Nutrition

Adequate calories do not guarantee adequate nutrition. Repeated fatigue and infections may indicate poor intake or absorption of protein and micronutrients such as iron, folate, vitamin B12, vitamin A, vitamin C, zinc, or vitamin D. Assessment should therefore examine dietary quality, protein sources, symptoms, medical causes, and relevant clinical or laboratory evidence.

Hidden hunger refers to deficiency of essential vitamins and minerals that may occur even when energy intake and body weight appear normal. Weight mainly reflects body mass and cannot reliably show micronutrient stores or dietary quality. Identification therefore requires dietary history, clinical signs, biochemical tests when appropriate, and consideration of risk factors for deficiency.

When appetite is poor, the patient may be unable to eat large portions, so every portion should provide useful nutrients. Nutrient-dense foods can supply more protein, vitamins, minerals, and energy in a small volume; examples may include fortified milk, yoghurt, eggs, pulses, nut pastes, or other clinically suitable foods. The plan must still consider tolerance and medical restrictions.