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PrincipLe OF SEFI®

SEFI® allows a visual assessment of the patient’s food intake, using a visual analogue scale, or a choice between consumed portions.


SEFI® aims are:

  • early and easily detecting a decrease in oral energy intake in in- or outpatients at hospital, which is present in 69% of hospitalized (1) patients and strongly associated with the risk of malnutrition,

  • diagnosing malnutrition in older patients at nursing home, or in the community practice by the general practitioner,

  • following up food intake at hospital or nursing home.

The Global Leadership Initiative on Malnutrition (GLIM), including the European Society for Clinical Nutrition and Metabolism (ESPEN) included reduced food intake as one of the top five criteria to diagnose malnutrition(2) SEFI® takes part in the process of the screening for malnutrition and aims at improving daily care.

If SEFI® shows a risk of malnutrition, an assessment of nutritional status should be performed. Early detection of the risk of malnutrition is a major public health issue, and the ESPEN recommends an early and systematic detection of malnutrition for all hospitalized patients. (3)


n.b.: SEFI® does not replace a food survey conducted by a dietician if needed.

The Simple Evaluation of Food Intake® is quickly and early identifying:

  • patients with malnutrition or at risk of malnutrition at hospital, at nursing home, or in the community practice

  • patients needing nutrition support, such as oral nutritional supplements (ONS), enteral, or parenteral nutrition.

1. Hiesmayr M, et al. Decreased food intake is a risk factor for mortality in hospitalised patients: The Nutrition Day survey 2006. Clin Nutr 2009;28:484-491.
2. Preiser JC, Hiesmayr M, et al. Epidémiologie de la dénutrition chez le malade hospitalisé. In : Quilliot D, Thibault R, Bachmann P, Guex E, Zeanandin G, Coti-Bertrand P, Dubern B, Peretti N, Caldari D, editors. Traité de Nutrition Clinique à tous les âges de la vie, 4e ed. Éditions de la SFNCM, K’noë ; Paris 2016. Chap. 41, pages 633-646
3. Thibault R, et al. Use of 10-point analogue scales to estimate dietary intake: A prospective study in patients nutritionally at-risk. Clin Nutr 2009;28:134-140.
4. Guerdoux-Ninot et al. Assessing dietary intake in accordance with guidelines: Useful correlations with an ingesta-Verbal/Visual Analogue Scale in medical oncology patients. Clin Nutr 2019;38:1927-1935.
5. Bouëtté G, et al. A visual analogue scale for food intake as a screening test for malnutrition in the primary care setting: Prospective non-interventional study. Clin Nutr 2021;40:174-180.
6. Thibault R, et al. Assessment of food intake in hospitalised patients: A 10-year comparative study of a prospective hospital survey. Clin Nutr 2011; 30: 289-296
7. Mesbah S, et al. The evaluation of consumed food portions as a screening test for malnutrition in the older people living in a nursing home: A cross-sectional pilot study. Nutrition Clin Metab 2023;37:62–67.
8. Billeret A, et al. Assessment of food intake assisted by photography in older people living in a nursing home: maintenance over time and performance for diagnosis of malnutrition. Nutrients 2023;15(3):646.
9. Thibault R, et al. ESPEN guideline on hospital nutrition. Clin Nutr 2021;40:5684-5709.

10. Jouneau S, et al. Malnutrition and decreased food intake at diagnosis are associated with hospitalization and mortality of idiopathic pulmonary fibrosis patients. Clin Nutr 2022;41:1335-1342.
11. Rageul E et al. Une prise alimentaire insuffisante à l’hôpital est associée à un risque plus élevé de réadmission hospitalière chez des patients pris en charge par l’Unité Transversale de Nutrition (UTN) d’un centre hospitalier universitaire (CHU). Communication orale. Journées Francophones de Nutrition 2022.
. Cederholm T, et al. GLIM criteria for the diagnosis of malnutrition: a consensus report from the global clinical nutrition community. Clin Nutr 2019;38:1-9
13. Delarue J, et al. Diagnosing undernutrition children and adults: new French criteria. Why, for what and for whom? A joint statement of the French National Authority for Health and French Federation of Nutrition. Br J Nutr 2022;127:739-751.
14. Kondrup J, et al. Educationnal and Clinical Practice Committee, European Society of Parenteral and Enteral Nutrition (ESPEN). ESPEN guidelines for Nutrition Screening 2002. Clin Nutr 2003;22:415-21. 15. Bouteloup C, Thibault R. Decision tree for nutritioinal care. Nutr Clin Metab 2014;28:52-56
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