History

Important features include:

• weight:
  • recent change with or without intention
  • indirect evidence e.g. loose clothes, comments by family members, old photographs
• diet:
  • intake, both normal and recent change
  • components
  • consistency
  • frequency
• energy output:
  • level of activity
  • fever
  • vomiting
  • diarrhoea
• functional capacity for feeding e.g. disability resulting in difficulty with feeding. This is a broad spectrum, and should include obvious problems such as the loss of the use of an arm, and less obvious problems such as confusion.
• gastrointestinal symptoms which might be affecting intake or efficient use of diet e.g. malabsorptive symptoms, pancreatic dysfunction
• psychological symptoms or states altering intake / activity:
  • fear
  • anxiety
  • anorexia
• general systemic symptoms possibly indicating an individual dietary deficiency:
  • lethargy
  • shortness of breath
  • failure of wound healing
• chronic disease e.g. renal failure, diabetes
• hypermetabolic states e.g. trauma and burns
• malignancy