There are times when a person can suffer from an imbalance in their normal nutritional state because they are not ingesting the essential micro and macro nutrients needed to satisfy their dietary requirements.

Normally we, personally, do not detect these nutritional deficiencies. And if we go to the doctor it�s because we feel tired, depressed, lacking in appetite or we have some health problem. In these cases, if the GP suspects poor nutrition to be the cause, as well as examining the patient, he or she may request specific biochemical tests and analyses, such as a proteinogram, to be able to find out the possible causes of the malnutrition.

However, a GP is more likely to refer the patient to an endocrinologist or nutritionist. Or in some very critical situations they may send the patient to the nearest hospital.

Tests to establish the degree of malnutrition
A problem of malnutrition is treated with personalised tests which consist of assessing the patient�s anthropometric parameters (weight, height, BMI [body mass index] skinfold thickness and circumferences), and biochemical parameters (e.g. albumin to creatinine ratio) to analyse the status of visceral and muscle protein and the immune system (lymphocyte count). The patient will also fill out a dietary questionnaire. The result of all these tests will determine the type and degree of malnutrition and will provide the basis for the treatment required to combat it.

Risk groups
There are large group of people who, due to certain illnesses or even their social situation are particularly prone to malnutrition:
� Old people suffering from some illness or some psychological disorder and living alone and unattended. As many as 71% of this group may suffer from malnutrition.
� Alcoholics and drug addicts. 56% are affected.
� Post operative patients who are in intensive care units for a period of time. 39% affected.
� Chronic and cancer patients. 41%.
� Anorexic. 50%.

How to prevent malnutrition
Malnutrition can be prevented by having the right dietary habits. The key is not to go hungry, to eat small amounts up to five times a day, and never miss a meal so as not to call on our food reserves. In that case we would have to take some vitamin supplements, explains Dr. David Mariscal, expert in nutrition. Conclusion: you should eat a little of everything.

Diets should be strictly personal. Let�s imagine two people who both weigh 84 kilos and are 1.70m tall, one is 23 and the other 54; one plays basketball every day and walks for half an hour; one is in the peak of good health and the other has a heart condition. How are they going to need the same diet?, asks Basilio Moreno, head of Endocrinology and Nutrition in the Madrid Gregorio Mara��n hospital.

Where to get information
� Vila-Rovira Institute
Dra. Montse Folch. Tel. 933 93 31 28
� Cl�nica Mariscal
Tel. 915 76 45 48
� Dr. Basilio Moreno�s surgery
Tel. 914 46 96 10
� Dr. Susana Monereo�s surgery
Tel. 914 11 55 72
� Catalonian Institute of Endocrinology
Tel. 934 18 17 75
� Association for the Promotion of the Mediterranean Diet
Tel. 934 03 45 41

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