The ‘Nutrition Wheel’ is a new interactive tool we are piloting with volunteers. The tool aims to identify whether someone is at increased risk of undernutrition by asking some simple questions, and then provides some basic advice and signposting to help support the person to improve their nutrition and wellbeing.
In clinical practice, undernutrition should be identified using the ‘Malnutrition Universal Screening Tool’ (‘MUST’). The Nutrition Wheel has been developed primarily for use by non-clinical people who work with older people in the community who may not be accessing traditional health and social care services, such as carers, care workers and volunteers. It provides a framework for having a conversation to explore the factors that could increase someone’s risk of undernutrition in a pro-active way.
The need for an interactive tool originated from a project we undertook using the PaperWeight Nutrition Armband with Age Concern Hampshire volunteers in 2016. The volunteers reported to like using a tool to start a conversation around nutrition. However the armband only measures is someone is already thin, and whilst designed to be used in conjunction with questions to determine recent unintentional weight loss, volunteers were often not always asking these questions and were using the armband in isolation. The questions asked on the Nutrition Wheel have been adapted from the Patients Association Nutrition Checklist, and the Patients Association have been consulted on the development of the Nutrition Wheel. The initial prototype was developed by a group of Adult Nursing and Midwifery students at Bournemouth University as part of their assignment on service improvement. It has since been modified and developed further by the Wessex AHSN with multidisciplinary support, and with support from Nutricia for the printing.
What is undernutrition?
Undernutrition is a form of ‘malnutrition’, which means ‘poor nutrition’. It affects 10-15% of people over 65. Put simply, a person can become undernourished when they don’t eat enough of the right foods to keep them healthy. Undernutrition has serious consequences because the body isn’t getting the right nutrition to work properly. Some consequences of undernutrition include reduced ability to fight infections, reduced mobility, increased risk of falls, poor wound healing and more frequent GP visits and hospital admissions. Undernutrition is not well recognised or treated in the community.
Instructions for using the Nutrition Wheel
- Ask the four questions on the outer edge of the dial. Your can ask the questions in any order
- If ‘yes’ is answered to any of the 'outer' questions, move to the 'inner' questions, and ask these. Your can also ask these questions in any order
- Twist the Wheel so the inner question they answered 'yes' to is aligned to the arrow
- Turn the Wheel back over and the corresponding advice and signposting will be shown in the window below
- If the person answers ‘yes’ to multiple 'inner' questions, the process can be repeated as many times as needed
- If the person answered 'yes' to any of the questions on the outer edge of the Wheel, provide them with the accompanying advice sheet (tear-off pad). You should tick the relevant boxes on the advice sheet and add any relevant local contact details to show the person their personalised advice / next steps. A copy of the accompanying advice sheet is available to download as a PDF from the 'resources' section on this page.
If the person has experienced recent unintentional weight loss, they should be advised to visit their GP or Practice Nurse. If the person is on a special diet or has a condition that may impact on eating (e.g. stroke, cancer, dementia, COPD), encourage them to see their relevant healthcare professional (e.g. GP, Practice Nurse, Dietitian) for more information on how to manage their diet or for reassurance, in addition to giving them practical advice and signposting as highlighted on the tool.
Where can I get more information and resources?
The following organisations produce useful downloadable leaflets and have additional information on undernutrition:
- Wessex AHSN OPEN toolkit - View, download or print the “Eating Well Feeling Good” – a leaflet which provides information on undernutrition identification and treatment and is suitable for anyone to read
- Malnutrition Pathway - View, download or print “Your guide to making the most of your food” – an A4 leaflet which gives simple ideas on how people can get the most nutrition from the food they are eating
- Malnutrition Task Force - View, download or print “Are you eating enough? Advice for older people” – a booklet which provides information about the signs of unhealthy weight loss and what you can do
- Dairy Council - View or download the “Bring it Back” leaflet and/or postcard set. Hard copies can be requested through the website