Clinical nutritional assessment: Advances, challenges, and future directions in screening and diagnosis

Abstract

Clinical nutritional assessment is a cornerstone of patient-centered healthcare, enabling early detection and management of malnutrition across diverse populations. This comprehensive review synthesizes current evidence and best practices associated with the assessment of nutritional status in clinical settings. Using a systematic literature search covering research from January 2000 to March 2024, the review explores the multidimensional “ABCD” framework encompassing anthropometric, biochemical, clinical, and dietary methodologies. Special attention is given to validated screening tools—such as MUST, MNA, NRS-2002, GLIM, and SGA—and their adaptation for specific populations including pediatrics, geriatrics, and the critically ill. The review highlights significant advancements, including the integration of electronic health record systems (EHRS), digital dietary assessment platforms, and emerging biomarker-driven and AI-powered approaches, all of which contribute to enhanced diagnostic accuracy and personalized care. However, implementation challenges persist: variability in tool use, lack of standardization, inadequate clinician training, and limited cultural adaptability constrain widespread adoption. Furthermore, subjective nutrition assessment methods remain vulnerable to recall bias and underreporting, emphasizing the need for objective metrics and technological innovation. The findings underscore the importance of interdisciplinary teamwork and the development of standardized and culturally sensitive protocols to improve patient outcomes. Ultimately, this review advocates for a multimodal, evidence-based approach to nutritional assessment, ongoing research into tool validation, and the strategic integration of novel technologies to advance equity and effectiveness in nutrition care worldwide1.