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Nutrition is a basic need in life and therefore plays an important role in promoting health and preventing disease. Nutritional screening and its control mechanisms (eg appetite, satiety) are very complex physiological processes.

The underlying disease can directly alter nutritional intake and can induce metabolic and/or psychological disorders, which increase nutritional requirements or reduce food intake. Frequent problems such as chewing and swallowing problems, immobility and side effects of drugs and poly-pharmaceuticals should not be underestimated in this regard.

Malnutrition should be viewed and treated as a complementary disease, as it has been shown to worsen clinical outcomes and increase morbidity, mortality and complication rates, thereby incurring additional costs. However, malnutrition is preventable and usually reversible with adequate early nutritional therapy.

Nutritional screening
Nutritional risk screening tools are very useful in the daily routine for the early detection of potential or manifest malnutrition. These tools must be easy to use, fast, inexpensive, standardized and validated. Screening tools should be both sensitive and specific and, if possible, predictive of the success of nutritional therapy. Nutrition screening should be part of a defined clinical protocol that leads to an action plan if the screening result is positive.

MNA is the most frequently used screening tool for institutionalized geriatric patients. Combine screening and assessment functions. The MNA includes several components (loss of appetite, alteration of taste and smell, loss of thirst, frailty, depression) often relevant to the nutritional status of the elderly. It also includes anthropometric measurements, eating habits, general condition and self-assessment.

Nutrition screening should be performed within the first 24 to 48 hours of hospitalization and at regular intervals thereafter (eg, weekly), to quickly and accurately identify those who should be referred to the nutritionist (eg, dietitian, medical expert) for further evaluation. Nutrition screening should include dynamic rather than static parameters, such as recent weight loss, current body mass index (BMI), recent food intake, and disease severity.

The evaluation of the quality of life is a more subjective parameter which is increasingly integrated into the nutritional evaluation. It reflects current health status and can be used as an outcome parameter to monitor nutritional therapy. It is based on the perception of well-being.

Conclusions
Malnutrition is a common threat in hospitals and is associated with negative outcomes. However, it remains a generally treatable condition when there is adequate nutritional management. It is essential to identify patients who are at nutritional risk or who are malnourished as early as possible, allowing rapid and effective nutritional support to be put in place.