Prevalence and Predictors of Malnutrition Risk among Saudi Adults on Home Enteral Nutrition: A Cross-Sectional MUST-Based Study

Background: Home Enteral Nutrition (HEN) is an essential therapeutic option for patients unable to meet their nutritional needs orally. While it supports long-term care, malnutrition remains a common complication in community and home-based settings. Objective: To determine the prevalence of malnutrition risk and its predictors among Saudi adults receiving HEN using the Malnutrition Universal Screening Tool (MUST). Methods: A cross-sectional study of 210 Saudi adults (≥18 years) on HEN was conducted across three cities. Data collection included structured interviews, home visits, and medical records. Nutritional risk was assessed using MUST. Group comparisons used chi-square/Fisher’s exact tests for categorical data and Kruskal-Wallis tests for non-normal continuous variables. Multinomial logistic regression (low-risk reference) identified independent predictors of malnutrition risk. Results: Malnutrition risk was high, with 65.7% (95% CI: 59.3–72.1) classified as high risk, 27.1% (95% CI: 21.1–33.2) as low risk, and 7.1% (95% CI: 3.7–10.6) as medium risk. Lower BMI and greater unintentional weight loss were the strongest predictors of higher MUST risk (p<0.001). Acute illness (>5 days no intake) was exclusively observed in the high-risk group. Age and gender were not significant predictors in multivariable models. Conclusion: Malnutrition is highly prevalent among Saudi adults on long-term HEN, with BMI, weight loss, and acute illness emerging as the most important predictors. These findings highlight the importance of routine nutritional screening, individualized feeding strategies, and consistent dietitian follow-up to reduce malnutrition risk in this population.