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Pocket Guide to Clinical Nutrition

A Pocket Guide to Clinical Nutrition: 5th Edition updated 2018

The 5th Edition has been extensively revised, reviewed, updated and expanded to provide concise and evidence-based data to assist the practitioner in assessing, planning, treating and monitoring patients who require nutritional support. Within the adult nutritional requirements section there are substantial changes from previous editions as a result of conducting 5 systematic reviews. Since publication in 2018 the Liver section has also been updated in 2019 and is now included in new orders.

The PENG Pocket Guide to Clinical Nutrition is available from PENG of the British Dietetic Association.

Please note – important information regarding orders

We are delighted to announce that individual sales of the PENG Pocket Guide to Clinical Nutrition are now available in addition to continuing with bulk orders. If you have been waiting to order, we thank you for your patience. For more details and to place an order please visit here

Hear Dr Elizabeth Weekes talking ‘nutritional requirements’ which compliments the new chapter of the PENG Pocket Guide to Clinical Nutrition

Online Resources – Adult Nutritional Requirements Guidelines


To provide additional material to aid the estimation of energy requirements in clinical practice, for patients requiring nutritional support.


The papers cited in the online resources were identified during the searches conducted by the PENG Requirements Guideline Development Group (GDG) in preparation for Section 3 of the Pocket Guide to Clinical Nutrition (2018). Data from these studies could not be included in Tables 3.1 or 3.2 because resting energy expenditure (REE) was not reported in kcal/kg body weight (BW) or kcal/kg fat free mass (FFM).

Online resource 1 – Disease-specific regression equations

Download the PDF files below

The underlying principle of disease-specific regression equations is to use a combination of static measures and physiological parameters to estimate requirements in specific populations. The equations presented in this resource were derived for specific clinical populations (e.g. patients with burn injury or chronic heart failure), and should only be used in similar populations. Clinicians are advised to read the full paper(s) before deciding whether or not the population in the study is sufficiently similar to their own patient population.

Note that a proportion of the regression equations were not validity-tested in a similar population and so they should be used with caution

Online resources 2 – Resting energy expenditure (REE), total energy expenditure (TEE) or physical activity

Download the PDF files below

This resource provides data on REE in kcal/day for clinical conditions where there were no data on REE kcal/kg BW or kcal/kg FFM. It also summarises data from studies where TEE was measured in clinical populations and data from studies where the energy expended in physical activity was either measured or estimated from measures of REE and TEE.

The data summarised in this resource are intended to provide guidance in the estimation of TEE and physical activity level only for those clinical populations where data have been presented. All data are mean (standard deviation) unless otherwise stated.

Clinicians are advised not to use these data to make assumptions about TEE and physical activity in other clinical conditions.

Basal metabolic rate (BMR) prediction equations

More than twenty BMR prediction equations derived in, and for, healthy populations exist in the literature. While the Henry (2005) BMR prediction equation was recommended for use in clinical practice in the previous version of the Pocket Guide to Clinical Nutrition, its use is no longer recommended by the PENG GDG for patients requiring nutritional support.Clinicians are reminded that the estimations derived using the new method presented in Section 3 of the Pocket Guide to Clinical Nutrition (2018) will not be directly comparable to estimations derived using the factorial method recommended in the previous edition of the Pocket to Clinic al Nutrition.

(Data for the online resources were compiled and tabulated by Elizabeth Weekes and Danielle Judges on behalf of the PENG GDG).

Summarised below are the core chapters of the PENG Pocket Guide to Clinical Nutrition:

  • Introduction
  1. Identifying
  2. Assessment
  3. Adult Requirements
  4. Paediatric Requirements
  5. Access Routes
  6. Monitoring and Reference Values
  7. Nutritional Values
  8. Parenteral Nutrition
  9. Acid-Base Balance
  10. Diabetes
  11. Microbial Control
  12. Refeeding
  13. Drugs and Enteral
  14. Renal
  15. Liver
  16. Critical Care
  17. COPD
  18. Bariatric
  19. Pancreatic

For queries relating to publications and the PENG Pocket Guide to Clinical Nutrition email:

Pocket Guide to Clinical Nutrition Q&A related to previous edition

What dietitians have said about the previous version of the PENG Pocket Guide to Clinical Nutrition:

“It contains all the information we require in order to assess patients on the wards. It is 'the bible' and I would really struggle to do my job effectively without.”

Dietitian, Trafford

“Because it helps inform and allow us to make complete and accurate nutritional assessments and aids professional judgement in decision making.”

Dietitian, Leeds

“I use it daily in assessments of patients but as a quick reference guide it is invaluable when faced with consultants/MDT to prove dietetic value.”

Dietitian, Ipswich

“Guides you to calculate estimated requirements for all patient groups, it is the Dietitian's bible.”

Dietitian Warrington

“This is essential in our clinical practice (dietetics).”

Dietitian, Aylesbury

“Practical evidence nutrition - a perfect guide.”

Dietetic Advisor, Sheffield

“Essential evidence base.”

Dietitian, Antrim

“All the information I need for nutrition assessments is ready to pick up and go and be with me wherever I need it!”

Dietitian, Cumbria

“I could not do my job without it!”

Dietitian, Daisy Hill Hospital

“It gives up to date evidence based information to carry around. A nutrition 'gospel'.”

Community Dietitian, Rotherham