MUST: Malnutrition Universal Screening Tool

Screen for adult malnutrition risk. Free to use.

nutrition, general 3 items Updated 2026-05-06

Score MUST below → Download printable PDF View source paper (DOI)
What is MUST? MUST (Malnutrition Universal Screening Tool) is a validated instrument used to assess screen for adult malnutrition risk. It comprises 3 items.

What is MUST?

MUST (Malnutrition Universal Screening Tool) is a validated clinical instrument used to assess screen for adult malnutrition risk. The instrument contains 3 items.

Source / attribution: BAPEN (British Association for Parenteral and Enteral Nutrition), 2003.

Clinical context: when MUST is used

The instrument's primary construct — screen for adult malnutrition risk — is operationalized through a fixed set of items, each with a defined response format. This standardisation is what allows MUST scores to be compared meaningfully across clinicians, sites, and studies.

Like all screening or assessment instruments, MUST is a structured aid — not a diagnostic test in isolation. Results should be interpreted alongside history, examination, and clinical context. Where a score crosses an actionable threshold, the next step is typically a more detailed clinical evaluation rather than a definitive diagnosis.

Score MUST

Answer all 3 items below to see your MUST score and interpretation.

Each item is scored on a 3-point scale (0–2). Your score updates live as you answer.

All scoring runs in your browser. No data is sent anywhere — close the tab and the answers are gone.

How MUST is scored

MUST uses simple summation: each item's selected response is converted to a numeric value, and the values are added to produce a total score. Reverse-scored items are inverted before summation.

MUST score interpretation

The cutoffs below are drawn from the published validation literature. Always interpret in clinical context.

Score rangeBandInterpretation
0–0Low riskRoutine clinical care; repeat screening per protocol.
1–1Medium riskDocument dietary intake for 3 days; repeat in 1 week.
2–6High riskRefer to dietitian / nutrition team; manage underlying cause.

How to score MUST: a step-by-step worked example

This is an illustrative walkthrough, not a real patient. Follow the same four steps with your own answers — or use the live calculator at the top of this page.

Step 1 — Score each item

Read each question and choose the response that best fits. Each response has a number next to it — that number is the item's score. The example below uses illustrative answers.

#ItemExample responseScore
1BMI (kg/m²)> 20 (or > 30 obese)0
2Unplanned weight loss in past 3–6 months< 5 %0
3Acute disease effect — patient acutely ill AND no nutritional intake (or likely none) for > 5 days?No0

Step 2 — Add up the scores

Add up all the item scores you noted in Step 1.

0 + 0 + 0 = 0

Step 3 — Look up the band

Find the row in the interpretation table whose range contains your total:

Total = 0 falls between 0 and 0Low risk

Step 4 — What does this mean clinically?

Low risk. Routine clinical care; repeat screening per protocol.

A score is one input alongside history and examination. MUST supports clinical judgment — it does not replace it.

Score MUST with your own answers above →

Limitations & common pitfalls

How MUST compares to other nutrition scales

If MUST doesn't fit your context, related instruments in nutrition include:

ScaleMeasuresItemsTime
MNA-SFMalnutrition risk in older adults6
FINDRISC10-year risk of developing type 2 diabetes8
PHQ-9Severity of depression9≈ 3 minutes
GAD-7Severity of generalized anxiety7≈ 2 minutes
AUDIT10-item WHO screening tool for hazardous alcohol consumption and dependence.10≈ 3 min
CHA2DS2-VAScAnnual stroke risk in non-valvular atrial fibrillation8
Glasgow Coma ScaleLevel of consciousness after head injury3
MELD-Na3-month mortality in advanced liver disease; transplant prioritization5

Frequently asked questions about MUST

What does MUST measure?

MUST (Malnutrition Universal Screening Tool) is a validated instrument that assesses screen for adult malnutrition risk.

How many items are on MUST?

MUST contains 3 items. Items are summed to produce a total score.

What is a high MUST score?

Scores of 2–6 fall in the "High risk" band. Refer to dietitian / nutrition team; manage underlying cause.

What is a low MUST score?

Scores of 0–0 fall in the "Low risk" band. Routine clinical care; repeat screening per protocol.

Is MUST free to use?

Yes — MUST is in the public domain and free for clinical, educational, and research use without permission.

What is the source paper for MUST?

Stratton RJ et al. 'Malnutrition Universal Screening Tool' predicts mortality and length of hospital stay in acutely ill elderly. Br J Nutr. 2006;95(2):325-330.

Can MUST replace clinical judgment?

No. MUST is a structured assessment aid. A score is one input alongside history, examination, and clinical context. Treatment decisions should never rest on a screening score alone.

References & validation

MUST is supported by the following peer-reviewed sources: