ALB and nutritional deficiency disease: However, Soeters et al., The European Society for Clinical Nutrition and Metabolism (ESPEN), and the American Society for Parenteral and Enteral Nutrition (ASPEN) recommend that low serum albumin should not be diagnostic of malnutrition, as there is a correlation between inflammation and malnutrition rather than malnutrition and low serum albumin [1,21,26].