes/PRO
Vijay Srinivasan, MD, Children's Hospital of Philadelphia

12:40‒12:50 p.m.

Pediatric Malnutrition Outcomes: Muscle Mass, Growth (stunting), Functional, Developmental (neuro and other), Quality of Life
TBD

Disparities, Family and System-level Determinants of Early Life Malnutrition Risk, Access, and Treatment

12:50‒1:00 p.m.

Health Disparities, SDOH, and Malnutrition
TBD

1:00‒1:10 p.m.

Combined Role of Medical, Developmental/Behavioral, and Social Dimensions on Clinical Malnutrition Care for Children in the U.S.
Deborah A. Frank, MD, Boston University

1:10‒1:20 p.m.

Research Considerations in Indigenous Children with Food Insecurity and Malnutrition
TBD

1:20‒1:30 p.m.

Research Considerations in Pregnancy/Lactation/Infant Feeding Dyads
Laurie Nommsen-Rivers, PhD, RD, IBCLC, University of Cincinnati

1:30-‒2:00 p.m.

Q&A
Moderator: Nilesh Mehta, MD, Boston Children’s Hospital and Harvard Medical School

2:00‒2:15 p.m.

Break

Session 10:  Early Life Malnutrition: Moving Towards a Unified Approach

2:15‒2:25 p.m.

Documenting Nutrition in the Electronic Health Records (EHR)
Robert Grundmeier, MD, Children's Hospital of Philadelphia

2:25‒2:35 p.m.

Research Needed to Support Better Pediatric Malnutrition Guidelines and Access
Liam McKeever PhD, RDN, The American Society for Parenteral and Enteral Nutrition

2:35‒3:05 p.m.

Q&A and Study Design Considerations Panel Discussion
Moderator:: Alison Steiber, PhD RD, Academy of Nutrition and Dietetics

Panelists:
Shelley Kirk, PhD, RD, LD, Cincinnati Children's Hospital Medical Center
Julie Ann Patterson, PhD, MBA, RDN, LDN, Northern Illinois University
TBD

3:05‒4:05 p.m.

Visit the Poster Hall for Poster Session: Early Life Track 2

Session 11:  Early Life Malnutrition Conclusions

4:05‒4:35 p.m.

Discussion
Moderators:
Todd Rice, MD, Vanderbilt University Medical Center
David S. Seres, MD, ScM, PNS, FASPEN, Columbia University Irving Medical Center

Panelists:
Chris Duggan, MD, MPH, Boston Children’s Hospital
TBD

4:35‒5:00 p.m.

Early Life Sessions/Workshop cosing and Adjourn Day 5