Prevalence of malnutrition in patients in general practice

The objective of this study was to determine the prevalence and correlates of malnutrition in patients living at home with cancer and chronic diseases. Patients (213) with cancer and 228 patients with chronic diseases were randomly selected from general practice registers. Nutritional status was determined from body mass index (BMI in kg/metre2), triceps skinfold thickness (TST), mid-arm muscle circumference (MAMC) and population centiles. Patients were classified as mildly malnourished if they had a BMI < 20 and TST or MAMC < 15th centile, moderately malnourished if they had a BMI < 18 and TST or MAMC < 5th centile, and severely malnourished if they had a BMI < 16 and TST or MAMC < 5th centile. Using these criteria, nearly 10% of patients were malnourished: 24 (5.4%) mildly, 12 (2.7%) moderately and 4 (0.01%) severely. Malnutrition was more common in patients in social classes 3.2, 4 and 5 than in social classes 1, 2 and 3.1 (P = 0.003), and in patients receiving district nurse care (P < 0.001). Malnutrition was more prevalent in cancer patients who complained of chronic or severe pain (32% vs 12%, P = 0.021) and in patients with chronic disorders who experienced mental apathy (22% vs 5%, P = 0.014). Clinicians need to be aware that malnutrition is common in patients living at home. In this study BMI proved to be a fairly good indicator of malnutrition and routine measurement of BMI would be one simple way of detecting patients who are at risk.