MUST: Malnutrition Universal Screening Test
Malnutrition: what is it, Risk Involved, Treatment and A tool for self-assessment
In the name of being a common ailment, malnutrition gets easily overlooked, which sometimes can cause severe disease or may delay recovery or decay the immunity strength of the body. Malnutrition is definitely fervent in a poor socio-economy group, people with good income are also not the exception.
Research shows that knowledge about SAM (Severe Acute Malnutrition) management protocol is not satisfactory even among nurses working in hospitals.
What is it?
It is a pathological state, which is an outcome of either absolute or relative deficiency or excess of one or more essential nutrients. In simple words, too much or too little consumption of nutrients.
Am I malnourished?
Who can be called malnourished? Am I malnourished? Let’s check it out.
Malnourishment is of four types:
- Undernutrition: This is a pathological condition resulted when an inadequate amount of food is eaten over an extended period of time, results in the decrement of physical and mental growth and low immunity. Wasting & Stunting are major sub-form of undernutrition.
- Wasting: This is low-weight-for-age, due to eating an insufficient amount of food or loss in weight due to some disease.
- Stunting: This is low-height-for-age. This happens usually due to low maternal nutrition and lack of proper care, which hinders one’s physical as well as cognitive potential.
2. Overnutrition: This is a pathological state, resulted due to consumption of excessive quantity of food over an extended period of time. Obesity and metabolic syndrome are it’s sub-form.
BMI (Body Mass Index) is a common method to classify obesity and overweight. It is the weight (in Kg) divided by the square of height (in m²). For an adult BMI 25 is overweight, 30 and beyond is obesity. Below, I have explained it in detail.
3. Imbalance: In this pathological state, one suffers from the disproportion of nutrients without absolute deficiency. Most of us suffer from it, which is usually resulted due to a lack of balance diet and proper care of the body. An “Immuneaty” diet and a healthy lifestyle can help us improve it.
4. Specific deficiency/surplus: In this pathological state, one suffers from an absolute deficiency of any one or more individual nutrient. This can be as alarming as being the cause of some degenerative diseases like cancer and as normal as hair loss or low eye-sight. Today poor nutrition is a major risk factor for several diets-NCD (Non-Communicable Disease) like heart stroke, high BP, etc. Deficiency of Iron, Iodine, Vit-A, and Vit-C is most commonly found, especially in children and pregnant women.
By the way, how is it going to affect me?
To answer this question, I would introduce here, MUST, and let you assess yourself. An easy self-analysis “MUST” (Malnutrition Universal Screening Test) tool to calculate your risk level to malnutrition:
Please note, this is a universally accepted tool used by Doctors for all kinds of patients.
MUST has good reliability and validity with respect to nutritional assessment in hospitalized patients and oncology outpatients.¹
MUST have better specificity over other methods like SNAQ (Short Nutritional Assessment Questionnaire) or SGA (Subjective global assessment)². However, there is no single tool to screen malnutrition with perfect accuracy.
Let’s understand MUST: 5 Steps
Step 1: Calculate BMI (Body Mass Index)
BMI = (Your weight in kg)/(Your height² in m²)
Do it on your own or use this calculator.
BMI Categories:
Critically Underweight<15
Underweight = <18.5
Normal weight = 18.5–24.9
Overweight = 25–29.9
Obesity Class-1 = 30–35
Obesity Class-2 = 35–40
Obesity Class-3 <40
Based on it, now give a score of 0 for normal weight, 1 if underweight or overweight, 2 for obesity or critically underweight
Step 2: Weight loss
The unplanned weight loss is riskier than poor BMI. To score it, watch your weight loss pattern in the last 3–6 months. If the weight loss is
Weight loss <5%, it is normal, give a score 0
Weight loss 5–10%, it is the precursor of malnutrition, score 1
Weight loss >10%, It is now clinically significant, score 2
Step 3: Identify the loss of appetite due to an acute physical or mental disease
If you are currently affected by an acute pathophysiological or psychological condition, and there has been no nutritional intake or likelihood of no intake for more than 5 days, you are likely to be at nutritional risk. Add score 2 in this case.
Step 4: Overall risk of malnutrition
Add scores together from Steps 1, 2, and 3 to calculate the overall risk of malnutrition.
0 = low risk, 1 = medium risk, 2 or more = high risk
What is the treatment?
If you score 0, congratulations! Let’s keep it up. Keep eating the “Immuneaty” diet and regular exercise.
If it is 1, Oh, you are at risk! Please watch your plate, it is not balanced with all essential nutrients. Soon contact a certified nutritionist.
If it is 2 or more, please don’t delay you may be at an early stage of development of low immunity or maybe some chronic disease, please consult your physician at earliest.
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