Malnutrition
Pictures of malnutrition and disease information have been excerpted from the VisualDx® clinical decision support system as a public health service. Additional information, including symptoms, diagnostic pearls, differential diagnosis, best tests, and management pearls, is available in VisualDx.
Synopsis
Malnutrition is defined as any nutritional imbalance (and as such includes overnutrition), but in common use it refers to states of nutritional deficiency of calories, protein, or other nutrients necessary for tissue repair and maintenance.
Malnutrition can occur due to inadequate nutrient intake (inadequate access to nutrients or inadequate intake despite availability, as in anorexia nervosa), increased nutritional demands that outstrip intake (infection, cancer, traumatic injury and burns, other etiologies for inflammation), inadequate or impaired bowel absorption and transport, and altered nutrient utilization by the body.
While inadequate nutritional intake is the most common etiology of malnutrition in the developing setting and remains a significant and often underrecognized issue in the elderly, impaired utilization and increased demand due to inflammation are a more common etiology in the developed world.
Regardless of etiology, malnutrition is associated with both increased morbidity and mortality, and its presence is associated with increased frequency and length of hospitalization and higher health care costs.
No single parameter is definitive for adult malnutrition. Consensus guidelines from the American Society for Parenteral and Enteral Nutrition (ASPEN) define malnutrition as the presence of 2 of the following 6 findings:
- Insufficient energy intake
- Weight loss
- Loss of muscle mass
- Loss of subcutaneous fat
- Localized or generalized fluid accumulation that may mask weight loss
- Diminished functional status measured by hand-grip strength
Specific deficiencies of or impaired utilization of specific micronutrients are also considered malnutrition but are addressed individually and are not within the scope of this topic.
Look For
Look for 2 of the following 6 findings:
- Insufficient energy intake
- Weight loss
- Loss of muscle mass
- Loss of subcutaneous fat
- Localized or generalized fluid accumulation that may mask weight loss
- Diminished functional status measured by hand-grip strength
The full text and image collection is available to VisualDx subscribers.
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