The Underappreciated Role of Low Muscle Mass in the Management of Malnutrition

Summary

This narrative review synthesises evidence on the underrecognised role of low muscle mass in malnutrition diagnosis and management, particularly in hospitalised patients and those with chronic disease. The authors argue that current clinical practice insufficiently prioritises muscle preservation and restoration, and provide five key recommendations for practitioners: centering muscle mass in nutritional assessment, implementing identification protocols, establishing management pathways, optimising nutrition for muscle gain, and promoting exercise/rehabilitation. The review highlights barriers to implementation, including measurement challenges and professional awareness gaps, and calls for systemic change in healthcare practice and investment in further research.

UK applicability

These clinical recommendations are directly relevant to UK healthcare systems, where hospitalised patients and those with chronic disease are routinely managed by nutritionists and clinical teams. The findings align with potential opportunities to strengthen malnutrition screening and management protocols in NHS settings, though implementation would require training, resource allocation, and integration into care pathways.

Key measures

Body composition compartments (muscle mass); clinical outcomes including readmission and mortality rates; disease states affected by low muscle mass (chronic obstructive pulmonary disease, cancer, cardiovascular disease)

Outcomes reported

The paper reviews current clinical approaches to identifying, assessing, and managing low muscle mass in patients with malnutrition, with a focus on outcomes including readmission rates and mortality. It provides evidence-based recommendations for integrating muscle mass assessment and preservation into nutritional management strategies across diverse disease states.

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