Signs of Malnutrition

A young girl is checked for signs of malnutrition in Sindh, Pakistan. April 2012 - Photo Credit: Wikipedia

Although largely considered synonyms, there is a marked distinction between signs and symptoms. A symptom is a subjective term used to define the changes felt by patients as consequence of a disease. A sign is an objective term because it encompasses the changes that can be measured by physicians (Lee and Bishop, 2012). There is a gray area where a sign can be a symptom and vice versa, but it is not common to all cases. In this sense, the majority of malnutrition symptoms, especially the most severe ones, can be classed as signs. In the early stages, though, these can only be associated to malnourishment by a medical professional. The same can be said for other signs of malnutrition, such as nutrient deficiencies.

NUTRITIONAL ASSESSMENT: EVALUATING SIGNS OF MALNUTRITION

As mentioned above, the symptoms and signs of malnutrition can be easily mistaken for other diseases. This has led to the preparation of a nutritional assessment when evaluating the possibility of malnutrition. The assessment consists of:

• Historical information: Encompasses obtaining information regarding the patient's socioeconomic, health and diet status. These factors reflect the intake and use of nutrients, as well as the potential presence of congenital diseases that could impair proper nutrient absorption. The socioeconomic status sheds light on food availability for the patient.
• Anthropometric measurements: Evaluates signs of malnutrition by taking the patient's weight and height measurements and comparing them to pre-existing standards for their age. Also, measurements taken periodically reveal patterns and trends in the patient's nutrition.
• Physical examinations: Visual inspections of hair, eyes, skin, nails and tongue can be useful, as most overt signs of malnutrition are found in these parts. In addition to this, an interview with the patient to reveal other symptoms is in order. Physical examinations might reveal more than one nutrient imbalance, so it is necessary to perform other tests.
• Laboratory tests: Useful in confirming suspicions that arise from previous assessments. Laboratory tests of blood and urine samples also help to uncover signs of malnutrition before the symptoms have developed.

The results of each of these four steps are analysed in correlation to the others in order to present a conclusion.

SIGNS OF MALNUTRITION

The primary signs of malnutrition are nutrient deficiencies. As said by Whitney and Rolfes (2015) using the example of iron deficiency, the lack of certain nutrients is asymptomatic at first and therefore cannot be detected by physical examinations or noticed by the patient until its later stages, thus making urine and blood tests compulsory for an early diagnosis. The following table is adapted from one found on Stewartnutrition.org, as well as information found on Healthline.com. It shows the signs of malnutrition (i.e. nutrient deficiencies) as well as the symptoms they carry in their acute stages.

Signs of malnutrition classed in nutrient deficiencies and the symptoms they carry