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Clinical Practice Guideline for Rehabilitation Nutrition 2026: Executive Summary of the Japanese Association of Rehabilitation Nutrition Guideline 2026-A Secondary Publication.

Researchers

Yoshihiro Yoshimura, Yusuke Yasumoto, Tomohiro Matsumoto, Ayano Nagano, Shinta Nishioka, Shinsuke Nagami, Fumihiko Nagano, Mai Tanaka, Yuki Iida, Youngjae Hong, Hideki Aragane, Atsuo Kitaoka, Kazuharu Nakagawa, Kanako Yoshimi, Hideaki Takahata, Ai Shiraishi, Yoko Saino, Hitomi Ichishima, Ayaka Matsumoto, Keiichiro Higashi, Naoko Kumagae, Dai Fujiwara, Kenji Omura, Hidetaka Wakabayashi

Abstract

The Japanese Association of Rehabilitation Nutrition (JARN) published its first Japanese-language clinical practice guideline on rehabilitation nutrition in 2018, followed by an English-language 2020 update covering cerebrovascular disease, hip fracture, cancer, and acute illness. The JARN Clinical Practice Guideline 2026 (JARN GL 2026) expands the framework to 11 domains and incorporates updated evidence on malnutrition diagnosis using the Global Leadership Initiative on Malnutrition criteria, sarcopenia assessment, and interactions between nutritional therapy and rehabilitation. This secondary publication summarizes the scope, methods, and all statements. JARN GL 2026 was developed in accordance with the Minds Clinical Practice Guideline Development Manual 2020 (version 3.0). Clinical questions were formulated in Population, Intervention, Comparison, and Outcome format and classified as clinical questions (CQs) with graded recommendations, background questions (BQs) providing evidence-based context, or future research questions (FRQs) identifying topics with insufficient evidence. Recommendations were graded for strength (1 = strong; 2 = weak/conditional) and certainty of evidence (A-D). Patient and public involvement and external peer review by related academic societies were incorporated. Across 11 domains-cerebrovascular disease, proximal femur fracture, chronic obstructive pulmonary disease (COPD), cancer, dysphagia, intensive exercise therapy, enhanced nutritional care, oral management, pharmaceutical intervention, hospital-associated sarcopenia, and social determinants of health-12 CQs, five BQs, and three FRQs are presented. Enhanced nutritional care combined with rehabilitation was strongly recommended for patients with proximal femur fracture and weakly recommended for patients with acute- and convalescent-phase cerebrovascular disease, COPD, cancer, and dysphagia. Registered dietitian-led nutritional assessment and counseling and professional oral management concurrent with rehabilitation were each weakly recommended. Three topics were classified as FRQs because of insufficient evidence. JARN GL 2026 provides a systematically developed, evidence-graded framework to support patient-centered, multidisciplinary rehabilitation nutrition across care settings.
Source: PubMed (PMID: 42840673)View Original on PubMed