Malnutrition

Question 1

What is malnutrition according to NICE?

Answer 1

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.

NICE defines specific criteria to identify malnutrition.

Question 2

What percentage of patients aged over 65 years are malnourished?

Answer 2

Around 10%

The majority of these patients are living independently.

Question 3

What tool is primarily used for screening malnutrition?

Answer 3

MUST (Malnutrition Universal Screening Tool)

The MUST score algorithm is used for assessment.

Question 4

When should screening for malnutrition be conducted?

Answer 4

On admission to care/nursing homes and hospitals, or if there is a concern.

For instance, when an elderly, thin patient has pressure sores.

Question 5

What factors does the MUST screening tool take into account?

Answer 5

• BMI
• Recent weight change
• Presence of acute disease

These factors help categorize patients into risk levels.

Question 6

What are the risk categories identified by MUST?

Answer 6

Low, medium, and high risk

Patients are categorized based on their screening results.

Question 7

What does NICE recommend for managing malnutrition in high-risk patients?

Answer 7

Dietician support

Professional guidance is crucial for effective management.

Question 8

What is the ‘food-first’ approach recommended by NICE?

Answer 8

Providing clear instructions like ‘add full-fat cream to mashed potato’ rather than just prescribing oral nutritional supplements (ONS)

This approach emphasizes enhancing food intake.

Question 9

How should oral nutritional supplements (ONS) be used according to NICE?

Answer 9

They should be taken between meals, rather than instead of meals

This strategy helps maintain overall nutritional intake.