Malnutrition and undernutrition

The term malnutrition is used to describe a deficiency, excess or imbalance of a wide range of nutrients, resulting in measurable adverse effects on body composition, function and clinical outcome.1 As such it can refer to individuals who are either over- or under-nourished although it is frequently used synonymously with undernutrition, as is the case in this article. Although it is well known that malnutrition is common in the developing world, the fact that significant malnourishment occurs in UK society and health settings is not widely appreciated. Malnutrition occurs for psychosocial reasons and as a consequence of disease. It has direct effects on clinical outcomes and is associated with massive healthcare expenditure. Recognition and treatment can have a significant impact on patient care and can reduce costs. Failure to diagnose and manage carries medico-legal risks. It is the responsibility of all doctors to recognize the fundamental importance of proper nutritional care to good clinical practice.2 The focus of this article is predominantly concerned with malnutrition and its consequences in the UK.