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:: Volume 20, Issue 5 (Winter: special issue: Policy Brief 2026) ::
Iranian J Nutr Sci Food Technol 2026, 20(5): 27-31 Back to browse issues page
Redesigning Physicians’ involvement in Nutrition Care for Hospitalized Patients to Combat Hospital Malnutrition: Evidence, Challenges, and Policy Options
M Zarif Yeganeh , A Haghaghian-Roudsari * , A Takian , N Omidvar , H Mohammadi Kangarani , A Hekmatdoost
Shahid Beheshti University of Medical Sciences , a_haghighian@sbmu.ac.ir
Abstract:   (152 Views)
Background and Aims: Malnutrition among hospitalized patients in Iranian hospitals remains a common yet hidden problem. Despite being associated with increased morbidity, mortality, length of hospital stay, and individual and societal costs, it continues to be among the neglected priorities of the health system. Given the importance of collaboration between physicians and dietitians, this policy brief was developed to provide policy options for enhancing physician involvement in the nutrition care of hospitalized patients.
Materials and Methods: This policy brief was prepared using a review of national and international scientific evidence, in-depth semi-structured interviews with experts and stakeholders at three levels (policy-making, academia, and service delivery) related to hospital nutrition care, and a comparative analysis of policy experiences from other countries.
Findings: A structural gap in physician involvement in the nutrition care process of hospitalized patients—resulting from weak medical education on nutrition, high physician workload, poor interprofessional collaboration culture, lack of supportive organizational structures and accountability indicators, shortage of clinical dietitians, and an inefficient referral system—was identified as one of the main drivers of the problem. This study proposes four priority and feasible policy options to address this issue: (1) Recruitment of clinical dietitians, (2) establishing Nutrition Support Teams (NSTs), (3) integrating nutrition indicators into hospital accreditation systems, and (4) revising the medical curriculum through an interprofessional education approach.
Conclusion: Without a systematic redesign of physician involvement in nutrition care, hospital malnutrition will continue to persist as a hidden, costly, yet preventable burden on Iran's health system.
Keywords: Hospital malnutrition, Nutrition care, Physicians, Health policy
Full-Text [PDF 776 kb]   (79 Downloads)    
Article type: Brief Policy | Subject: nutrition
Received: 2026/05/25 | Accepted: 2026/01/30 | Published: 2026/06/1
References
1. Butterworth Jr CE. The skeleton in the hospital closet. Nutrition today. 1974;9(2):4-8. [DOI:10.1097/00017285-197403000-00001]
2. Hiesmayr M, Tarantino S, Moick S, Laviano A, Sulz I, Mouhieddine M, et al. Hospital malnutrition, a call for political action: a public health and nutritionday perspective. Journal of clinical medicine. 2019;8(12):2048. [DOI:10.3390/jcm8122048]
3. Damari B, Abdollahi Z, Pourghaderi M, Mohammadi-Nasrabadi F. An evaluation of four years implementation of National Nutrition and food security policy in Iran: lessons learned. International journal of preventive medicine. 2020;11(1):173. [DOI:10.4103/ijpvm.IJPVM_405_19]
4. Tappenden KA, Quatrara B, Parkhurst ML, Malone AM, Fanjiang G, Ziegler TR. Critical role of nutrition in improving quality of care: an interdisciplinary call to action to address adult hospital malnutrition. Journal of the Academy of Nutrition and Dietetics. 2013;113(9):1219-37. [DOI:10.1016/j.jand.2013.05.015]
5. Feyzabadi Z, Jamalie S, Fazli B, Shams SS, Badpeyma M, Sedaghat A. The nutritional status of patients hospitalized in the ICUs of Iranian hospitals: a systematic review. Evidence Based Care. 2024;14(2):67-84.
6. Mahdavi-Roshan M, Salari A, Hasandokht T, Rahbar-Taramsari M. Malnutrition status and associated factors in cardiac patients admitted to heart hospital, in the north of Iran. Hospital Topics. 2019;97(2):60-5. [DOI:10.1080/00185868.2019.1605864]
7. Poudineh S, Shayesteh F, Kermanchi J, Haghdoost A-A, Torabi P, Pasdar Y, et al. A multi-centre survey on hospital malnutrition: result of PNSI study. Nutrition journal. 2021;20(1):87. [DOI:10.1186/s12937-021-00741-1]
8. Correia MIT, Waitzberg DL. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clinical nutrition. 2003;22(3):235-9. [DOI:10.1016/S0261-5614(02)00215-7]
9. Álvarez-Hernández J, Vila MP, León-Sanz M, de Lorenzo AG, Celaya-Pérez S, García-Lorda P, et al. Prevalence and costs of malnutrition in hospitalized patients; the PREDyCES® Study. Nutricion hospitalaria. 2012;27(4):1049-59.
10. Reber E, Strahm R, Bally L, Schuetz P, Stanga Z. Efficacy and efficiency of nutritional support teams. Journal of clinical medicine. 2019;8(9):1281. [DOI:10.3390/jcm8091281]
11. Dahka SM, Fathi S, Salimi Z, Roumi Z, Aminnejad B, Valisoltani N, et al. The status of clinical nutrition in hospitals of Guilan province, Iran-A mixed-method study. Nutrición Hospitalaria. 2023;40(1).
12. Emami M, Zarezadeh M, Sharifzadeh M, Fazelifarsani Z, Khorshidi M. Evaluation of Nutritional Assessment Quality and Rate of Referral to a Dietitian in Shariati Hospital, Tehran, Iran: A Clinical Audit. Journal of Nutritional Sciences and Dietetics. 2019:8-13.
13. Jabbari M, Haghighian-Roudsari A. Nutritional challenges of hospitalized cancer patients from the perspective of healthcare professionals: a qualitative study. Journal of Qualitative Research in Health Sciences. 2024;13(4):177-86. [DOI:10.34172/jqr.2024.26]
14. Hand RK, Lamers-Johnson E, Jimenez EY, Steiber AL. Patient Malnutrition Risk or Number of Initial Nutrition Intervention Categories Can Be Used to Develop Registered Dietitian Nutritionist Staffing Models in the Inpatient Adult and Pediatric Hospital Setting: A Cohort Study. J Acad Nutr Diet. 2025;125(3):348-65. [DOI:10.1016/j.jand.2024.08.006]
15. Hand RK, Jordan B, DeHoog S, Pavlinac J, Abram JK, Parrott JS. Inpatient staffing needs for registered dietitian nutritionists in 21st century acute care facilities. Journal of the Academy of Nutrition and Dietetics. 2015;115(6):985-1000. [DOI:10.1016/j.jand.2015.01.013]
16. Barrocas A, Schwartz DB, Bistrian BR, Guenter P, Mueller C, Chernoff R, et al. Nutrition support teams: Institution, evolution, and innovation. Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition. 2023;38(1):10-26. [DOI:10.1002/ncp.10931]
17. Holst M, Staun M, Kondrup J, Bach-Dahl C, Rasmussen HH. Good nutritional practice in hospitals during an 8-year period: The impact of accreditation. e-SPEN Journal. 2014;9(4):e155-e60. [DOI:10.1016/j.clnme.2014.05.001]
18. Braun B, Grünewald M, Adam-Paffrath R, Wesselborg B, Wilm S, Schendel L, et al. Impact of interprofessional education for medical and nursing students on the nutritional management of in-patients. GMS journal for medical education. 2019;36(2):Doc11.
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Zarif Yeganeh M, Haghaghian-Roudsari A, Takian A, Omidvar N, Mohammadi Kangarani H, Hekmatdoost A. Redesigning Physicians’ involvement in Nutrition Care for Hospitalized Patients to Combat Hospital Malnutrition: Evidence, Challenges, and Policy Options. Iranian J Nutr Sci Food Technol 2026; 20 (5) :27-31
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Volume 20, Issue 5 (Winter: special issue: Policy Brief 2026) Back to browse issues page
Iranian Journal of  Nutrition Sciences and Food  Technology
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