Review Article
Volume 8 Issue 7 - 2021
A Comprehensive and Practical Guide to Clinical Nutrition in Medical Practice
Nicholas A Kerna1,2*, Hilary M Holets3,4, Abdullah Hafid5, John V Flores3,4, ND Victor Carsrud6, Uzoamaka Nwokorie7, Sahalia Rashid8, Joseph Anderson II9 and Shain Waugh10
1SMC–Medical Research, Thailand
2First InterHealth Group, Thailand
3Beverly Hills Wellness Surgical Institute, USA
4Orange Partners Surgicenter, USA
5Academy of Integrative Health & Medicine (AIHM), USA
6Lakeline Wellness Center, USA
7University of Washington, USA
8All Saints University School of Medicine, Dominica
9International Institute of Original Medicine, USA
10Fettle Path, USA
*Corresponding Author: Nicholas A Kerna, (mailing address) POB47 Phatphong, Suriwongse Road, Bangkok, Thailand 10500.
Received: May 26, 2021; Published: June 30, 2021


Clinical nutrition is a medical discipline defined as the study of food nutrients and their application in healthcare for managing diseases, affecting the absorption and metabolism of nutrients. Any nutritional measure, preventive or curative, targeting individual patients, is considered is clinical nutrition. Clinical nutrition plays a vital role in both health and chronic disease management. Registered dieticians or nutritionists aid in restoring optimal maintaining patient health. Based on the nature and duration of therapy, medical treatment could be exhaustive to patients. Hence, optimal nutrition management is essential to support the patient’s overall health and minimize medical care complications. The main goal of nutrition therapy is to foster faster patient recovery, minimize complications of medical care, and improve clinical outcomes.

For several decades, dietary nutrition has been presumed to have an association with chronic diseases. Through experimental and clinical studies, it has been demonstrated that appropriate nutritional intervention and management results in enhanced outcomes with accelerated recovery in patients with chronic diseases compared to standard pharmaceutical treatment alone. This review explains the origin and development of nutrition science, and highlights the importance of nutritional intervention in clinical practice.

Keywords: Dietary Foods; Functional Foods; Malnutrition; Nutraceuticals; Nutritional Therapy; Refeeding Syndrome


  1. WHO Report of a Joint WHO/FAO Expert Consultation on Diet Nutrition and the Prevention of Chronic Diseases (2003).
  2. Carpenter KJ. “A short history of nutritional science: part 3 (1912-1944)”. Journal of Nutrition 133 (2003): 3023-3032.
  3. Carpenter KJ. “A short history of nutritional science: part 4 (1945-1985)”. Journal of Nutrition 133 (2003): 3331-3342.
  4. Mozaffarian D., et al. “History of modern nutrition science-implications for current research, dietary guidelines, and food policy”. BMJ 361 (2018): k2392.
  5. National Research Council Food and Nutrition Board. Toward healthful diets. National Academy of Sciences (1980).
  6. Backstrand JR. “The history and future of food fortification in the United States: a public health perspective”. Nutrition Reviews 60 (2002): 15-26.
  7. Bishai D and Nalubola R. “The history of food fortification in the United States: Its relevance for current fortification efforts in developing countries”. Economic Development and Cultural Change 51 (2002): 37-53.
  8. Fletcher RJ., et al. “Public health aspects of food fortification: a question of balance”. Proceedings of the Nutrition Society 63 (2004): 605-614.
  9. Van Den Wijngaart A., et al. “Regulatory monitoring systems of fortified salt and wheat flour in selected ASEAN countries”. Food and Nutrition Bulletin 34 (2013): S102-111.
  10. Tanumihardjo SA., et al. “Poverty, Obesity, and Malnutrition: An International Perspective Recognizing the Paradox”. Journal of the American Dietetic Association 107 (2007): 1966-1972.
  11. Briggs AD., et al. “Overall and income specific effect on prevalence of overweight and obesity of 20% sugar sweetened drink tax in UK: Econometric and comparative risk assessment modelling study”. BMJ 347 (2013): f6189.
  12. Kearns CE., et al. “Sugar industry and coronary heart disease research: a historical analysis of internal industry documents”. JAMA Internal Medicine 176 (2016): 1680-1685.
  13. Mozaffarian D., et al. “Role of government policy in nutrition-barriers and opportunities for healthier eating”. BMJ 361 (2018): k2426.
  14. Ippolito PM. “How government policies shape the food and nutrition information environment”. Food Policy 24 (1999): 295-306.
  15. Boutayeb A. “The double burden of communicable and non-communicable diseases in developing countries”. Transactions of the Royal Society of Tropical Medicine and Hygiene 100 (2006): 191-199.
  16. The double burden of malnutrition: policy brief (2017).
  17. USDA Dietary Guidelines for Americans (2015).
  18. Whatley Blum JE., et al. “Implementation of low-fat, low-sugar, and portion-controlled nutrition guidelines in competitive food venues of Maine public high schools”. Journal of School Health 77 (2007): 687-693.
  19. Brown IJ., et al. “Salt intakes around the world: Implications for public health”. International Journal of Epidemiology 38 (2009): 791-813.
  20. Sommer A and West KPJ. “Vitamin A deficiency: health, survival, and vision. Oxford University Press (1996).
  21. National Health and Medical Research Council Australian Dietary Guidelines (2013).
  22. World Health Organization, Food and Agricultural Organization. Diet, nutrition and the prevention of chronic diseases: Report of a joint WHO/FAO expert consultation (report 916). World Health Organization (2003).
  23. WHO Report of a Joint WHO/FAO Expert Consultation on Diet Nutrition and the Prevention of Chronic Diseases (2003).;jsessionid=06096C9A1400CFEB9F83869568E722FD?sequence=1
  24. Thomson CA and Ravia J. “A systematic review of behavioral interventions to promote intake of fruit and vegetables”. Journal of the American Dietetic Association 111 (2011): 1523-1535.
  25. Micha R., et al. “Etiologic effects and optimal intakes of foods and nutrients for risk of cardiovascular diseases and diabetes: systematic reviews and meta-analyses from the Nutrition and Chronic Diseases Expert Group (NutriCoDE)”. PLoS One 12 (2017): e0175149.
  26. Frieden TR. “Evidence for health decision making-beyond randomized controlled trials”. The New England Journal of Medicine 377 (2017): 465-475.
  27. Bishop KS and Ferguson LR. “The interaction between epigenetics, nutrition and the development of cancer”. Nutrients 7 (2015): 922-947.
  28. Cederholm T., et al. “ESPEN guidelines on definitions and terminology of clinical nutrition”. Clinical Nutrition (2016).
  29. Sobotka L. “Basics in clinical nutrition”. 4th Galen (2012).
  30. ADA (American Dietetic Association). ADA policy statement on licensure”. Journal of the American Dietetic Association 91 (1991): 985.
  31. Estruch R., et al. “Primary prevention of cardiovascular disease with a Mediterranean diet”. The New England Journal of Medicine 368 (2013): 1279-1290.
  32. Sacks FM., et al. “Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet”. The New England Journal of Medicine 344 (2001): 3-10.
  33. Mozaffarian D., et al. “Components of a cardioprotective diet: new insights”. Circulation 123 (2011): 2870-2891.
  34. Orrevall Y. “Nutritional support at the end of life”. Nutrition 4 (2015): 615-616.
  35. Mlinšek G. “Cost-effectiveness of treatment with nutritional supplements in patients with chronic kidney disease”. Clinical Nutrition ESPEN 14 (2016): 48.
  36. Clydesdale F. “IFT Expert Panel Report on Functional Foods: Opportunities and challenges”. Food Technology 58 (2004): 35-40.
  37. Donaldson MS. “Nutrition and cancer: A review of the evidence for an anti-cancer diet”. Nutrition Journal 1 (2004).
  38. Sesso HD., et al. “Dietary Lycopene, Tomato-Based Food Products and Cardiovascular Disease in Women”. The Journal of Nutrition 7 (2003): 2336-2341.
  39. Mozaffarian D., et al. “Interplay Between Different Polyunsaturated Fatty Acids and Risk of Coronary Heart Disease in Men”. Circulation 2 (2005): 157-164.
  40. Castillejo G., et al. “A Controlled, Randomized, Double-Blind Trial to Evaluate the Effect of a Supplement of Cocoa Husk That Is Rich in Dietary Fiber on Colonic Transit in Constipated Pediatric Patients”. Pediatrics3 (2006): e641-e648.
  41. Van Rosendaal GM., et al. “Effect of time of administration on cholesterol-lowering by psyllium: a randomized cross-over study in normocholesterolemic or slightly hypercholesterolemic subjects”. Nutrition Journal 1 (2004).
  42. Cardenas D. “What is clinical nutrition? Understanding the epistemological foundations of a new discipline”. Clinical Nutrition ESPEN 11 (2016): e63-e66.
  43. Blunt SB and Kafatos A. “Clinical Nutrition Education of Doctors and Medical Students: Solving the Catch 22”. Advances in Nutrition 2 (2019): 345-350.
  44. Cederholm T., et al. “Diagnostic criteria for malnutrition- an ESPEN consensus statement”. Clinical Nutrition 34 (2015): 335-340.
  45. ESPEN guidelines on definitions and terminology of clinical nutrition (2016).
  46. CDR (Commission on Dietetic Registration). Registered dietitian (RD) certification (1999).
  47. Obesity: preventing and managing the global epidemic. Report of a WHO Consultation”. World Health Organization Technical Report Series 894 (2000): 1-253.
Citation: Kerna NA, Holets HM, Hafid A, Flores JV, Carsrud NDV, Nwokorie U, Rashid S, Anderson II J, Waugh S. “A Comprehensive and Practical Guide to Clinical Nutrition in Medical Practice”. EC Gastroenterology and Digestive System 8.7 (2021): 76-86.

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