Malnutrition: how common is it, and what can you do? 

Malnutrition is something most of us associate with developing countries. However, it occurs right around Australia and is more common than you think. 

What is malnutrition 

According to the World Health Organisation, “malnutrition refers to deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients”. 

In short, this means that the body doesn’t receive enough nutrients for it to function properly, and under that definition both under-nutrition and over-nutrition (overweight and obesity) are classified as malnutrition. 

In Australia, one group of people who are most at risk of being undernourished are the elderly. 

Nutritional deficiencies can cause a host of problems, including: 


  • impaired immune function 
  • muscle atrophy (loss of muscle mass, strength and function) 
  • poor wound healing 
  • increased risk of osteoporosis, recurrent falls and fractures 
  • frailty

 

What do the statistics say? 

It’s estimated that anywhere between 10 to 44 per cent of older Australians are at risk of malnutrition, while a third of Australians aged over 65 who are admitted to hospital are malnourished. Of those living in residential care, between 20 to 65 per cent are malnourished and almost 75 per cent are at risk. Up to 10 per cent of older adults living at home are likely to be malnourished and a further 35 per cent are also at risk.. 

What causes it? 

Malnutrition in the elderly can be caused by a number of things, including medical, physical and social, and physiological reasons:

  • Medical - depression, poor dentition (condition of teeth), difficulty swallowing, side effects of medication, dementia, and chronic illness
  • Physical and social - social isolation and loneliness, financial problems 
  • Physiological - loss of smell and taste, and early satiety (feeling full early). 

In addition, because their energy needs are lower, many elderly people eat less food than they did when they were younger, despite their requirements for some nutrients such as protein and calcium being higher 


What are the signs and symptoms 

  • weight loss and loose-fitting clothes 
  • fragile or pale skin 
  • hair loss
  • mental confusion 
  • poor wound healing 
  • muscle wasting 

 

Diagnosing malnutrition can be complex and needs to be done by a health professional. Blood tests may also identify any specific nutrient deficiency. If someone you care about is at risk of malnutriton, speak to your health professional.  

It's important that anyone diagnosed with malnutrition receives prompt treatment, and anyone at risk should take steps to improve their nutritional intake. 

Treating malnutrition usually involves a team of health professionals including dietitians, nurses, hospital doctors and GPs, and of course anyone caring for someone who is malnourished. 

 

Improving nutritional intake 

The key to improving nutritional intake is to eat a wide variety of foods to meet nutritional needs. It’s important to ensure adequate amounts of protein, vitamins and minerals, and kilojoules are included as part of a healthy eating plan.

A convenient and effective way to meet nutritional requirements is to include high energy and high protein nutritional supplements in the diet. These can be convenient and effective, particularly if mood and/or appetite is low. Good nutritional supplements for seniors include protein powders, such as Beneprotein, oral supplements such as Forticreme, and liquid nutrition meals like Ensure Plus Juice. Taking micronutrient supplements can also help when levels of particular nutrients (e.g. vitamin A, vitamin C and vitamin D) are low.

Other tips to improve nutrition in the elderly and the sick include: 

 

    • eating small, frequent meals and snacks throughout the day
    • consuming full-cream milk between meals 
    • adding more oil, cream or margarine to food when cooking 
    • fortifying foods with skim milk powder 
    • adding grated cheese to cooked foods 
    • using flavour enhancers to make food tastier 
    • ensuring that food suits chewing and swallowing ability 
    • ensuring nourishing snacks are readily available and easy to access or prepare. 

 

Please note the information supplied is general in nature. Please consult your medical practitioner for individual advice.


References 

Charlton, Karen and Walton, Starvation in the land of plenty  https://theconversation.com/starvation-in-the-land-of-plenty-why-australians-are-malnourished-27640

Charlton, KE, Nichols, Bowden S, Lambert K, Barone L, Mason M, Milosavljevic M, Older rehabilitation patients are at high risk of malnutrition: Journal; of nutrition, Health & Ageing, Volume 14, No. 8, October 2010, pp 622-628

Dietitians Association of Australia, Malnutrition - who is at risk and things to consider https://daa.asn.au/smart-eating-for-you/smart-eating-fast-facts/medical/malnutrition-who-is-at-risk-and-things-to-consider/

Royal Australian College of General Practitioners, Managing undernutrition in the elderly: Prevention is better than cure, Psychological strategies, Volume 41, No. 9, September 2012, pp 659 - 699 https://www.racgp.org.au/afp/2012/september/managing-undernutrition-in-the-elderly/