Unit 3 - Diet and nutritional treatment approach for dysphagia

3.1. Basics of nutrition on dysphagia condition

3.1.3.2. Identifying malnutrition in patients with dysphagia

Early referral to the clinical nutritionist has a pivotal importance in halting the progressive nature of malnutrition and allowing close monitoring of patients’ weight and oral intake and the tolerability of the prescribed diet.

Health professionals must do nutrition screening to detect patients at risk of malnutrition.

The clinical nutritionist carries out a full nutritional status assessment and the results determine the dietary counselling and/or treatment.



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  • Nutritional status screening:

Nutritional status screening ...

    • is a process to identify an individual who is malnourished or at risk of being malnourished.

    • is used to determine whether a full nutrition assessment is indicated.

    • is generally completed by someone other than the nutrition provider.

Malnutrition risk screening (MNRS) tools …

  • should be quick, simple, and easy to use

  • a certain degree of validity, agreement, and inter-rater reability in identifying malnutrition risk is necessary

  1. MNRS for adults:

  • MST – Malnutrition Screening Tool

  • MUST – Malnutrition Universal Screening Tool


  1. MNRS for elderly:

  • MNA – Mini Nutritional Assessment


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  1. Paediatric MNRS:

  • STAMP – Screening Tool for Assessment of Malnutrition in Paediatrics.

  • PNST – Paediatric Nutrition Screening Tool.








  • Nutritional status assessment:

Nutritional status assessment ...

  • is used to determine the nutritional status of individual or population groups as influenced by the intake and utilization of nutrients

  • can be defined as the interpretation from dietary, laboratory, anthropometric, and clinical studies.

An easy way to remember the components of the nutritional status assessment is:



  1. ANTHROPOMETRIC ASSESSMENT:

Consists in the measurement of the size, weight and proportions of the body.




The most common measurements are weight, height, perimeters and skin folds.


  1. BIOCHEMICAL ASSESSMENT:

Uses laboratory measurements of serum protein, serum micronutrient levels, serum lipids, and immunological parameters to assess general nutritional status and to identify specific nutritional deficiencies. Urine and stools samples may also be analysed.





  1. CLINICAL ASSESSMENT:

The estimation of nutritional status on the basis of recording a medical history and conducting a physical examination to detect signs (observations made by a qualified observer) and symptoms (manifestations reported by the patient) associated with malnutrition. Some sociodemographic and psychological factors related to nutritional status are also collected.






  1. DIETARY ASSESSMENT:

It provides information on dietary quantity and quality and the results are compared with recommended intake.

Several common methods to assess dietary intake exist: 24h-recall, food-frequency questionnaires and food weighted records