Anabolic competence: assessment and integration of the multimodality interventional approach in disease-related malnutrition

Abstract Disease-related malnutrition (DRM) is a frequent clinical problem and is characterized by loss of lean body mass, and decreased function including muscle function and immunocompetence. In DRM, nutritional intervention is necessary, but it has not consistently been shown to be sufficient. Other factors, e.g., physical activity and hormonal/metabolic influencers of the internal milieu, are also important in the treatment of DRM. A prerequisite for successful treatment of DRM is the positive balance between anabolism and catabolism. We propose to approach DRM using this paradigm of anabolic competence, for conceptual and practical reasons. Anabolic competence is defined as “that state which optimally supports protein synthesis and lean body mass, global aspects of muscle and organ function, and immune response.” Anabolic competence and interdisciplinary, multimodality interventions create a practical foundation to approach DRM in a proactive comprehensive way. In this narrative review we describe the paradigm of anabolic competence, and its operationalization by measuring factors related to anabolic competence and suited for clinical management of patients with DRM.