Which Nutritional Screening Tool is Most Commonly Used? A Comprehensive Guide

December 29, 2025 •

3 min read

According to UNICEF data, over a third of households in Pakistan were food insecure in 2018, highlighting the global scale of nutritional risk. A critical step in addressing this is determining which nutritional screening tool is most commonly used to identify at-risk individuals for timely intervention.

Quick Summary

The most appropriate nutritional screening tool varies based on the patient population and clinical setting, with no single universal standard for all adults. Widely used tools like MUST, NRS-2002, and MNA target different groups and environments.

Key Points

Context is King: There is no single most commonly used nutritional screening tool; the choice depends on the patient's age and the clinical setting.
MUST is Versatile: The Malnutrition Universal Screening Tool (MUST) is widely used across different settings, including community and hospital care, for broad-spectrum screening of adults.
NRS-2002 for Hospitals: The Nutritional Risk Screening 2002 (NRS-2002) is the standard recommended by ESPEN for hospitalized adult patients.
MNA for the Elderly: The Mini Nutritional Assessment (MNA) is the most validated and widely used tool specifically for screening malnutrition risk in geriatric patients.
Screening Is the First Step: Effective nutritional screening identifies at-risk patients early, which is the foundation for timely nutritional assessment and intervention.
Benefits Are Broad: Timely screening leads to improved patient outcomes, reduced hospital stays, and lower healthcare costs.

Understanding the Need for Nutritional Screening

Nutritional screening is the initial process of identifying patients who are malnourished or at risk of malnutrition. The timely identification and intervention that follows can significantly improve patient outcomes, reduce complications, shorten hospital stays, and lower overall healthcare costs. However, the landscape of screening tools is diverse, and the best choice is highly dependent on the context.

The Malnutrition Universal Screening Tool (MUST)

Developed by BAPEN, MUST is a five-step tool for adults used across community, care home, and hospital settings. It is effective for broad screening and applicable to most adults. Steps involve calculating BMI, scoring unintentional weight loss and the effect of acute disease, determining an overall risk score, and following management guidelines.

The Nutritional Risk Screening 2002 (NRS-2002)

Recommended by ESPEN for hospital patients, NRS-2002 is designed to predict clinical outcomes and is typically used within 24 hours of admission. An initial screen determines if a full screening is needed. The full screening assesses nutritional impairment, severity of disease, and includes an age adjustment for those 70 or older. A score of 3 or more indicates nutritional risk.

The Mini Nutritional Assessment (MNA)

Validated for individuals aged 65 and above, the MNA is the most widely validated tool for geriatric patients. It has a short form (MNA-SF) for initial screening and a full version for detailed assessment. The MNA-SF asks six questions covering areas like food intake, weight loss, mobility, and BMI, and is used in various settings for older adults.

Other Significant Nutritional Screening Tools

Other tools include the two-question Malnutrition Screening Tool (MST) used in Australia, the Short Nutritional Assessment Questionnaire (SNAQ) and its elderly version SNAQ65+, and the Patient-Generated Subjective Global Assessment (PG-SGA) often used for cancer patients.

Which Nutritional Screening Tool is Most Commonly Used? The Context Matters

No single tool is universally the most commonly used, as guidelines recommend different tools based on the patient population and setting. While NRS-2002 is widely used in hospitals and MUST is popular globally, selecting the tool most appropriate and validated for the specific context is crucial. The GLIM criteria also emphasize using a validated screening tool as a first step in diagnosing malnutrition.

Comparison Table: MUST vs. NRS-2002 vs. MNA


Feature	MUST	NRS-2002	MNA (Short Form)
Target Population	General adults	Hospitalized adults	Geriatric patients (65+)
Primary Settings	Community, hospitals, care homes	Hospitals	Hospitals, care homes, clinics
Key Components	BMI, unintentional weight loss, acute disease effect	BMI, weight loss, food intake, disease severity, age	Food intake, weight loss, mobility, stress, psychological problems, BMI/calf circumference
Scoring	Low, Medium, High risk	Numerical score (0-7), ≥3 is at risk	Numerical score, 0-14, 8-11 is at risk
Administration	By any trained caregiver	By trained nurses or dietitians	By healthcare professionals or self-administered for elderly
Validation	Widely validated in various settings	Strong evidence base for hospital patients	Most validated for the elderly population

Benefits of Nutritional Screening

Systematic nutritional screening offers numerous benefits, including improving clinical outcomes, reducing hospital stays, enhancing quality of life, lowering healthcare costs, and personalizing care by identifying patients needing urgent attention and guiding tailored plans.

How to Choose the Right Tool

Choosing the right tool involves considering the patient population, clinical setting, and required detail. A hospital might use MUST for initial triage and NRS-2002 for admitted adults, while MNA is ideal for geriatric clinics. Staff training is essential for reliable application, and a multi-disciplinary team should collaborate on screening and follow-up.

Conclusion: The Evolving Standard of Care

The most commonly used nutritional screening tool is context-dependent, not a single instrument. MUST is widely adopted for general use, NRS-2002 is strong for hospitals, and MNA leads for the elderly. Proper use of these tools is vital for preventing and managing malnutrition, improving health, and controlling costs. Selecting the appropriate tool for the specific patient and setting is key to making systematic screening a routine part of quality care. Consulting guidelines from professional bodies like ESPEN is recommended for best practices.

Frequently Asked Questions

A nutritional screening is a rapid process to identify patients who are malnourished or at risk of malnutrition. A comprehensive nutritional assessment is a more detailed, in-depth evaluation performed by a dietitian for patients identified as at-risk during the screening.

The MNA is tailored for the geriatric population because it considers factors particularly relevant to older adults, such as mobility issues, cognitive problems, and specific eating habits, making it a highly validated and accurate tool for this age group.

Yes, MUST is designed for use in a variety of settings, including hospitals, care homes, and the community. It is a highly practical and accessible tool for identifying malnutrition risk in adults.

According to ESPEN guidelines, nutritional screening with a tool like NRS-2002 should be performed within 24 hours of a patient's hospital admission.

If a patient is identified as at-risk, a nutritional care plan is initiated. This often involves a more detailed assessment by a registered dietitian, nutritional counseling, and monitoring of intake.

No, there is no single universal tool. The choice of tool should be based on the specific patient population (e.g., adult vs. pediatric, geriatric) and the clinical setting (e.g., hospital vs. community) to ensure the highest validity and accuracy.

The NRS-2002 scores patients based on impaired nutritional status (BMI, weight loss), severity of disease, and age. An additional point is added for patients aged 70 or older.