Health & Wellbeing
Identifying Malnutrition in Acute Care Patients: Nutrition Focused Physical Assessment
Jessica Perez
Jessica Perez

Malnutrition develops when the body does not get the right amount of micronutrients, vitamins, and or minerals it needs to maintain healthy tissues and organ function. According to the Academy of Nutrition and Dietetics it is estimated that 30-50% of hospitalized patients can be considered malnourished. Malnutrition can be identified by percentage of weigh lost over a given time, documented low nutrition consumption, and/ or low BMI. However, this information is not always available. Thus, it is also important to recognize the physical signs that a patient is malnourished.

The Sodexo Nutrition Team is strengthening their skills with emphasis on malnutrition diagnosis and care by using nutrition focused physical examinations. These exams are an essential component of practice and provide the opportunity for early identification and treatment of patients that are malnourished upon admit or are at risk for becoming malnourished during their hospitalization.

A few of the physical signs of malnutrition are:

Muscle wasting- which is defined as a decrease in the mass of the muscle; it can be a partial or complete wasting away. Muscle atrophy results from a co-morbidity of several common diseases, including cancer, AIDS, chronic obstructive pulmonary disease, renal failure, anorexia and severe burns. Muscle waiting can be present in many areas including the temporal region, clavicle, deltoid, biceps, quadriceps, and chest.

Reduced grip strength- measurement of hand grip strength has gained attention as a simple, non-invasive way to test muscle strength using a tool known as a dynamometer. Impaired grip strength is an indicator of increased postoperative complications, increased length of hospitalization, and higher re-hospitalization rate. In the elderly, loss of grip strength can mean loss of independence.

Low percent body fat – Essential body fat is necessary to maintain life and reproductive functions. The percentage of essential body fat for women is greater than that for men, due to the demands of childbearing and other hormonal functions. The percentage of essential fat is about 2–5% in men, and 10–13% in women. A number of methods are available for determining body fat percentage, such as measurement with calipers or through the use of bioelectrical impedance analysis.

Other signs physical signs of malnutrition include edema, poor skin turgor, poor dentition, a


nd poor appearance of skin, hair or nails. For more specifics on malnutrition and nutrition focused physical exams visit the Academy of Dietetics and Nutrition, American Society for Parenteral and Enteral Nutrition or Sodexo Nutrition Team at

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