Moreover, he had severe nutritional problems despite an apparently normal BMI, with calf circumference measuring 29.5 cm (which is below the normal reference values), serum albumin levels of 3.1 g/dL (normal value above 4.0 g/dL), and the Mini Nutritional Assessment (MNA) scoring 8/14, suggesting overt malnutrition. This evidence concerns the gene ALB and nutritional deficiency disease.