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Malnutrition Universal Screening Tool (MUST)

MUST is a validated screening tool developed by the British Association for Parenteral and Enteral Nutrition (BAPEN). It assesses malnutrition risk through a three-step process:



  1. Body Mass Index (BMI): Patients are categorized based on their BMI, with lower scores indicating a higher risk of malnutrition.
  2. Percentage Weight Loss: This assesses unintentional weight loss over the past three to six months, which is a critical indicator of nutritional decline.
  3. Acute Disease Effect: This evaluates the impact of any acute illness on nutritional intake, which can exacerbate malnutrition risk.

Each parameter is scored from 0 to 2, allowing for a cumulative score that classifies patients into low (0), medium (1), or high (≥2) risk categories for malnutrition.



Step Criteria Score
BMI Calculation BMI > 20 kg/m² 0 points

BMI 18.5–20 kg/m² 1 point

BMI < 18.5 kg/m² 2 points
Weight Loss Percentage Weight loss < 5% (in the past 3-6 months) 0 points

Weight loss 5-10% 1 point

Weight loss > 10% 2 points
Acute Disease Effect Acutely ill, with no nutritional intake for > 5 days 2 points
Total MUST Score Add scores from BMI, Weight Loss, and Acute Disease Effect -

0 points: Low risk Routine care, annual review

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