Malnutrition is often an issue that is overlooked and not considered as serious. It is not a clinical priority when there are other medical concerns. However, research has taught us that individuals heal much better when they are properly nourished [1].
How can your body be expected to properly mend and repair itself when it does not have adequate nutrients to do so? For instance, zinc plays a big role in wound healing and protein helps to repair and build cells. Additionally, you need energy to fuel these processes. Nutrition is also important in building up the immune system – decreasing the risk of contracting further infections. We will discuss this in more detail below.
Statistics
- At least one in three Australian hospital patients are malnourished
- One study of a Melbourne hospital showed that 90% of their patients were malnourished or at risk of being malnourished [2]. Only 15% of these patients were acknowledged as being malnourished by the hospitals staff. Under half of these patients were referred to a dietitian [2].
- In 2002-2003 30-40% of public hospital patients in QLD were malnourished – 20% were severely malnourished [1].
- Malnutrition increases as the hospital length of stay increases [1].
- In residential aged care, between 40 – 70% of residents are malnourished [3].
- In the community, between 8 – 30% of people are malnourished [3].
What are the associated risks with malnutrition?
- Increased risk of infection or rate of infection [1].
- Increased risk of other complications e.g. falls, sepsis, deterioration of mental health. Hospital patients or those on bed rest are at double the risk of developing a pressure sore if they are malnourished – this will be hard to heal in the malnourished individual due to their increased energy and protein requirements and inadequate nutrition intake [1].
- Limits the positive outcomes and effects of treatments [1].
- Can decrease quality of life and life expectancy.
Who is at risk?
The elderly population are those who suffer most from malnutrition. Many elderly people in the community are malnourished. If they are admitted to hospital, malnourishment often worsens. The risk can be lessened or eliminated with dietetic input.
However, it is also important to note that not only the elderly or those who are underweight are at risk of being malnourished. Someone who is overweight or obese can also be malnourished if they are not getting a variety of healthy foods and/ or they have lost a large amount of weight in a short time period. You can still get excessive amounts of kilojoules without adequate nutrients.
Some of the people most at risk of malnutrition include:
- The elderly
- Those with Poor appetite secondary to taste changes, depression, disease, decreased activity levels, dysphagia.
- Individuals who struggle to open packaging or to prepare food.
- People with increased requirements e.g. cancer, HIV, wound healing, burns, post surgery.
- Those with malabsorption e.g. people who have had bowel resections.
- Those who have poor access to food or that cannot afford it.
- Individuals with drug or alcohol addiction.
- Individuals who eat only a very limited number of foods.
Signs of malnutrition
- Loss of fat/ muscle stores – a hollowed or gaunt look can result
- Unintentional weight loss
- Decreased oral intake and loss of appetite
- Prolonged nausea/vomiting / diarrhoea
How is malnutrition diagnosed?
A dietitian can assess whether an individual is malnourished or at risk of malnutrition. They can then develop an appropriate nutrition intervention that will prevent further deterioration and work towards building a person back up.
The assessment process will involve the collection of relevant patient histories and a quick ‘hands off’ physical assessment. A screening tool must also be completed by the dietitian that will indicate the severity of malnutrition.
If you have an elderly relative, it might be a good idea to check on what they are eating. Many elderly people will eat far below their energy and protein requirements and will often eat no more than two small meals per day.
References
- Queensland Dietitians. Malnutrition: The Skeleton In the Hospital Closet [internet]. 2013 [Cited 2014 Nov 4]. Available from: Malnutrition inservice for nursing, medical and allied health
- Wiley-Blackwell. Malnutrition: A skeleton in the health care closet. ScienceDaily. ScienceDaily, 8 February 2011. Available from Malnutrition: A skeleton in the health care closet – ScienceDaily.
- Dietitian Association of Australia. Preventing and treating Malnutrition in Older Australians: Pre-Budget Submission 2013-2014. Dietitians Association of Australia. Canberra; 2013.
Contact us for results focused nutritional advice
This article was written by our dietitian Belinda Elwin, who is a Dietitians Association of Australia member and Accredited Practising Dietitian and Nutritionist.
If you have questions about healthy eating, make an appointment. We‘ll provide you with a simple and effective routine targeted to your concerns. Contact us today.
