Screen for adult malnutrition risk. Free to use.
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.
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.
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.
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.
The cutoffs below are drawn from the published validation literature. Always interpret in clinical context.
| Score range | Band | Interpretation |
|---|---|---|
| 0–0 | Low risk | Routine clinical care; repeat screening per protocol. |
| 1–1 | Medium risk | Document dietary intake for 3 days; repeat in 1 week. |
| 2–6 | High risk | Refer to dietitian / nutrition team; manage underlying cause. |
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.
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.
| # | Item | Example response | Score |
|---|---|---|---|
| 1 | BMI (kg/m²) | > 20 (or > 30 obese) | 0 |
| 2 | Unplanned weight loss in past 3–6 months | < 5 % | 0 |
| 3 | Acute disease effect — patient acutely ill AND no nutritional intake (or likely none) for > 5 days? | No | 0 |
Add up all the item scores you noted in Step 1.
0 + 0 + 0 = 0
Find the row in the interpretation table whose range contains your total:
Total = 0 falls between 0 and 0 → Low risk
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.
If MUST doesn't fit your context, related instruments in nutrition include:
| Scale | Measures | Items | Time |
|---|---|---|---|
| MNA-SF | Malnutrition risk in older adults | 6 | — |
| FINDRISC | 10-year risk of developing type 2 diabetes | 8 | — |
| PHQ-9 | Severity of depression | 9 | ≈ 3 minutes |
| GAD-7 | Severity of generalized anxiety | 7 | ≈ 2 minutes |
| AUDIT | 10-item WHO screening tool for hazardous alcohol consumption and dependence. | 10 | ≈ 3 min |
| CHA2DS2-VASc | Annual stroke risk in non-valvular atrial fibrillation | 8 | — |
| Glasgow Coma Scale | Level of consciousness after head injury | 3 | — |
| MELD-Na | 3-month mortality in advanced liver disease; transplant prioritization | 5 | — |
MUST (Malnutrition Universal Screening Tool) is a validated instrument that assesses screen for adult malnutrition risk. It is designed for clinicians, medical students, evidence-synthesis researchers. The 3 items are summed to produce a total score.
MUST contains 3 items. Item scores are summed to produce the total. Scores run from 0 to 6, grouped into 3 interpretation bands from ‘Low risk’ up to ‘High risk’.
On the MUST (total score 0–6), scores of 2–6 fall in the ‘High risk’ band — interpreted as: Refer to dietitian / nutrition team; manage underlying cause. The full ladder is: 0 — Low risk: Routine clinical care; repeat screening per protocol.; 1 — Medium risk: Document dietary intake for 3 days; repeat in 1 week.; 2–6 — High risk: Refer to dietitian / nutrition team; manage underlying cause. A higher score reflects a more severe presentation, and crossing a cutoff is a prompt to step up assessment or care — but these bands are screening thresholds, not diagnoses.
Scores of 0 fall in the ‘Low risk’ band: Routine clinical care; repeat screening per protocol. A low score is reassuring but does not by itself rule out the underlying condition — if symptoms or clinical suspicion persist, reassess over time or use a complementary evaluation rather than relying on the number alone.
Yes — MUST is in the public domain and free for clinical, educational, and research use without permission. You can use this calculator and the scale itself freely; if you publish results or reproduce the scale, cite the original source paper.
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. This is the original publication for the MUST — the reference to cite when reporting results.
No. MUST is a structured assessment aid, not a diagnostic test. Its proper role is clinical assessment of screen for adult malnutrition risk — it standardizes assessment and flags who needs closer evaluation, but the result must be weighed alongside history, examination, and clinical context. When a score conflicts with your clinical impression, clinical judgment takes precedence; treatment decisions should never rest on a screening score alone.
MUST is supported by the following peer-reviewed sources: