What is the Nutrition Focused Physical Exam

By Barbara Gordon, RDN, LD
Physical Examination

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Did you know that pale skin and spoon-shaped nails might be a physical sign of iron deficiency? Or, that weight gain may be related to fluid buildup in body tissues and determined by touch?

Like other health practitioners, registered dietitian nutritionists, or RDNs, can perform a physical exam. The Nutrition Focused Physical Exam, or NFPE, is a physical exam that RDNs perform to assess nutritional status or evaluate malnutrition. This exam may be part of your nutrition assessment when you meet with an RDN

Step 1: Getting Started

Before conducting the physical exam, the RDN will make sure you have privacy and are comfortable. He or she will explain to you what to expect during the exam.

Step 2: Conducting the Exam

During the exam, the RDN looks for signs of nutrient deficiencies and malnutrition. How in-depth the exam is can vary based on the setting. For example, the exam may be more extensive in the hospital. In an outpatient setting, the RDN may do a shorter version of the NFPE.

There are several areas an RDN may check during your exam, which may serve as indicators of your nutrition status. Some examples include:

  • Muscle or grip strength
  • Scalp, hair, mouth, skin and nail health
  • Appearance and feeling of different body parts, including the arms, legs, chest, back and face
  • Signs of fluid retention or dehydration 

Step 3: Interpreting the Findings

The RDN will share the findings of your exam with you and the health care team. The RDN will also discuss any recent changes in your eating patterns or weight. Based on this assessment, the RDN may recommend further testing or make specific recommendations to meet your nutrition needs.

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