MUST: Malnutrition Universal Screening Tool
Calculator suite (1)
The Malnutrition Universal Screening Tool (MUST) is a screening tool provided by BAPEN: the British Association for Parenteral and Enteral Nutrition. It is used to identify adults, who are malnourished, at risk of malnutrition (undernutrition), or obese. It also includes management guidelines which can be used to develop a care plan.
Click on the answer to each question below, then click on calculate.
Current Weight
If weight cannot be measured, use a weight recently documented in the notes or use self-reported weight (if reliable and realistic) – see BAPEN MUST explanatory booklet.
Heaviest available weight 3-6 months ago
Use a weight documented in their notes or use self-reported weight (if reliable and realistic.)
How to assess nutritional status if height, weight or BMI cannot be obtained – see BAPEN MUST explanatory booklet.
Does the patient have oedema (swelling caused by fluid)?
Is the oedema?
How weight is adjusted for oedema
Mild – subtract 1.0 kg;
Moderate – subtract 5.0 kg;
Severe – subtract 10.0 kg.
From BDA Parenteral and Enteral Nutrition Specialist Group: A pocket guide to clinical nutrition. 5th edn, 2018.
Was the oedema present when the heaviest available weight 3-6 months ago was recorded?
Does the patient have any amputations?
Adjustment for amputation
If the patient is an amputee, select missing limb segments
How score is adjusted for amputees – from BAPEN MUST explanatory booklet.
Was the weight loss planned or unplanned?
If the patient is an amputee, your answer should refer only to any additional weight loss over and above the amputation weight loss, as the calculation adjusts original weight to take account of amputation.
Estimating BMI if neither height nor weight cannot be measured – from BAPEN MUST explanatory booklet.
Date current height measured
Acute Disease Effect (ADE)
Select yes if acutely ill and if there has been or is likely to be no nutritional intake for more than 5 days. Note that ADE is unlikely to occur outside hospital.
'Acutely ill' includes critical illness, swallowing difficulties (e.g. after stroke), head injuries, or undergoing gastro intestinal surgery.
BAPEN Malnutrition Action Group (MAG), Elia, M. (2003). The ‘MUST’ report. Nutritional screening of adults: a multidisciplinary responsibility. Development and use of the ‘Malnutrition Universal Screening’ Tool (‘MUST’) FOR ADULTS.
BAPEN Malnutrition Action Group (MAG) (2003). The ‘MUST’ explanatory booklet. A guide to the ‘Malnutrition Universal Screening Tool’ (‘MUST’) for adults.
Use of the MUST tool is advocated by:
- The Care Inspectorate Best Practice Standards and Guidance on Food, Fluid and Nutrition for Care Homes for Older People (2014).
- Healthcare Improvement Scotland Food, Fluid and Nutritional Care Standards (2014).
NHS Inform: Malnutrition
Product Name: Calculator Suite
Calculator Name: Malnutrition Universal Screening Tool (MUST)
Calculator Version: v2.0.0
InnoScot Health
272 Bath Street
Glasgow
Scotland
G2 4JR
Calculators are not intended to be used by members of the public as a substitute for professional advice.
