Redesigning Physicians’ Involvement in Nutrition Care for Hospitalized Patients to Combat Hospital Malnutrition: Evidence, Challenges, and Policy Options; [بازطراحی مشارکت پزشکان در مراقبت تغذیهای بیماران بستری برای مقابله با سوءتغذیه بیمارستانی: شواهد، چالشها و گزینههای سیاستی] Publisher



Zarif Yeganeh M ; Haghaghian Roudsari A ; Takian A ; Omidvar N ; Mohammadi Kangarani H ; Hekmatdoost A
Source: Iranian Journal of Nutrition Sciences and Food Technology Published:2026

Abstract

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. © 2026, National Nutrition and Food Technology Research Institute. All rights reserved.