Malnutrition

Question 1

What is malnutrition?

Answer 1

Malnutrition is an important consequence of and contributor to chronic disease. It is a complex and multifactorial problem.

Question 2

How does NICE define malnutrition?

Answer 2

NICE defines malnutrition as:
1. A Body Mass Index (BMI) of less than 18.5; or
2. Unintentional weight loss greater than 10% within the last 3-6 months; or
3. A BMI of less than 20 and unintentional weight loss greater than 5% within the last 3-6 months.

Question 3

What percentage of patients aged over 65 years are malnourished?

Answer 3

Around 10% of patients aged over 65 years are malnourished, the vast majority of those living independently.

Question 4

What tool is used for screening malnutrition?

Answer 4

Screening for malnutrition is mostly done using MUST (Malnutrition Universal Screening Tool).

Question 5

When should screening for malnutrition be done?

Answer 5

Screening should be done on admission to care/nursing homes and hospitals, or if there is a concern.

Question 6

What factors does the MUST tool take into account?

Answer 6

The MUST tool takes into account BMI, recent weight change, and the presence of acute disease.

Question 7

How does the MUST tool categorize patients?

Answer 7

The MUST tool categorizes patients into low, medium, and high risk.

Question 8

What does NICE recommend for managing malnutrition?

Answer 8

NICE recommends:
1. Dietician support if the patient is at high risk.
2. A ‘food-first’ approach with clear instructions.
3. If oral nutritional supplements (ONS) are used, they should be taken between meals.

Question 9

What is an example of a ‘food-first’ approach?

Answer 9

An example of a ‘food-first’ approach is to ‘add full-fat cream to mashed potato’.