Nutrition Screening: You May Be Surprised What You'll Find

Nutrition screening should be performed by a specialist (e.g., a dietitian) using subjective and objective parameters such as clinical history, physical examination, body composition measurements, functional assessment, and laboratory values.

A set of laboratory parameters in the clinical routine (e.g., complete blood count, lipid profile, electrolytes, liver parameters) may provide valuable information about a patient’s nutritional status (e.g., proof of nutrient deficiency, information about the etiology of malnutrition, follow-up nutritional therapy), about the severity and activity of the disease, and about changes in body composition.

Laboratory values—particularly in chronically malnourished patients—may help to detect deficiencies in vitamins (C, D, E, K, thiamin, B6, B12, and folate) and trace elements (zinc, selenium, and iron) and help to monitor current substitution therapies. In the early phase of refeeding, potassium, phosphate, and magnesium deficiencies may occur, potentially leading to severe complications (e.g., refeeding syndrome); hence, there is a need for close monitoring of these electrolytes.

Physical examination is an objective method of detecting clinical signs and symptoms of nutritional deficiencies of vitamins and minerals (e.g., poor muscle control, night vision impairment, vertical lip cracks, depression), and allows the assessment of tolerance to nutritional support (e.g., abdominal distention, vomiting, diarrhea).

Some clinical signs are specific to a specific disease or nutrient deficiency. Others are non-specific and need further tests to elucidate their etiology (Table 6). Physical examination includes the control of vital parameters, the inspection and palpation for water retention (edema and ascites), and a rough assessment of muscle mass and subcutaneous fat stores.

  Compartment models of body composition.

Whole Foods Checklist 

Don't forget a basic checklist of the most important foods to consume:

• Fruits, including berries, grapes, citrus, olives, etc.

• Vegetables, including leafy greens, cruciferous vegetables,

  orange/yellow vegetables, onions, garlic, etc.

• Herbs and spices, including basil, oregano, rosemary, parsley, turmeric, cumin, ginger, etc.

• Nuts, including almonds, walnuts, pistachios, etc.

• Seeds, including cacao, chia, flax, pumpkin, hemp, etc.

• Whole grains as tolerated, including oatmeal, non-GMO corn, etc.

• Legumes as tolerated, including peanuts, non-GMO soybeans, lentils, black beans, etc.

• Clean lean protein, including organic poultry and eggs, grass-fed beef and dairy, seafood, etc.

• Omega-3 sources, including salmon, sardines, and occasionally tuna.

• Fermented foods, including yogurt, cheese, kefir, sauerkraut, etc.

• Hydrate with plenty of pure alkalized water and healthy beverages, including organic coffee, tea, homemade alkaline lemon-limeade, etc.

A sustainable Mediterranean-style diet is a healthy choice: