By Esther Onyegbula

The West African Society for Parenteral and Enteral Nutrition and the Indian Society for Parenteral and Enteral Nutrition have called for an urgent overhaul of clinical nutrition protocols, urging hospitals to adopt a “golden hour” approach to nutritional screening to curb the growing burden of hospital malnutrition.

The recommendation was made during a high-level global webinar themed “Strengthening Clinical Nutrition Care Through Effective Nutrition Assessment,” where international experts warned that malnutrition among hospitalised patients remains a silent but deadly global health crisis requiring immediate intervention.
Delivering the keynote address, Daphnee Lovesley, Chief Clinical Dietitian at Apollo Hospitals, stressed the urgency of early nutritional intervention, noting that malnutrition often begins at the point of hospital admission.

She disclosed that every 60 seconds, at least 11 hospitalised patients go undiagnosed with malnutrition, adding that up to two-thirds of patients are already malnourished at admission, with figures rising to as high as 85 per cent in parts of Africa.
According to her, delays in initiating nutritional care, particularly beyond the first 24 hours, significantly increase the risk of complications and mortality.

“If we delay our nutrition prescription for more than 24 hours, the patient is at extreme risk,” she warned.
Lovesley advocated a mandatory “golden hour” framework, recommending that all patients undergo nutritional screening within the first six hours of admission to enable early detection and prompt intervention.
She explained that early screening is critical in preventing complications such as Sarcopenia, a condition characterised by accelerated loss of muscle mass and function, which contributes to frailty, increased fracture risk and poor recovery outcomes.

She also highlighted the need to adopt the Global Leadership Initiative on Malnutrition, which supports multidisciplinary teams in identifying high-risk patients using indicators such as recent weight loss, reduced dietary intake and disease severity.
Corroborating the call, Teresa Pounds, President of WASPEN, underscored the need for structured implementation of clinical nutrition systems across Nigeria.

She urged the Federal Government to adopt a coordinated, top-down approach to ensure full operationalisation of the Nutritional Steering Committee (NSC) across healthcare facilities, noting that effective implementation is critical to reducing hospital-related malnutrition nationwide.

Pounds also called on chief medical directors and hospital administrators in both public and private health institutions to prioritise routine nutritional assessment for all admitted patients and establish multidisciplinary nutrition steering committees to ensure screening within 24 hours.
She emphasised that nutrition care must be recognised as a core component of treatment outcomes, stressing the need for stronger institutional commitment.

“When we work together, we achieve more. Nigeria is making meaningful progress toward establishing a Nutritional Steering Committee, but global best practices must be domesticated. Accreditation bodies must integrate these standards into the healthcare system,” she said.
Experts at the webinar further advocated a multidisciplinary approach involving physicians, nurses and dietitians, alongside practical measures such as protected mealtimes to minimise clinical interruptions during feeding and a “food-first” protocol that prioritises natural dietary intake before supplementation.

Lovesley warned that untreated malnutrition can prolong hospital stays by two to three days, while increasing susceptibility to infections, delayed wound healing and premature death, thereby placing additional strain on healthcare systems.

In her closing remarks, Pounds described clinical nutrition as a critical pillar of public health and patient care, calling for sustained commitment from all stakeholders.
She also announced that WASPEN will host its conference from June 22 to 25, 2026, describing it as a key platform for advancing clinical nutrition practice across the region.

“Nutritional assessment remains the most effective tool for preventing morbidity and early mortality among patients,” she added, reaffirming WASPEN’s commitment to embedding nutrition at the centre of healthcare delivery in Nigeria and across West Africa.