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March 1979

Hospital Malnutrition— A Diagnostic Challenge: Dr Osier, Where Are You?

Author Affiliations

New England Deaconess Hospital 185 Pilgrim Rd Boston, MA 02215

Arch Intern Med. 1979;139(3):278-279. doi:10.1001/archinte.1979.03630400010005

In 1973, Phil White, director of the American Medical Association's Department of Nutrition, and the Nutrition Advisory Group (Ted Butterworth, Maurice Shils, Stan Dudrick, and others) met to establish guidelines for improved hospital nutrition. These guidelines, entitled "Skeleton in a Closet," were published in Nutrition Today.1 Butterworth's short review revealed glaring deficiencies in such seemingly simple measurements of nutritional status as the recording of height and weight.

Working independently, Bruce Bistrian, an internist with an MPH from Johns Hopkins who had been matriculated in the Department of Nutrition and Food Science at Massachusetts Institute of Technology, planned to pursue his interest in the area of malnutrition at the Albert Schweitzer Hospital in Haiti. I invited him to the Boston City Hospital, where he could observe as many cases of malnutrition as he wanted. Though disbelieving, he did join us and developed his first methodology report from the study of

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