Nutritional factors figure prominently in the pathogenesis of
coronary heart disease, cancer, stroke, and type 2 diabetes—diseases
that account for more than half of all deaths in the United States.
Dietary habits also play an extensive role in other causes of morbidity
and mortality, including hypertension, obesity, and osteoporosis.
This situation is compounded by the epidemic of obesity in the United
States, which is expected to cause sharp increases in the incidence
of chronic illness. In recognition of the serious health implications
of obesity, current definitions of “malnutrition” include
states of overnutrition as well as conditions marked by nutritional
The link between nutritional status and health risk extends beyond
chronic disease to include acute illness. Surveys place the incidence
of malnutrition among hospitalized patients between 30% and
55%. Malnutrition increases the risk of adverse clinical
outcomes of hospital stays. In short, poor nutrition increases the
risk of becoming ill, and when illness does strike, malnutrition complicates
treatment and impairs recovery.
|Negative Effects of Malnutrition on Clinical Outcome|
- Greater susceptibility to infectious complications
- Reduced immune competence
- Poor skin integrity
- Delayed wound healing
- Higher incidence of surgical complications
- Prolonged need for mechanical ventilation
- Increased mortality
- Extended length of stay, higher health care costs
As the interplay between nutritional status and illness has become
better understood, nutritional assessment has taken on greater importance
in clinical care. By integrating nutritional assessment into the
evaluation of all patients, clinicians not only identify malnutrition
but also uncover risk factors for chronic disease and unfavorable
clinical outcome, determine nutritional requirements, recognize
people likely to benefit from nutritional support, and establish
a framework for developing a therapeutic plan.
No single assessment technique has the validity to serve as the
sole indicator of nutritional status. Nutritional assessment is
a comprehensive process that combines objective data with relevant clinical
information. Evaluate body composition, anthropometric measurements,
and results of laboratory tests, and use the data in the context
of the patient’s history, physical examination findings,
and clinical condition to make decisions concerning nutritional
Body weight is a reliable indicator of nutritional status. Details
concerning body weight include deviation of weight from ideal level,
change in weight over time, and relation between weight and height.
Body weight 20% over or under the ideal level places a
patient at nutritional risk. Numerous methods for determining ideal
body weight exist, but the Hamwi formula is the most widely used
in clinical settings because the calculation is simple and provides
a reasonable estimate of ideal body weight:
|Formula for Determining Ideal Body Weight|
|Men: 106 lb for 5 ft of height plus 6 lb for every inch of
height over 5 ft|
|Women: 100 lb for 5 ft of height plus 5 lb for every inch ...|
Pop-up div Successfully Displayed
This div only appears when the trigger link is hovered over.
Otherwise it is hidden from view.