Total Nutrition Therapy – GERI – 2nd version

An international educational course on nutrition in older people.Total Nutrition Therapy – Geriatrics – 2nd edition (TNT-Geri 2)

Leader: Alfonso Cruz Jean-Pierre Michel


Nutritional problems are a frequently neglected aspect of Geriatric care that underlies most clinical situations in older people. All over the world, undernutrition is frequent in old community dwelling individuals (up to 30%). At hospital admission the prevalence is higher (40 to 50%) and what is very surprising is that at hospital discharge, survivors have the same undernutrition problem. Prevalence of undernutrition is also high in care homes and in rehabilitation settings.

To help educating physicians and other health care providers on all the nutritional aspects linked with care of older people, the EUGMS, in cooperation with Abbott Nutrition Institute, developed course to educate Geriatricians on how to screen, assess, manage and follow old adults suffering from nutritional problems. This course, named TNT-Geriatrics, used a “train the trainers” approach to cascade the educational program around the world. It was coordinated by Alfonso Cruz-Jentoft and Jean-Pierre Michel (both former Presidents of the EUGMS) who stimulated numerous European colleagues to write 12 chapters, 6 clinical cases and 4 workshops (please find below the list of contributors).

The” train the trainers” course was launched in 2010 in Spain, where more than 40 geriatricians were successfully trained. Then the teaching activities were spread out to Chile, Singapore, Turkey and England. More than 200 geriatricians were trained. At their turn they have trained worldwide more than 1,600 colleagues (physicians and other health care professionals) from three continents.

The success of this teaching activity, insights learned from students’ feedback, and fast advances in geriatric nutrition science prompted the decision to prepare a second updated version. The work started at the end of 2012 and has been finished recently. The first train the trainers event for this edition will take place in Krakow (Poland) in November 2014


The two directors of the TNT-Geri 2 course are Alfonso Cruz-Jentoft (Spain) and Jean-Pierre Michel (Switzerland)

The authors who have contributed to the 2 versions of the TNT course, and are thus members of this T&F group are:

  • Hidenori Arai (Japan)
  • Jean-Pierre Baeyens (Luxembourg)
  • Juergen Bauer (Germany)
  • Yitshal N. Berner (Israel)
  • Yves Boirie (France)
  • Tommy Cederholm (Sweden)
  • Antonio Cherubini (Italy)
  • Matthias Kaiser (Germany)
  • Francesco Landi (Italy)
  • Finbarr Martin (UK)
  • Frauke Müller (Switzerland)
  • Harnish Patel (UK)
  • Marwan Ramadan (Qatar)
  • Teresa San Miguel (Spain)
  • Stéphane Schneider (France)
  • José A. Serra-Rexach (Spain)
  • Cornel C. Sieber (Germany)
  • Eva Topinkova (Czech Republic)
  • Dieneke van Asselt (Netherlands)
  • Maurits Vandewoude (Belgium)
  • Emilio Vargas Castrillón (Spain)
  • Mauro Zamboni (Italy)



Educate physicians around the world in geriatric nutrition using a comprehensive, standardized course that includes lectures and interactive training, including study of clinical cases and workshops

The main topics of the TNT-Geri 2 course are:

  • Session 1: Nutrition, Aging, and Longevity.
  • Session 2: Nutrition, Frailty, and disability
  • Session 3: Sarcopenia
  • Session 4: Oral Health and Nutrition
  • Session 5: Nutritional Requirements
  • Session 6: Nutrition Screening and Assessment
  • Session 7: Diet Enrichment and Oral Nutrition Supplements
  • Session 8: Tube-fed Enteral and Parenteral Nutrition
  • Session 9: Nutrition Issues and Interventions in Specific Diseases
  • Session 10: Obesity
  • Session 11: Drug and Food Interactions
  • Session 12: Program Review


Spread out the course by cascading teaching in as many countries as possible around the world.

Fostering European leadership in geriatric nutrition, by linking with the Geriatric Nutrition SIG of ESPEN.


All the participants of the course get a book of 224 pages. Instructors who get formal training are allowed to teach the course and get an instructor workbook and a complete set of slides with the course content.