Nutritional Assessment: BMI, Abdominal Girth, MUST

Question 1

How would you calculate BMI

-interpretation

Answer 1

kg/m2 
Underweight - U18.5
Healthy - 18.5-24.9
Overweight - 25-29.9
Obesity I - 30-34.9
Obesity 2 - 35-39.9
Obesity 3 - 40+

Question 2

How would you measure abdominal girth

-interpretation

Answer 2

Top of iliac crest
Tape is snug but not compressing skin, parallel to floor
Measure at end of normal expiration

Indication of total body fat and risk of obesity related problems
Increased risk
-women 80cm+
-asian men 90cm+
-men 94cm+

Question 3

How to do a MUST assessment

• steps
• interpretation

Answer 3

Step 1 - BMI
0 - 20+
1 - 18.5-20
2 - U18.5

Step 2 - % of unplanned weight loss in past 3-6months
0 - U5%
1 - 5-10%
2 - 10%+

Step 3 - acute illness AND likely to be no nutritional intake for 5+ days
2

Overall malnutrition risk
0 - low
1 - medium
2+ - high

Question 4

Must score

-management

Answer 4

0 - low risk
Hospital - weekly

1 - medium risk
3 days of dietary monitoring
Adequate - weekly screen
Inadequate - local policy to improve intake

2 - high risk
Dietician referral - improve intake
Monitor, review care plan

Question 5

BMI results significance

-too high

Answer 5

Too high
Increased risk of
-T2DM, HTN, CVD, strokes, some cancers

How to lose weight
Diet recommendations
-reduce intake of saturated fats, high salt, sugar
-increase intake of fibre, fruit, protein

Increased physical activity
-150mins of moderate activity/week (can speak but cannot sing)

GP/practice nurse - come up with a weight loss plan together, will be seen regularly for follow up appointments to adjust and support your weight loss effort.
Community weight loss groups - meet with other people on their weight loss journeys, support network.

Question 6

BMI results significance

-too low

Answer 6

Too low
Increased risk of
-nutritional deficiencies => osteoporosis, anemia
-weak immune system
-amenorrhea

May explore why

• medical cause
• lost appetite
• difficulty making time to eat
• trying to lose weight
• eating disorder?

Gaining weight gradually

• regular meals - 5 a day, balance of starchy carbs, protein and fats
• try eating foods that are healthy and high in energy (whole milk, peanut butter)