Malnutrition (undernutrition / poor protein-energy status) causes a reduction in muscle and body tissue mass, and also results in altered metabolic and physiological function, which has adverse effects on health. Muscle wasting and weakness decrease mobility and stamina and impair functions of the lung and heart. Malnutrition is associated with poor wound healing, impaired immune responses and delayed recovery from illness, with a higher incidence of post-operative complications. Correcting undernutrition has many benefits, including improved disease recovery with fewer complications, and shorter hospital stays.

In the UK, malnutrition risk has been identified in 20% - 60% of hospital admissions to medical, surgical, elderly and orthopaedic wards. One study of 500 consecutive hospital admissions determined malnutrition in 40% of patients. Further, hospitalization with surgery or other medical treatments often result in additional weight loss. Although malnutrition is common in hospital admissions, it has been reported as undiagnosed in up to 70% of cases.

The early detection of malnutrition by routine screening of vulnerable risk groups (those with chronic disease, the elderly) can do much to identify those who would benefit from dietary support measures and nutrition intervention. The development of menus providing nutritionally adequate and tempting meals that the patient can eat and where necessary the supply of additional food and nutrient supplements may be all that is needed for some patients whilst others may require more intensive artificial nutritional support via a tube or intravenously

Dietitians support the greater use of standardised risk screening procedures (such as the ‘MUST’*) for all elderly patients and for adults with disease conditions known to be associated with impaired nutrition status. This allows dietitians and other health professionals to easily identify those at risk of malnutrition in a rapid and consistent manner, and then to best target appropriate nutrition therapy. The closer monitoring of malnutrition risk, as a marker for disease progression, allows the earlier and more effective placement of nutrition care measures.

* ‘MUST’ is the ‘Malnutrition Universal Screening Tool’ developed by the Malnutrition Advisory Group (MAG) of the British Association for Parenteral and Enteral Nutrition (BAPEN).

This information was correct at issue. For personal dietary information, a local registered dietitian is the best source of information. The Health Professions Council site provides a search facility of dietitians registered in the UK (www.hpc-uk.org)

Issue date: January 2006