Malnutrition Flashcards
Why is malnutrition important?
Consequence and contributor to chronic disease
How does NICE define malnutrition?
a Body Mass Index (BMI) of less than 18.5
OR
unintentional weight loss greater than 10% within the last 3-6 months
OR
a BMI of less than 20 and unintentional weight loss greater than 5% within the last 3-6 months
What percentage of patients over 65 are malnourised?
10%
How do we screen for malnutrition?
MUST (Malnutrition Universal Screen Tool)
When should a MUST be done?
On admission to care/nursing homes and hospital
or if there is concern e.g. elderly, thin patient with pressure sores
How should malnutrition be managed?
dietician support if the patient is high-risk
a ‘food-first’ approach with clear instructions e.g. add cream to potatoes
What is ONS?
Oral nutritional supplements
should be between meals not instead of meals
How might faltering growth be diagnosed?
Monitoring of growth parameters e.g. weight, height and head circumference
Define faltering growth
less than expected growth over time during the first 3 years of life when tracked on appropriate growth charts for children of the same age and sex
What are the signs of malnutrition?
Listlessness
Skin folds from loss of muscle mass
What are RF for faltering growth in children?
Small for gestational age GI problems e.g. reflux or coeliac Poor carer knowledge Poor carer-child interaction Cerebral palsy Prematurity
Poverty
Food insecurity
Lack of family mealtime routine
What investigations should be considered in malnourished children?
Driven by clinical assessment
- FBC
- Urinalysis
- Coeliac testing
What is the management for faltering growth?
Feeding recommendations
Specialist referral
Potential hospitalisation
What foods have Vit C?
citrus fruits, tomatoes, potatoes, Brussel sprouts, cauliflower, broccoli, cabbage and spinach
What does Vit C deficiency lead to?
impaired collagen synthesis and disordered connective tissue
ascorbic acid is a co-factor for enzymes that produce some aa’s
