Milestone for clinical nutrition: WHO’s establishes first undernutrition code for adults – nutritioninsight.com

Advancements in Global Health Diagnostics: Aligning with Sustainable Development Goals 2 and 3

WHO’s ICD-11 Update: A Milestone for SDG 2 (Zero Hunger)

In a significant step toward achieving Sustainable Development Goal 2 (Zero Hunger), which aims to end all forms of malnutrition, the World Health Organization (WHO) will formally recognize undernutrition in its 11th edition of the International Classification of Diseases (ICD-11). This update, effective in 2027, provides a standardized diagnostic framework essential for monitoring and addressing malnutrition globally.

• Standardized Language: The ICD-11 serves as a universal tool for health professionals to diagnose, report, and monitor diseases, thereby improving data collection on undernutrition, a key target of SDG 2.
• Specific Definition: The WHO uses the term “undernutrition” to refer specifically to the loss of body mass (based on weight, BMI, or muscle mass) resulting from disease, inflammation, or starvation. This clarity helps in targeting interventions more effectively.
• Broad Applicability: The new code acknowledges that undernutrition can co-exist with overweight or obesity, addressing the complex “double burden” of malnutrition that SDG 2 seeks to eliminate.

Enhancing Clinical Practice to Achieve SDG 3 (Good Health and Well-being)

The new coding structure is designed to improve clinical outcomes and strengthen health systems, directly supporting SDG 3 (Good Health and Well-being). By enabling accurate diagnosis, the update enhances the ability of healthcare practitioners to provide quality care and improve patient health.

1. New Diagnostic Code (5B72): This code outlines specific subcategories for undernutrition, including inflammation-related, disease-related, and starvation-related types.
2. Severity Specification: Coordination codes are used to define the severity of the condition, with XS0T for Moderate Undernutrition and XS25 for Severe Undernutrition.

To ensure high-quality care and alignment with the new code, clinicians are encouraged to use validated assessment tools. These tools are crucial for the early identification and treatment of undernutrition, contributing to universal health coverage (Target 3.8).

• Subjective Global Assessment (SGA)
• Academy/American Society of Parenteral and Enteral Nutrition (ASPEN) Indicators
• Mini Nutrition Assessment (MNA)
• Global Leadership in Malnutrition (GLIM) criteria

Global Collaboration and Implementation: A Reflection of SDG 17 (Partnerships for the Goals)

The development and support for this new code exemplify SDG 17 (Partnerships for the Goals), highlighting the importance of global cooperation to tackle major health challenges. Leading international organizations have endorsed this initiative as a critical advancement.

• Key Supporters: The American Society of Nutrition (ASN), the European Society for Clinical Nutrition and Metabolism (ESPEN), and the Academy of Nutrition and Dietetics have all expressed strong support.
• Expert Consensus: ESPEN has described the update as a “milestone for clinical nutrition,” while ASN noted it will enhance the ability to recognize prevalence, identify effective treatments, and determine the impact of undernutrition on health outcomes.
• Future Actions: In preparation for the 2027 implementation, the focus for 2026 will be on developing official guidance and raising awareness to ensure the update benefits both patients and healthcare systems worldwide.

Analysis of SDGs, Targets, and Indicators

SDG 2: Zero Hunger

This goal is addressed as the article’s central theme is the formal recognition and standardized diagnosis of “undernutrition,” a critical form of malnutrition. The initiative described aims to improve the identification and treatment of individuals suffering from nutrient deficiencies, directly aligning with the goal of ending hunger and all forms of malnutrition.

SDG 3: Good Health and Well-being

This goal is highly relevant because the article discusses the implementation of a new diagnostic code (5B72) within the International Classification of Diseases (ICD-11). This is a fundamental tool for global health systems. By standardizing the diagnosis of undernutrition, the initiative enhances the ability of healthcare professionals to provide quality care, monitor a significant health condition, and improve patient outcomes, all of which are central to ensuring healthy lives and promoting well-being.

Specific SDG Targets Identified

1. Target 2.2: End all forms of malnutrition

   The article directly relates to this target by focusing on a new, standardized approach to diagnosing undernutrition in adults. The text states that the new code will “enhance health care practitioners’ ability to recognize the prevalence of undernutrition, identify treatments that effectively resolve undernutrition.” This systematic approach is a crucial step toward ending the specific form of malnutrition known as undernutrition.

2. Target 3.4: Reduce premature mortality from non-communicable diseases through prevention and treatment

   The article specifies that the new code includes subcategories for “disease-related” undernutrition. By improving the diagnosis and subsequent treatment of undernutrition, which often coexists with and exacerbates other diseases, healthcare systems can improve overall patient outcomes and potentially reduce mortality associated with these underlying conditions. The article notes the importance of determining “the impact of undernutrition on health outcomes.”

3. Target 3.8: Achieve universal health coverage, including access to quality essential health-care services

   The standardization of diagnostic language is a cornerstone of quality healthcare. The article highlights that the ICD-11 “standardizes the language used by global health professionals in diagnosing, reporting, and monitoring diseases.” Implementing a universal code for undernutrition ensures a consistent and high-quality approach to care, which is an essential component of universal health coverage.

4. Target 3.d: Strengthen the capacity of all countries… for early warning, risk reduction and management of national and global health risks

   The article emphasizes that the new code will enable “global cooperation to tackle this serious health challenge.” By creating a universal diagnostic standard, the WHO is strengthening the global capacity to monitor the prevalence of undernutrition, understand its scope, and manage it as a global health risk more effectively.

Indicators for Measuring Progress

While the article does not mention official SDG indicators by their numerical codes, it implies several metrics that can be used to measure progress:

• Prevalence of undernutrition: The article explicitly states that the new code will help “recognize the prevalence of undernutrition.” Data collected using this standardized code will serve as a direct indicator of the scale of the problem in clinical settings.
• Adoption of standardized diagnostic tools: The article mentions several validated tools, including the “Subjective Global Assessment,” the “Mini Nutrition Assessment,” and the “Global Leadership in Malnutrition” criteria. The rate at which healthcare facilities adopt and use these standardized tools is an indicator of improved quality of care and diagnostic capacity.
• Data on health outcomes: The article mentions the goal of determining “the impact of undernutrition on health outcomes.” This implies tracking metrics such as mortality rates, recovery times, and disease complication rates among patients diagnosed and treated for undernutrition, which would serve as indicators of treatment effectiveness.
• Global implementation of the ICD-11 undernutrition code: The article discusses the planned implementation in 2027 and the need to raise awareness. The number of countries and health systems that officially adopt and report using the new code (5B72) will be a key indicator of strengthened global health monitoring and cooperation.

Summary Table of SDGs, Targets, and Indicators

Source: nutritioninsight.com