Malnourishment versus Underweight

[Guest guest]

When looking at patients who have a low BMI but lab work is all normal would you

classify them as malnourished or just underweight?

For example: 66 YO F, ht of 63 " weight of 40.2kg BMI: 15.6. All labs are WNL,

minus glucose whish is slightly elevated. Albumin is 4.5, prealbumin 21,

CRP:0.5. This is a pt in our Psych are related to hallucinations Which of

course can play a role in her intake during her episodes.

Would you call her malnourished or underweight?

[Guest guest]

How are you prepared to prove " malnourished " ?

Digna Cassens, MHA, RD

Cassens Associates - Diversified Nutrition Management Systems

facebook.com/cassensassociates

PO Box 581

La Habra, CA 90633

NOW AVAILABLE on Amazon.com - Flavorful Fortified Foods - Recipes to Enrich

Life - a collection of 60 high calorie, high protein, easy to prepare

recipes for home or facility use by Digna Cassens and Eck Mills

From: rd-usa [mailto:rd-usa ] On Behalf Of

G

Sent: Wednesday, August 01, 2012 11:21 AM

To: rd-usa

Subject: Malnourishment versus Underweight

When looking at patients who have a low BMI but lab work is all normal would

you classify them as malnourished or just underweight?

For example: 66 YO F, ht of 63 " weight of 40.2kg BMI: 15.6. All labs are

WNL, minus glucose whish is slightly elevated. Albumin is 4.5, prealbumin

21, CRP:0.5. This is a pt in our Psych are related to hallucinations Which

of course can play a role in her intake during her episodes.

Would you call her malnourished or underweight?

[Guest guest]

How are you prepared to prove " malnourished " ?

Digna Cassens, MHA, RD

Cassens Associates - Diversified Nutrition Management Systems

facebook.com/cassensassociates

PO Box 581

La Habra, CA 90633

NOW AVAILABLE on Amazon.com - Flavorful Fortified Foods - Recipes to Enrich

Life - a collection of 60 high calorie, high protein, easy to prepare

recipes for home or facility use by Digna Cassens and Eck Mills

From: rd-usa [mailto:rd-usa ] On Behalf Of

G

Sent: Wednesday, August 01, 2012 11:21 AM

To: rd-usa

Subject: Malnourishment versus Underweight

When looking at patients who have a low BMI but lab work is all normal would

you classify them as malnourished or just underweight?

For example: 66 YO F, ht of 63 " weight of 40.2kg BMI: 15.6. All labs are

WNL, minus glucose whish is slightly elevated. Albumin is 4.5, prealbumin

21, CRP:0.5. This is a pt in our Psych are related to hallucinations Which

of course can play a role in her intake during her episodes.

Would you call her malnourished or underweight?

[Guest guest]

I used the nutrition diagnosis of underweight. Our doctor noted mild

malnutrition mainly all based off BMI since all the other lab " indicators " are

WNL

From: rd-usa [mailto:rd-usa ] On Behalf Of Digna

Cassens

Sent: Wednesday, August 01, 2012 12:25 PM

To: rd-usa

Subject: RE: Malnourishment versus Underweight

How are you prepared to prove " malnourished " ?

Digna Cassens, MHA, RD

Cassens Associates - Diversified Nutrition Management Systems

facebook.com/cassensassociates

PO Box 581

La Habra, CA 90633

NOW AVAILABLE on Amazon.com - Flavorful Fortified Foods - Recipes to Enrich

Life - a collection of 60 high calorie, high protein, easy to prepare

recipes for home or facility use by Digna Cassens and Eck Mills

From: rd-usa <mailto:rd-usa%40yahoogroups.com>

[mailto:rd-usa <mailto:rd-usa%40yahoogroups.com>] On Behalf Of

G

Sent: Wednesday, August 01, 2012 11:21 AM

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

Subject: Malnourishment versus Underweight

When looking at patients who have a low BMI but lab work is all normal would

you classify them as malnourished or just underweight?

For example: 66 YO F, ht of 63 " weight of 40.2kg BMI: 15.6. All labs are

WNL, minus glucose whish is slightly elevated. Albumin is 4.5, prealbumin

21, CRP:0.5. This is a pt in our Psych are related to hallucinations Which

of course can play a role in her intake during her episodes.

Would you call her malnourished or underweight?

[Guest guest]

A person with anorexia may have long term low BMI and stable " normal " nutrition

related labs (body normalizes).

 

If possible to get a weight history - wt loss could indicate " malnourishment " ,

while long term low BMI is probably just " underweight " . 

 

Look at skin integrity, hair, finger nails, loose folds of skin, obvious

cachecia as signs of " malnourishment " .  How about diet history for quality of

food intake?  i.e. If living on alcohol or chips, even if normal weight, to me

that is an indication of " malnourishment " .

Holly

----------

Holly Lee Brewer, MS RD

Pediatric Dietitian, Diabetes Educator

Medical Nutrition Therapist, Las Vegas, NV

Maj Holly Brewer, USAFR BSC

301st MDS, NAS Fort Worth JRB (Carswell), TX

http://hollyinbalad.blogspot.com

>To: rd-usa

>Sent: Wednesday, August 1, 2012 11:21 AM

>Subject: Malnourishment versus Underweight

>

>

> 

>When looking at patients who have a low BMI but lab work is all normal would

you classify them as malnourished or just underweight?

>

>For example: 66 YO F, ht of 63 " weight of 40.2kg BMI: 15.6. All labs are WNL,

minus glucose whish is slightly elevated. Albumin is 4.5, prealbumin 21,

CRP:0.5. This is a pt in our Psych are related to hallucinations Which of course

can play a role in her intake during her episodes.

>

>Would you call her malnourished or underweight?

>

>

>

>

>

[Guest guest]

I think you did the right thing using underweight. Malnutrition is not

easily proven and it's a term much thrown around. If in a real pinch I use

the term undernourished which is less troublesome to me.

Digna Cassens, MHA, RD

Cassens Associates - Diversified Nutrition Management Systems

facebook.com/cassensassociates

PO Box 581

La Habra, CA 90633

NOW AVAILABLE on Amazon.com - Flavorful Fortified Foods - Recipes to Enrich

Life - a collection of 60 high calorie, high protein, easy to prepare

recipes for home or facility use by Digna Cassens and Eck Mills

From: rd-usa [mailto:rd-usa ] On Behalf Of

Green

Sent: Wednesday, August 01, 2012 11:25 AM

To: 'rd-usa '

Subject: RE: Malnourishment versus Underweight

I used the nutrition diagnosis of underweight. Our doctor noted mild

malnutrition mainly all based off BMI since all the other lab " indicators "

are WNL

From: rd-usa <mailto:rd-usa%40yahoogroups.com>

[mailto:rd-usa <mailto:rd-usa%40yahoogroups.com> ] On Behalf

Of Digna Cassens

Sent: Wednesday, August 01, 2012 12:25 PM

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

Subject: RE: Malnourishment versus Underweight

How are you prepared to prove " malnourished " ?

Digna Cassens, MHA, RD

Cassens Associates - Diversified Nutrition Management Systems

facebook.com/cassensassociates

PO Box 581

La Habra, CA 90633

NOW AVAILABLE on Amazon.com - Flavorful Fortified Foods - Recipes to Enrich

Life - a collection of 60 high calorie, high protein, easy to prepare

recipes for home or facility use by Digna Cassens and Eck Mills

From: rd-usa <mailto:rd-usa%40yahoogroups.com>

<mailto:rd-usa%40yahoogroups.com> [mailto:rd-usa

<mailto:rd-usa%40yahoogroups.com> <mailto:rd-usa%40yahoogroups.com>] On

Behalf Of

G

Sent: Wednesday, August 01, 2012 11:21 AM

To: rd-usa <mailto:rd-usa%40yahoogroups.com>

<mailto:rd-usa%40yahoogroups.com>

Subject: Malnourishment versus Underweight

When looking at patients who have a low BMI but lab work is all normal would

you classify them as malnourished or just underweight?

For example: 66 YO F, ht of 63 " weight of 40.2kg BMI: 15.6. All labs are

WNL, minus glucose whish is slightly elevated. Albumin is 4.5, prealbumin

21, CRP:0.5. This is a pt in our Psych are related to hallucinations Which

of course can play a role in her intake during her episodes.

Would you call her malnourished or underweight?