Nutritional Status Assessment in Adults

Updated: Sep 25, 2020
  • Author: William Aaron Hood, DO; Chief Editor: Vikram Kate, MBBS, MS, PhD, FACS, FACG, FRCS, FRCS(Edin), FRCS(Glasg), FFST(Ed), FIMSA, MAMS, MASCRS  more...
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An assessment of nutritional status in adults may include a comprehensive evaluation consisting of a tailored history and physical examination, laboratory assessment, anthropometrics, body composition, and functional data. [1, 2]

No single variable accurately and reliably relays nutritional status of a subject in every situation. Validated screening tools are available for use in certain populations.

Poor nutritional status has been known to have unfavorable effects. Individuals with less than 80% expected total body protein levels have demonstrated increased morbidity, and 10% or greater unintentional weight loss has been associated with adverse outcomes and prolonged hospitalizations. In lean healthy subjects, weight loss over 35%, protein loss over 30%, and fat loss over 70% from baseline has been associated with death. [3]  A systematic review of 7 studies with 16 biomarkers showed that there was a significant association between the nutritional assessment score and albumin level. [4]

A review article on management of nutrition in hospitalized patients highlighted the importance of individualizing nutrition plans and adequate support by nutritional risk screening for patients during the time of admission and subsequent detailed assessment of patients at risk of malnutrition for better outcome. [5]

A systematic review of 29 studies with 6,298 free living adults and a mean of 107 participants was carried out to evaluate the validity of dietary assessment methods used to estimate the energy intake (EI) and total energy expenditure (TEE). The results showed under-reporting of EI (P < 0.05) when compared to TEE. [6] Accurate quantification of EI is vital for interpreting the relationship between diet and chronic disease. 



Measurement of nutritional status in adults has no absolute indications. The importance of nutritional assessment becomes apparent during acute illness, in which malnutrition has been associated with increased morbidity and mortality. Identification of malnourishment and appropriate intervention may improve outcomes.



Assessment of nutritional status in adults has no specific contraindications. However, owing to the cooperation required, hydrodensitometry may not be suitable for subjects who are physically challenged, children, or elderly persons. Additionally, bioelectrical impedance analysis (BIA) should not be performed in subjects with pacemakers.