ASPEN Definition of Terms, Style, and Conventions Guidance

Administration: The act of delivering substance(s) to an individual by a prescribed dosage and route.

Admixture: The result of combining 2 or more fluids.

Adolescent: The definition of adolescent differs depending on the organization defining it. Authors must define the specific age range of their population within the manuscript.

Adult: The definition of adult differs depending on the organization defining it. Authors must define the specific age range of their population within the manuscript.

Alternate Site: Healthcare organizations that provide care to patients outside of the traditional hospital or outpatient office settings, including skilled nursing facilities (SNFs), long-term acute care hospitals (LTACHs), and rehabilitation hospitals.⁷

Automated Compounding Device: A device that compounds parenteral preparations, including parenteral nutrition. It transfers large-volume parenteral solutions such as dextrose, amino acids, lipid emulsions, and sterile water, as well as small-volume parenteral components including electrolytes, minerals, vitamins, and non-nutrient medications to the final parenteral nutrition container.⁸

Beyond-Use Date: The date and time after which a compounded product or preparation should not be stored, transported, or administered. The date is determined from the date and time the preparation is compounded or prepared.

Birth Weight: The first weight of the newborn obtained after birth.¹⁰

• Low Birth Weight: Weight of 1500 g to 2499 g (up to and including 2499 g)
• Very Low Birth Weight: Weight of 1000 to 1499 g
• Extremely Low Birth Weight: Weight of less than 1000 g

Blenderized Enteral Formula: Food and liquid that are sufficiently pureed for administration through an enteral access device. This term replaces blenderized tube feeding.¹¹ (Refer to Enteral Formula)

• Commercial Blenderized Enteral Formula: A formula manufactured with food ingredients or pureed foods. These formulas may or may not have added vitamins and minerals.
• Prepared Blenderized Enteral Formula: A formula prepared in a home or hospital blender.

Body Weight: (Refer to Weight) The total weight of an individual’s body, including all components (e.g., muscle, fat, bone, organs, and fluids).

Cachexia: Significant fat and muscle loss related to proinflammatory factors and metabolic changes often associated with long-term illnesses (e.g., cancer, renal failure, heart failure). Metabolic aberrations (e.g., mobilization of fat stores to replace glucose as a primary energy source) differentiate simple starvation from cachexia.

Central Line-Associated Bloodstream Infection: A laboratory-confirmed bloodstream infection that develops in a patient with a central line in place for more than 2 calendar days before the onset of the infection, which is not related to infection at another site.¹²

Child: The definition of child differs depending on the organization defining it. Authors must define the specific age range of their population within the manuscript.

Clinical Nutrition: “Clinical nutrition deals with the prevention, diagnosis and management of nutritional and metabolic changes related to acute and chronic diseases and conditions caused by a lack or excess of energy and nutrients (macro and micro). Any nutritional measure, preventive or curative, targeting individual patients is clinical nutrition. Clinical nutrition is largely defined by the interaction between food and nutrients, disease, and the life cycle.”¹³

Closed Enteral System: A closed, ready-to-hang enteral container pre-filled with sterile, liquid formula by the manufacturer and considered ready-to-administer.¹⁴ (Refer to Open Enteral System)

Commercial Enteral Formula: Enteral formulas that are commercially manufactured and packaged.

Compatibility: The harmonious coexistence of two or more products or components (e.g., medications, excipients, electrolytes) in a solution or formulation (e.g., intravenous solutions/admixtures, enteral formulas) over time without undergoing physical (e.g., complexation) or chemical (e.g., degradation) changes.^15,16 (Refer to Incompatibility)

Computerized Provider Order Entry (CPOE): Providers using computer assistance to directly enter medical orders from a computer or mobile device. The order is also documented or captured in a digital, structured, and computable format for use in improving safety and organization.¹⁷

Corrected Age: For preterm infants, “corrected age” is a calculation that accounts for their prematurity when assessing their development, growth, and nutrition needs up to 2 years of age.¹⁸

Diet: A prescribed allowance of food or nutrients provided via the oral route

• General, Regular, or House Diet: A full, well-balanced diet containing the essential nutrients needed for optimal growth, tissue repair, and normal functioning of organs. Such a diet contains foods that appropriately balance proteins, carbohydrates, fats, minerals, and vitamins in proportions that meet the specific nutrient requirements of the individual.
• Therapeutic Diet: A diet intervention ordered by a healthcare practitioner as part of the treatment for a disease or clinical condition to eliminate, decrease, or increase certain substances in the diet (e.g., sodium, potassium).¹⁹

Dietary Supplements: The Food and Drug Administration defines a dietary supplement as: “a product intended for ingestion that, among other requirements, contains a ‘dietary ingredient’ intended to supplement the diet. The term ‘dietary ingredient’ includes vitamins and minerals; herbs and other botanicals; amino acids; ‘dietary substances’ that are part of the food supply, such as enzymes and live microbials (commonly referred to as ‘probiotics’); and concentrates, metabolites, constituents, extracts, or combinations of any dietary ingredient from the preceding categories.”²⁰

Donor Human Milk: Donated, pooled, and pasteurized human milk.²¹

Drug-Drug Interaction: When one drug modifies the actions of another drug through pharmacokinetic and/or pharmacodynamic changes.²²

Drug-Nutrient Interaction: An event that results from a physical, chemical, physiologic, or pathophysiologic relationship between a drug and a nutrient(s)²³

Energy: Required to sustain the body’s various functions. Produced through the oxidation of primarily carbohydrates, fats, and amino acids, yielding the chemical energy needed to sustain metabolism, nerve transmission, respiration, circulation, and physical work.²⁴ This term should be used in preference to calorie. Calorie or kilocalorie should only be used in the quantification of energy.

Enteral Access Device: Tube placed directly into the gastrointestinal tract for the delivery of nutrients and/or medications. Enteral access device is to be used in preference to “feeding tube.”

Enteral Autonomy: Enteral autonomy is the ability to meet nutrition and fluid needs by means of enteral support without the use of parenteral support for a period of time (authors should specify time frame in the document).²⁵

Enteral Formula: Liquid nutrition formula administered via an enteral access device. It can include ready-to-feed liquid, reconstituted powder, or commercial or prepared blenderized foods. It does not include human milk, medications, or water administered via an enteral access device.

Enteral Misconnection: An inadvertent and erroneous connection between an enteral feeding system and a non-enteral system (e.g., vascular access device, peritoneal dialysis catheter, tracheostomy, medical gas tubing).²⁶

Enteral Nutrition: A system of providing nutrition directly into the gastrointestinal tract via an enteral access device that bypasses the oral cavity. Drinking a formula per os (PO) is not considered enteral nutrition.¹⁴ Enteral nutrition is to be used in preference to “enteral feeding” or “tube feeding.”

Enteral Nutrition Use Process: The system within which enteral nutrition (EN) is used. This involves a number of major steps: the initial patient assessment, the recommendations for an EN regimen, the selection of the enteral access device, the EN prescription, the review of the EN order, the product selection or preparation, the product labeling and dispensing, the administration of the EN to the patient, and the patient monitoring and reassessment, with documentation at each step as required.¹⁴

Enteral Small-Bore Connector: An enteral connector used to link or join an enteral device for the purposes of delivering enteral fluid or water (International Organization for Standards 80369‐3).²⁷ Commonly known by the trade name ENFit.

Essential Fatty Acids: Fatty acids that cannot be synthesized by the body and are required from dietary sources.

Exclusive Formula Nutrition: The provision of all necessary nutrients using only commercial liquid nutrition formula,²⁸ without reliance on parenteral nutrition or solid food, via the oral and/or enteral route. This regimen is primarily used to induce remission in patients with inflammatory bowel disease. This term is favored over “exclusive enteral nutrition” as enteral nutrition implies that nutrition bypasses the oral cavity. This does not include infant formulas. (Refer to Nutrition Formula)

Expiration Date:

• Foods (applies to nutrition formulas): “Generally, ‘expiration’ dates and ‘use-by’ dates are the last dates that the manufacturer recommends a food item be consumed to ensure peak quality and nutrient retention. However, there is no regulation requiring that manufacturers mark their products with such dates.
  • The one exception to these general rules is commercially manufactured infant formula. The U.S. Food and Drug Administration (FDA) requires manufacturers to label infant formula with a ‘use-by’ date. Additionally, the FDA prohibits the sale of infant formula after the use-by date.”²⁹ (Refer to Infant Formula)
• Drugs: The date assigned by the manufacturer after which a drug stored in the unopened manufacturer’s storage container away from harmful and variable factors like heat and humidity should not be used.³⁰ (Refer to Beyond-Use Date)

Formulation: A defined list of ingredients (or components) for the preparation of an enteral formula or parenteral nutrition admixture (adapted from Pharmaceutical formulation).³¹

Frailty:  A condition marked by heightened susceptibility to stressors due to reductions in physiological reserve and function across multiple body systems, leading to diminished capacity to manage routine or acute challenges. While the original term refers to frailty associated with aging, the condition of frailty is also often associated with physical decline associated with chronic disease.³²

Gestational Age: The time between the first day of the last menstrual period and delivery.³³

Hang Time (for enteral or parenteral nutrition): The duration an enteral or parenteral preparation or product is considered safe for administration to the patient, beginning with the time the preparation or product has been compounded, reconstituted, warmed, poured from one container to another, or has had the original package seal broken.¹⁴

Human Milk: Milk from a human that “is a complex, variable biological fluid that is comprised of macronutrients, vitamins, and minerals, along with important compounds for immune and developmental health.”³⁴

Incompatibility: The physical and/or chemical alteration of a product when combined with one or more other products as a result of concentration or temperature-dependent reactions (e.g., precipitation) that can alter activity or stability. Incompatibility refers to concentration-dependent precipitation or acid-base reactions that result in physical and/or chemical alteration of the product or products when combined together.^15,16 (Refer to Compatibility)

Infant: The definition of infant differs depending on the organization defining it. Authors must define the specific age range of their population within the manuscript.

Infant Formula (commercial product): Commercial infant formula is designed for infants less than 12 months of age and if properly prepared, is an alternative for human breast milk. It is available in ready-to-serve, concentrated liquid, and powdered forms.²⁹

Instability: Physical or chemical degradation of a substance resulting in changes to its pharmacologic action (e.g., efficacy) or chemical characteristics; may lead to treatment failure and/or adverse effects.^15,16 (Refer to Stability)

International Dysphagia Diet Standardization Initiative: The IDDSI standardizes terminology and definitions that describe the texture of modified foods and thickened liquids, including enteral formulas.³⁵

Intestinal Failure: The reduction of gut function below the minimum necessary for the absorption of macronutrients and/or water and electrolytes, such that intravenous supplementation is required to maintain health and/or in the case of pediatrics, growth. Pediatric intestinal failure is specifically defined as dependence on supplemental parenteral support for a minimum of 60 days within a 74 consecutive day interval.²⁵

Intestinal Failure-Associated Liver Disease: Liver injury, as manifested by cholestasis, steatosis, and fibrosis, in patients with intestinal failure that is independent of, or in addition to, other potential etiologies.

Intestinal Insufficiency (or Deficiency): The reduction of gut absorptive function that does not require intravenous supplementation but may require oral supplementation, enteral nutrition, or vitamin and trace element supplementation to maintain health and/or growth.³⁶

Intestinal Rehabilitation Program: An interdisciplinary, collaborative patient care paradigm that serves to coordinate care for individuals with intestinal failure through comprehensive management of their specialized nutrition and corollary needs, attention to and support of associated chronic comorbidities, and evaluation and treatment of acute complications.

Lipid Injectable Emulsion: An intravenous oil-in-water emulsion of oil(s), egg phosphatides, and glycerin. The term should be used in preference to fats, intravenous fat emulsion, and intravenous lipid emulsion. Lipid injectable emulsions can be further defined by the source of the lipid (e.g., soybean oil, fish oil, olive oil). Lipid injectable emulsions can be administered as a component of parenteral nutrition formulation or can be given as an individual nutrient.³⁷

Macronutrient: Nutrients that are required in relatively large amounts as compared to other nutrients, and can be metabolized to produce energy (carbohydrates, fats, proteins).³⁸

Malnutrition (undernutrition):

• Adult: Acute, subacute, or chronic state of inadequate nutrition with or without inflammatory activity leading to underweight status or an adverse change in body weight, body composition, and/or function.³⁹
• Pediatric: “An imbalance between nutrient requirement and intake, resulting in cumulative deficits of energy, protein, or micronutrients that may negatively affect growth, development, and other relevant outcomes.”⁴⁰

Medical Food: “… a food which is formulated to be consumed [orally] or administered enterally under the supervision of a medical provider and which is intended for the specific dietary management of a disease or condition for which distinctive nutritional requirements, based on recognized scientific principles, are established by medical evaluation.”⁴¹

Medical Nutrition Therapy: An evidence-based application of the Nutrition Care Process that may include one or more of the following: nutrition assessment/re-assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring and evaluation that typically results in the prevention, delay, or management of diseases and/or conditions.⁴²

Micronutrient: Nutrients present and required in the body in minute quantities (e.g., vitamins, trace elements, minerals) and are often required in metabolic pathways. Their deficiencies are associated with serious health consequences. Not produced in the body and must be acquired exogenously.⁴³

Mixed-Oil Lipid Injectable Emulsion: Lipid injectable emulsion that is composed of more than one source of lipid.⁴⁴

Modular Product (or Components): Single macronutrients used to enhance the carbohydrate, protein, fat, or fiber content of an enteral nutrition regimen.¹⁴

Multi-Chamber Bag Parenteral Nutrition: A parenteral nutrition admixture that utilizes a multi-chamber bag to separate some components (e.g., lipid injectable emulsion) from the other components. The bag consists of two or more chambers separated by a seal or tubing that is clamped. Prior to administration, the seal or clamp is opened to allow the contents of the chambers to mix. The term “premixed” should be avoided, as these products require activation and mixing prior to administration. Examples of these products are concentrated amino acids (with or without electrolytes), concentrated dextrose, and with or without intravenous lipid emulsions in multi-chamber bags.⁴⁵

• Commercial: A standardized parenteral nutrition formulation available from a manufacturer and requiring fewer compounding steps before administration that utilizes a multi-chamber bag to separate some components.⁴⁶
• Compounded: A patient-specific parenteral nutrition formulation that utilizes a multi-chamber bag to separate some components.⁴⁶

Neonate: The definition of neonate differs depending on the organization defining it. Authors must define the specific age range of their population within the manuscript.

Nutrient: A substance that provides nourishment for growth and maintenance of life. The six main categories of nutrients include protein, carbohydrate, fat, vitamins, minerals, and water.⁴⁷

Nutrition: The sum of processes by which one takes in and uses nutrients for the body’s growth, repair, and maintenance.⁴³ Of or relating to the state of nutrition or items related to the field of nutrition. Can be used as a compound structure with terms such as nutrition support, nutrition nurse, nutrition team, nutrition program, etc. (Refer to Nutritional)

Nutritional: Refers to that which has nutrient value, such as nutritional cereal, nutritional meal, etc. (Refer to Nutrition)

Nutrition Assessment: A comprehensive approach to identifying nutrition-related problems that uses a combination of the following: medical, nutrition, medication, and client histories; nutrition-focused physical examination; anthropometric measurements; and biomedical data/medical diagnostic tests and procedures.¹³

Nutrition Formula: Liquid formulas containing macro and micronutrients that can be taken either enterally via an enteral access device or orally. Includes enteral formula, infant formula, and liquid oral nutrition supplements (Refer to Enteral Formula, Infant Formula, and Oral Nutrition Supplements).

 Nutrition Risk: State of being at risk for developing malnutrition; nutrition risk is identified by a nutrition screening process. (Refer to Nutrition Screening)

Nutrition Care: Interventions, monitoring, and evaluation designed to facilitate appropriate nutrient intake based upon the integration of information from the nutrition assessment and identified nutrition diagnosis.

Nutrition Care Plan: A formal statement of the nutrition goals and interventions prescribed for an individual using the data obtained from a nutrition assessment and identified nutrition diagnosis. The plan should include statements of nutrition goals, with monitoring and evaluation parameters, the most appropriate route of administration of nutrition therapy, method of nutrition access, anticipated duration of therapy, and training and counseling goals and methods.⁴⁸

Nutrition Care Process: The assessment, diagnosis, ordering, preparation, distribution, administration, monitoring, evaluation, and documentation of nutrition therapy.⁴⁹

Nutrition Screening: A process of identifying an individual who may be malnourished or at risk for malnutrition to determine if a comprehensive nutrition assessment and appropriate intervention are indicated. Nutrition screening is the preferred term over other terms such as malnutrition screening and nutrition risk assessment.^50,51

Nutrition Status: State of the body in relation to the consumption and utilization of nutrients.⁵²

Nutrition Support or Nutrition Support Therapy: When nutrition needs cannot be met orally, nutrients must be supplied by a different route; nutrition support refers to the provision of enteral nutrition and/or parenteral nutrition.⁵³ (Refer to Enteral Nutrition and Parenteral Nutrition)

Nutrition Support Team (or Service): An interdisciplinary group that may include dietitians, nurses, nurse practitioners, pharmacists, physicians, physician assistants and/or other healthcare professionals with expertise in nutrition who manage the provision of nutrition support therapy.^54,55

Nutrition Support Specialist or Nutrition Support Practitioner or Nutrition Support Professional: A healthcare professional (e.g., dietitian, nurse, nurse practitioner, pharmacist, physician, physician assistant) with specialized training and/or experience in nutrition support therapies. The specialized training may include independent or formalized education endeavors. Specialists may be recognized with specialty certification.

Nutrition Therapy: A component of medical treatment that includes oral, enteral, and/or parenteral nutrition.

Older Adult: The definition of older adult differs depending on the organization defining it. Authors must define the specific age range of their population within the manuscript. This term is preferred over terms such as geriatric, elderly, and aged.

Open Enteral System: A feeding system in which the clinician/patient/caregiver is required to decant formula into the enteral container or bag.¹⁴ (Refer to Closed Enteral System)

Oral Nutrition: Nutrients taken by mouth.

Oral Nutrition Supplement: A commercially manufactured or homemade liquid, reconstitutable powder, and/or solid product that contains a combination of carbohydrates, proteins, fats, fiber, vitamins, and/or minerals intended to supplement a portion of a patient’s nutrition intake.⁵⁶

Osmolality: The measured concentration of a liquid expressed in osmoles or milliosmoles of solute(s) per kilogram of solvent (Osmol per kg or mOsmol per kg, respectively). Osmolality is a measure of the osmotic pressure exerted by a liquid across a semipermeable membrane.⁵⁷ Osmolality is applicable to enteral formulas.

Osmolarity: The theoretical, calculated concentration of a liquid expressed in number of osmoles or mOsmol of solute(s) per liter of a solution; used in clinical practice because it expresses osmoles as a function of volume. Osmolarity cannot be measured, only calculated.⁵⁷  Osmolarity is applicable to parenteral formulas.

Parenteral Nutrition: The intravenous administration of a nutrition formulation containing macronutrients that, at a minimum, must contain amino acids and dextrose (or glucose).^58,59 Parenteral nutrition is used in preference to “parenteral feeding.”

• Central: Parenteral nutrition formulated for delivery into a large-diameter vein.
• Peripheral: Parenteral nutrition formulated for delivery into a peripheral vein.

Parenteral Nutrition Use Process: The system within which parenteral nutrition (PN) is used. This involves a number of major steps: the initial patient assessment, the recommendations for a PN regimen, the selection of the vascular access device, prescribing PN, the review and verification of the PN order, compounding the PN admixture or preparing the PN product, labeling and dispensing the PN admixture, administering PN to the patient, and patient monitoring and reassessment, with documentation at each step as required.^60,61

Parent’s Own Milk: milk expressed from the infant’s biological parent;^62,63 often referred to as “mother’s own milk.”

Pediatric: The definition of pediatric differs depending on the organization defining it. Authors must define the specific age range of their population within the manuscript.

Preterm birth/infant: The definition of preterm differs depending on the organization defining it. Authors must define the specific age range of their population within the manuscript.

Preparation: A food, drug, or dietary supplement (or mixtures thereof) compounded in a licensed pharmacy or other healthcare-related facility pursuant to the order of a licensed prescriber.⁶⁴

Rate-Based Feeding: Delivery method of enteral nutrition where the enteral nutrition is dosed based on an infusion rate.¹⁴

Refeeding Syndrome: “a range of metabolic and electrolyte alterations occurring as a result of the reintroduction and/or increased provision of calories after a period of decreased or absent caloric intake.”⁶⁵

Sarcopenia: Loss of muscle mass and decline in muscle function. Originally associated with aging, but has been expanded to etiologies including disease, malnutrition, and physical inactivity.⁶⁶

Stability: “The extent to which a product retains, within specified limits and throughout its period of storage and use, the same properties and characteristics that it possessed at the time of its manufacture.”^15,16 (Refer to Instability)

Standardized Parenteral Nutrition Formulation: An organization-specific parenteral nutrition formulation intended to meet the daily maintenance requirements of a specific patient population (e.g., age-specific, stress-specific, or disease state-specific) and differentiated by route of administration (central vs. peripheral vein).⁶⁷

Supplemental Parenteral Nutrition: Parenteral nutrition provided in addition to enteral nutrition or oral intake to meet calorie and protein targets. Typically, the patient has already been receiving enteral and/or oral nutrition and has been unable to meet their nutrition requirements, and parenteral nutrition is added to supplement these other routes of nutrition.⁶⁸

Total Nutrient Admixture: A parenteral nutrition formulation, also referred to as 3-in-1, containing lipid injectable emulsion as well as the other components of parenteral nutrition (dextrose, amino acids, vitamins, minerals, water, and other additives) in a single container.⁶⁸

Transitional Feeding: Progression from one mode of feeding to another while continuously administering estimated nutrient requirements.¹⁴

Vascular Access Device: Catheter placed directly into the arterial or venous system for diagnostic or therapeutic purposes, including infusion therapy and/or phlebotomy.⁶⁹ Venous access devices can be placed into central or peripheral veins for purpose of infusing parenteral nutrition and fluids.

Visceral Proteins: Serum proteins such as albumin, prealbumin (transthyretin), and transferrin in which concentrations can change during an acute phase response or inflammation. They are not considered reliable proxy measures of total body protein or total muscle mass and should not be used as nutrition markers.⁷⁰

Volume-Based Feeding: Delivery method of enteral nutrition where the enteral nutrition is dosed based on the volume of formula. Delivery rates may vary to ensure a specific volume is provided during a given time period.¹⁴

Weight: The weight of an individual’s body, which can be expressed as actual, dosing, dry, estimated, ideal, etc. With feeding and drug regimens, authors must describe how the dosing weight was determined.⁷¹

1. Use a space between numerical values and unit symbols (e.g., 25 mg, not 25mg).^72,73
2. Do not use trailing zeros for integers (e.g., 5 mg, not 5.0 mg). Exception: A trailing zero may be used to indicate precision (e.g., lab results, lesion size, catheter/tube diameters).⁷³
3. Use a leading zero for values less than 1 (e.g., 0.3, not .3). Exception: Statistical values like P values and α levels should omit the leading zero (e.g., P < .05).⁷⁴
4. Do not alter unit symbols for pluralization (e.g., 175 cm, not 175 cms).⁷⁵
5. Do not follow unit symbols with a period unless ending a sentence (e.g., 175 cm, not 175 cm.).^72,73
6. Do not mix information with unit names or symbols (e.g., use “the water content is 20 mL/kg,” not “20 mL H₂O/kg” or “20 mL of water/kg”).⁷⁵

1. Refer to drug products by lowercase generic name. Match FDA or USP-approved nomenclature. Do not abbreviate or use slang/stem names.⁷³
2. Use proprietary/trade names only when the following criteria are met:⁷³
   a. The trade name is needed to distinguish it, for clinical or research purposes, from similar products
   b. Specific documentation is provided to document the proprietary product  or contrast the use of the proprietary product.
3. If a proprietary name must be used, capitalize the first letter, with a few exceptions (e.g., pHisoHex), but do not include trademark (™) or registered trademark (®) symbols. Capitalization alone is sufficient to indicate the proprietary nature of the product name.⁷⁴
4. Express vitamins by generic chemical name for therapeutic use (e.g., cobalamin). Familiar names like vitamin B12 may be used for dietary or in vivo contexts.⁶⁴

1. Use standard abbreviations (e.g., those listed in this document) when possible, as nonstandard abbreviations confuse readers. Do not use abbreviations in manuscript titles.⁷⁴
2. Spell out terms at first mention, followed by abbreviation in parentheses (unless it is a standard unit of measurement). Do not use the same abbreviation for more than one term in the same document.

1. Use inclusive language.⁷⁴
   1. Use person-first language to emphasize the individual rather than the condition (e.g., “patients with diabetes” rather than “diabetics”).
   2. Avoid referencing gender or sex unless clinically or contextually relevant. Use gender-neutral terms (e.g., “chairperson” rather than “chairwoman”) and pronouns to refer to individuals of unknown or unspecified gender (e.g., When the patient is receiving parenteral nutrition, the healthcare provider should monitor their (not his/her) fluid balance closely to ensure optimal hydration).
   3. Use “older adult” instead of “elderly.” When discussing research, it is acceptable to refer to specific age groups (e.g., “adults aged 65 and older”).
   4. Capitalize racial and ethnic identifiers such as Black, White, and Hispanic. Use these terms as adjectives rather than nouns (e.g., “Black patients” rather than “Blacks”). Avoid capitalizing White when used in contexts that could reinforce supremacist ideologies (e.g., “White Power”).
   5. Use non-stigmatizing, medically accurate language (e.g., “alcohol use disorder” rather than “alcoholic” or “alcohol abuse”).

^a All symbols are recognized by National Institute of Standards and Technology (NIST)⁷⁵ or United States Pharmocepeia (USP)⁶⁴ unless otherwise specified.

^b All symbols should be expressed with a space between the number and the symbol unless otherwise specified.

^c To prevent confusion with mg, The Institute for Safe Medicine Practices (ISMP)⁷³ and The Joint Commission⁷² recommend using mcg and avoiding the symbol μg.

^d This is not a true symbol but is identified by NIST/USP guidelines as acceptable in contexts where it functions symbolically (such as in equations). Must be spelled out in narrative contexts.

^e Not recognized as a standardized symbol by NIST or USP guidelines. Use is acceptable only in contexts where it functions symbolically (such as in equations). Must be spelled out in narrative text.

^f No space between number and symbol and no space between degree symbol and unit: Example: 10°C.

^g Celsius (°C) is the preferred unit of temperature in all clinical, pharmaceutical, and scientific documentation, in alignment with standards from the USP, ISMP, FDA, NIST, and SI (International System of Units). Fahrenheit (°F) may be included in parentheses following the Celsius value only when needed for reader clarity. Example: Store at 4°C (39°F)

^vaThe mu (μ) symbol is acceptable in the scientific literature; however, ISMP and The Joint Commission recommend that μ not be used as μg (e.g., mcg should be used to avoid confusion with mg. Refer to Table 4).^72,73

^bCan be confused with the statistical symbol for population mean (Refer to Table 3).

^aCan be confused with the symbol prefix for micro (Refer to Table 2).

^a cm³ is SI nomenclature

^a Terms and Abbreviations in this table shall not be used in ASPEN Board of Directors-approved documents

^b Frank Barancyk, Oct 6, 2009, personal communication, Communications Manager, The Joint Commission.

ASPEN Definition of Terms, Style, and Conventions Guidance. The American Society for Parenteral and Enteral Nutrition. Updated [date page was last updated]. Accessed [date user accessed the page]. https://nutritioncare.org/definition-of-terms-style-and-conventions-used-in-aspen-board-of-directors-approved-documents/

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Jeanette Hasse, PhD, RD, LD, CNSC, CCTD, FASPEN, FADA
Transplant Nutrition Manager, Annette C. and Harold C. Simmons Transplant Institute
Baylor University Medical Center, Dallas, TX

Titilola M. Afolabi, PharmD, FCCP, BCPPS, BCNSP
Associate Professor, The University of Tennessee Health Science Center
College of Pharmacy, Memphis, TN

Sandra Citty, PhD, APRN-BC, FASPEN
Clinical Professor, Family, Community, and Health[GU1.1] Systems Science
University of Florida College of Nursing
North Florida South Georgia Veterans Health System, Gainesville, FL

Catherine Larson-Nath, MD, CNSC
Director of Intestinal Rehabilitation Program; Fellowship Program Director; Associate Professor, Pediatric Gastroenterology, Hepatology, and Nutrition
University of Minnesota Medical School, Minneapolis, MN

Stacey S. Beer, MPH, RD, LD, CSP, CCTD
Clinical Dietitian, Pediatric Gastroenterology, Hepatology, and Nutrition
Texas Children’s Hospital, Houston, TX

Mark R. Corkins, MD, SPR, FAAP
Professor of Pediatrics
University of Tennessee Health Science Center, Memphis, TN

Diana W. Mulherin, PharmD, BCNSP, BCCCP, FCCM, FASPEN
Clinical Pharmacist Specialist, Nutrition Support, Pharmacy Clinical Programs
Vanderbilt University Medical Center, Nashville, TN

Kathleen Price, PhD, RDN, LDN
Director, Clinical Practice, ASPEN

Lingtak-Neander Chan, PharmD, BCNSP, FASPEN
Professor of Pharmacy, Interdisciplinary Faculty in Nutritional Sciences
School of Pharmacy and School of Public Health
University of Washington, Seattle, WA

Jennifer Doley, MBA, RD, CNSC, FAND
Dietetic Internship Director and Regional Clinical Nutrition Manager, Morrison Healthcare
Carondelet St. Mary’s Hospital, Tucson, AZ

Angela Bingham, PharmD, BCNSP, BCCCP, FASPEN
Chair, PharmD Program Director, Clinical Professor
Philadelphia College of Pharmacy
Saint Joseph’s University, Philadelphia, PA

Ann-Marie Brown, PhD, RN, CPNP-AC, CCRN
Professor of Nursing
Emory University, Atlanta, GA

Simone Chaves de Miranda Silvestre, MD, MSc
Coordinator, Nutrition Support Committee; Specialist in Nutrology (Parenteral and Enteral Nutrition); Specialist in Internal Medicine
Hospital Felício Rocho, Belo Horizonte, Brazil

Kelly Goyette
Clinical Content Writer and Editor, Publications, ASPEN