Risk Factors for Nutritional Deficiencies

Neither the basic NICE guidelines alone nor even detailed dietary assessment will detect all of those who have significant nutritional deficiencies.

The more detailed NICE publication Nutrition Support for Adults: Oral Nutrition Support, Enteral Tube Feeding and Parenteral Nutrition (reference here and see footnote on page 70) details other clinical situations that give doctors cause for concern about a patient’s nutrition state including:

• fragile skin
• poor wound healing
• apathy
• wasted muscles
• poor appetite
• altered taste sensation
• impaired swallowing
• altered bowel habit
• loose fitting clothes
• Persistent intercurrent illness.   

These and other well-defined clinical situations suggest a high probability of nutritional deficiencies developing or being present are covered below or are dealt with in the section Symptoms of Nutritional Deficiency. 

As a general rule the risk of an individual having one or more nutritional deficiencies rises steeply as the number of risk factors increase.

Common Risk Factors for Nutritional Deficiencies

• The Extremes of Life - Infants
• The Extremes of Life - The Elderly
• Feeding or Swallowing Difficulties
• Socio-Economic Deprivation
• Anaemia
• Heavy Menstrual Blood Loss
• Pregnancy
• Alcohol Excess
• Smoking
• Other Chronic Diseases
• Medical Drug Use
• Genetic Variations in Nutrient Metabolism
• Persistent Diarrhoea
• Persistent Vomiting

This list covers many but by no means all situations of increased risk of nutritional deficiency.

More information on The Four Uses of the Essential Nutrients can be found here.