Assessment of nutrition

The assessment of nutritional status can largely be achieved by history and examination. Investigations provide supportive evidence.

The key questions to consider are:

• is the protein-energy malnutrition significant i.e. is is severe enough to interfere with normal physiological functions?
• what type of malnutrition is it e.g. marasmus, kwashiorkor, combinational or individual dietary element deficiency?
• is the patient physiologically stressed?
• what type of stresses are likely to be encountered e.g. chemotherapy, surgery, period of nil by mouth, and what provision should be made for this time?

Commonly, the history and examination are supplemented by a battery of simple practical measures over a period of at least 2 weeks:

• body weight
• triceps skin-fold thickness
• mid-arm muscle circumference
• plasma albumin with or without transferrin and pre-albumin

Screening for malnutrition in the community can be achieved via the The Malnutrition Universal Screening Tool (MUST), for example, may be used to do this

• a link to an example of the MUST tool is provided..click here

Reference

1. Manary MJ, Sandige HL. Management of acute moderate and severe childhood malnutrition. BMJ. 2008 Nov 13;337