CRITERIA FOR MALNUTRITION IN ADULTS
Check to determine if one of the following types of malnutrition is present.
PROTEIN DEFICIENT (260)
The following criteria must all be met:
a. serum albumin < 2.5 gm/dL*
b. weight has been maintained
c. peripheral edema by physical examination
CALORIE DEFICIENT (261)
The following criteria must all be met:
a. patient is 20% below usual weight or
significant history of weight loss can be
documented
b. overt muscle wasting is present (prominence
of body skeleton especially in extremities
and chest cavity)
c. serum proteins are maintained; serum
albumin > 2.9gm/dL*
A patient is deemed to have a significant history of weight loss if the following percent of
weight is lost in the given time period.
% Loss of UBW
1 - 2%
5%
7.5%
10%
1/18/2006
PROTEIN-CALORIE DEFICIENT
(262)
The following criteria must all be met:
a. patient is 20% below usual weight
or significant history of weight loss
documented
b. serum albumin < 2.9gm/dL*
c. overt signs of muscle wasting are
present
MODERATE MALNUTRITION
(263)
Two of the following criteria must be
met:
a. serum albumin 2.5 – 2.9 gm/dL*
b. weight is 70-79% of IBW
c. weight is 75-84% of usual weight
MILD MALNUTRITION (263.1)
Two of the following criteria must be
met:
a. serum albumin > 2.9 to 3.4gm/dL*
b. weight is 80 to 89% of IBW
c. weight is 85 to 95% of usual weight
Time Period
1 week
1 month
3 months
6 months
*Serum albumin as measured at UMMC by Bromocresol Green reagent methodology:

Normal  3.5 to 4.9 g/dl

Malnourished:
Mild > 2.9 but  3.4 g/dl
Moderate  2.5 but  2.9 g/dl
Severe < 2.5 g/dl

Clinical conditions in which albumin may not be valid indicator of visceral protein status
include:
1) Liver disease
2) Post-op state
3) Infection
4) Nephrotic Syndrome
5) Fluid imbalance.

Use of clinical judgment is required in these cases.

1/18/2006
Functional Health Physical Assessment – Nutrition/Metabolic Section
NUTRITION/METABOLIC
Height: Weight: lbs. □ see 24 hour flowsheet
Diet: □ Regular □ Special □ weight loss □ cal. ADA diet □ salt restricted □ low
fat/cholesterol □ other
Appetite: □Good □ Fair □ Poor Recent unintentional weight gain (how much? lbs.)
*Refer to RD for focused assessment within 24 hours if any of the following are present:
Ate less than half of usual meals/snacks during past week? □ Yes
Appears malnourished or recent unplanned weight loss (how much? lbs.) □ Yes
On Tube-feeding or TPN/PPN? □ Yes
Pressure ulcers/wounds/burns/fistulas present? □ Yes
Pregnant/lactating? □ Yes

1/18/2006