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Word On Malnutrition in the Community

Our grateful thanks to Consultant Dietitian, Anne Holdoway, Chair of the Managing Adult Malnutrition in the Community Panel (click here to visit the Managing Adult Malnutrition in the Community website) for her input to our 'on-air' radio report which you can hear again via the audio player further down this page.  Our grateful thanks also to NHS Direct for the use of the support information below. 

Malnutrition, NHS Direct tells us, is a serious condition that occurs when a person’s diet doesn't contain the right amount of nutrients. It means "poor nutrition" and can refer to:

  • Undernutrition – not getting enough nutrients
  • Overnutrition – getting more nutrients than you need

As you heard 'on-air' the focus of our radio report and the information on this page relates to undernutrition.

Who is at Risk of Malnutrition.  Malnutrition is a common problem, affecting, as we heard, up to 3 million people across the UK. Anyone can be affected, but it's more common in:

  • People with long-term health conditions that affect appetite, weight and/or how well nutrients are absorbed by the gut, such as Crohn's disease
  • People with swallowing problems
  • People who are socially isolated, have limited mobility or have a low income
  • People who need extra energy, such as those with cystic fibrosis, those recovering from a serious injury or burns, and those with tremors (uncontrollable shaking)
  • Elderly people are particularly at risk, and weight loss is not an inevitable result of old age.

Your GP can check if you're at risk of malnutrition by measuring your weight and height, ask about any medical problems you have, and about recent changes in your weight or appetite.

If they think you could be malnourished, they may refer you to a healthcare professional such as a dietitian to discuss treatment.

The Clinical Consequences of Malnutrition (according to the Managing Adult Malnutrition in the Community Panel) are:

  • Impaired immune response
  • Reduced muscle strength
  • Impaired wound healing
  • Impaired psycho-social function
  • Impaired recovery from illness and surgery
  • Poorer clinical outcomes

The Common Signs of Malnutrition, NHS Direct tell us, include:

  • Unintentional weight loss – losing 5-10% or more of weight over three to six months is one of the main signs of malnutrition
  • A low body weight – people with a body mass index (BMI) under 18.5 are at risk of being malnourished (use the BMI calculator to work out your BMI)
  • Lack of interest in eating and drinking
  • Feeling tired all the time
  • Feeling weaker 
  • Getting ill often and taking a long time to recover
  • In children, not growing at the expected rate or not putting on weight as would normally be expect

When to see your GP:

  • If you've unintentionally lost a lot of weight over the last three to six months
  • If you have other symptoms of malnutrition
  • If you're worried someone in your care, such as a child or elderly relative, may be malnourished
  • If you're concerned about a friend or another family member, try to encourage them to see their GP

Treatments for Malnutrition depend on the underlying cause and how malnourished the person is. They may be given advice, to follow at home, or they may be supported at home by a dietitian or other qualified healthcare professional. In severe cases, treatment in hospital may be needed.

Dietary Changes and Supplements. A dietitian will advise about dietary changes that can help. They may create a tailored diet plan that ensures the person gets enough nutrients. They may also suggest:

  • Having a healthier, more balanced diet
  • Eating "fortified" foods that contain extra nutrients
  • Snacking between meals
  • Having drinks that contain lots of calories
  • Getting home supermarket deliveries

Some people also need support to help with underlying issues such as limited mobility – for example, care at home or occupational therapy. If a child is malnourished, their family may need advice and support to address the underlying reasons why this may have happened.

If these initial dietary changes aren't enough, a doctor, nurse or dietitian may also suggest taking extra nutrients in the form of nutritional drinks or supplements. If the person has difficulty eating that can't be managed by making changes such as eating soft or liquid food, other treatments may be recommended.

Preventing Malnutrition. The best way to prevent malnutrition is to eat a healthy, balanced diet.

You need to eat a variety of foods from the main food groups, including:

  • plenty of fruit and vegetables
  • plenty of bread, rice, potatoes, pasta and other starchy foods
  • some milk and dairy foods
  • some meat, fish, eggs, beans and other non-dairy sources of protein

See the NHS Direct Eatwell Guide for more information about the types of food that should make up your diet and the proportions you should eat them in.

Cost Implications of Malnutrition.  According to the Managing Adult Malnutrition in the Community Panel, the healthcare cost of managing individuals with malnutrition is more than twice that of managing non-malnourished individuals, due to higher use of healthcare resources.

Listen to this weeks radio report

All material on this website is provided for your information only and may not be construed as medical advice or instruction. No action or inaction should be taken based solely on the contents of this information; instead, readers should consult appropriate health professionals on any matter relating to their health and well-being.