Conducting a Nutritional Assessment

The Importance of Early Diagnosis in Effective Nutrition Management

Nutritional assessment is typically defined as “a comprehensive approach to determining nutritional status using medical, nutritional, and medication histories; physical examination, anthropometric measurements and laboratory data.”1,2,3

Once nutritional risk screening has indicated the patient is at risk of malnutrition, a more in-depth evaluation of the causes of hospital malnutrition and the risk factors for nutrition and fluid deficiency should be conducted. Nutritional assessment is critical to fully understand the patient’s condition, thus allowing for the development of a specific nutrition care plan.

Assessment Parameters: What Dietitians Should Look For

Relevant assessment parameters, which should be evaluated in detail, include anthropometric parameters, disease and treatment-related risk factors such as nausea, dehydration, diarrhea, acute infections; social and psycho-social risk factors such as depression and social isolation; and nutrition-related risk factors such as allergies and restrictive diets. Biochemical data are also a useful, objective, and readily available means to assess nutritional status and nutritional risk.

Biochemical parameters for the assessment of protein malnutrition include the measurement of:

Subjective Global Assessment

Subjective Global Assessment (SGA) is a nutritional non-invasive questionnaire that has been found to be highly predictive of nutrition-associated complications. SGA considers alterations in body composition and changes in physiological function. SGA is performed considering the following factors:5,6

If a patient receives an SGA “A” rating, they are considered well nourished. An SGA “B” rating indicates a moderately malnourished patient, an SGA “C” rating indicates a severely malnourished patient.

Assessment of Food and Fluid Intake

Food intake as well as the ability to metabolize food can deteriorate during treatment or during a stay in a hospital or nursing home. Documentation of foods and fluid intake can be useful from admission to discharge. The data can be used to define the individual nutrition therapy plan by calculating the needed nutritional supplementation and needed fluid substitution of the patient.

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