EDUCATIONAL PAPER Basic concepts in nutrition: Diagnosis of malnutrition e Screening and assessment Karin Barendregt a , Peter B. Soeters b , Simon P. Allison c , Jens Kondrup d, * a Academic Hospital Maastricht, Maastricht, The Netherlands b Department of Surgery, University Hospital Maastricht, Maastricht, The Netherlands c Department of Surgery, University of Nottingham, Nottingham, UK d Nutrition Unit-5711, Rigshospitalet University, 9 Blegdamsvej, 2100 Copenhagen, Denmark Received 5 February 2008; accepted 8 February 2008 KEYWORDS Nutritional screening; Malnutrition; Assessment; Anthropometry; Body mass index; Bioelectrical impedance Learning objectives e To be familiar with nutritional screening e To understand different methods used for the nutri- tional assessment e To know limitations of different method for nutritional assessment Malnutrition goes largely undiagnosed and untreated par- ticularly among hospital patients. This is mainly due to lack of nutritional training and awareness among staff, but also to lack of proper protocols for screening, assessment and action. Screening Screening should be a simple and rapid process, which can be carried out by busy admitting nursing and medical staff. It should be sensitive enough to detect all or nearly all the patients at nutritional risk. There are some advantages in registering disease severity as well as nutritional status since the two interact. Moderate malnu- trition may be more significant in the presence of severe disease. It should be capable of being scored numerically and audited, and should lead to appropriate and explicit action. Most screening tools address four basic questions: re- cent weight loss, recent food intake, current body mass index and disease severity or some other measure of predicting risk of malnutrition. In 2003, ESPEN published * Corresponding author. E-mail address: espenjournals@espen.org (Editorial Office). 1751-4991/$ - see front matter ª 2008 Published by Elsevier Ltd on behalf of European Society for Clinical Nutrition and Metabolism. doi:10.1016/j.eclnm.2008.02.004 e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism http://intl.elsevierhealth.com/journals/espen e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism (2008) 3, e121ee125