Did you know that on average between 10 to 44 percent of older Australians are at risk of malnutrition, while a third of Australians over 65 admitted to hospital are malnourished? And 4 in 10 residents of Residential Aged Care (RAC) facilities in Australia are malnourished with only 37.5% of adults with intellectual disability reported having a healthy Body Mass Index? On top of that, research shows that 55% of adults aged 18 and over with disability were eating less than the recommended nutrients each day.
Malnutrition is a serious condition that occurs when an individual is receiving poor nutrients to the body. This can be due to diet, health conditions (such as cancer or liver disease) as well as mental and/or physical impairments that inhibit cognitive functions (like dementia) that can cause unbalanced diets, digestive issues, gastrointestinal issues, gastroesophageal reflux, and other feeding difficulties (such is the case when an adult may have Crohn’s disease or ulcerative colitis).
Research has shown that adults with Intellectual Disability are at higher risk of developing diseases associated with poor nutrition, and also show that malnutrition and poor nutrition can affect cardiovascular health and may lead to coronary heart disease, hypertension, and diabetes melitus, as well as an increased risk of falls, infection and pressure wounds.
Common Symptoms of Malnutrition in Adults
When an adult is malnourished, they tend to lose weight although this can be difficult to notice unless specifically monitored. It’s also important to remember that it’s possible to be a healthy weight or even overweight and still be malnourished. Some key indicators that an adult may be malnourished are:
- Unintentionally losing 5 to 10% of your body weight within 3 to 6 months
- A Body Mass Index (BMI) under 18.5
However, unintentional weight loss is not the only symptom of malnutrition in adults. According to the National Health Service (NHS), there are several common symptoms of malnutrition in adults to be aware of.
- Reduced Appetite
- Lack of Interest in Food and Drink
- Fatigue or Excessive Tiredness
- Feeling Weakness
- Taking A Long Time To Recover After Illness
- Wounds Take A Long Time To Heal
- Poor Concentration
- Constant Cold Feeling
-
Low Mood
The Critical Role of Early Diagnosis in Malnutrition
Early diagnosis and risk assessment that leads to immediate action and treatment of malnutrition in adults will help prevent various health conditions, including type 2 diabetes, cardiovascular disease and some forms of cancer.
In addition, ageing related health conditions can be improved, prevented or the decline in health slowed by eating a nutrient rich diet.
Essential Treatments for Malnutrition in Adults
Treatment for malnutrition heavily depends on the underlying cause and how malnourished an individual is. Certain advice can be followed at home or further support from healthcare professionals may be required (such as a dietician or other qualified healthcare practitioner). In severe cases, treatment in a hospital may be required. The below outline some simple ways to treat malnutrition in adults.
Dietary Changes and Supplements
A simple way to improve nutritional intake is to eat a wide variety of nutrient-rich foods. Meals should contain a good blend of protein, vitamins and minerals in line with the Australian Dietary Guidelines, which provide evidence-based recommendations on nutritional requirements such as food groups and dietary patterns.
It’s also important to remember that older people have higher protein and energy requirements. This means that introducing dietary changes and nutritional supplements (such as oral nutritional supplements) and other nutrition products can help make up for their higher energy and protein intake needs.
Scheduled Eating
A technique known as “eating by the clock” is one of the easiest ways to establish a routine for someone whose appetite has decreased or for an individual who requires mental prompts to eat. It involves eating six small meals at the same time everyday on a schedule to maintain a consistent diet and avoid potential under-feeding / missed meals.
Nutritional Supplement Drinks & Fortified Foods
Incorporating nutritional products and supplements is a simple way to ensure that someone is getting the nutrients that they need. Another option is to add more fortified foods into the dietary rotation that contain extra nutrients, proteins and energy. Nutritional supplements should only be taken on the advice of a healthcare professional.
Medical & Emotional Support Services
Adults who are malnourished may need extra care and support services to help them cope with underlying issues causing the condition. Causes can be things like limited mobility due to injury or disability whereby support is offered through services like occupational therapists, at-home meal delivery services and speech and language therapy (for those who have swallowing problems).
It’s also important to seek care and support services to address the cause of why malnutrition may have developed. This can be either in the form of visiting an allied health professional such as a dietician or an exercise physiologist, who can create a specific dietary plan or exercise routine to be followed. Those who suffer from chronic disease may also be eligible for up to 5 subsidised sessions with an allied health professional.
Feeding Tubes and Enternal Feeding
If an individual is unable to eat enough to meet their body’s needs (such as with feeding and/or swallowing difficulties) then looking into alternative feeding options may be required. Feeding tubes can be utilised either nasogastrically (through the nose) or with a percutaneous endoscopic gastrostomy (PEG) tube.
Conclusion
Malnutrition is a serious condition that affects a significant percentage of older Australians and that can lead to various health conditions. Early diagnosis and treatment is critical to preventing long-term health issues associated with malnutrition in adults. With dietary changes, the incorporation of nutritional supplements and scheduled daily eating, the prevention of malnutrition can be achieved.
Sources
BMJ Nutrition, Prevention & Health. (January 10, 2024). Are children with disabilities more likely to be malnourished than children without disabilities? Evidence from the Multiple Indicator Cluster Surveys in 30 countries. https://nutrition.bmj.com/content/early/2024/01/10/bmjnph-2023-000779
Tropical Medicine & International Health. (August 27, 2018). The association between malnutrition and childhood disability in low-and-middle income countries; systematic review and meta-analysis of observational studies. https://onlinelibrary.wiley.com/doi/10.1111/tmi.13139
Harvard Health Publishing. (June 1, 2022). The truth about nutrient deficiencies. https://www.health.harvard.edu/nutrition/the-truth-about-nutrient-deficiencies
Nutrients. (September 15, 2021). Burden of Malnutrition among Children and Adolescents with Cerebral Palsy in Arabic-Speaking Countries: A Systematic Review and Meta-Analysis. https://www.mdpi.com/2072-6643/13/9/3199
Pediatric Gastroenterology, Hepatology and Nutrition. (March 22, 2019). Malnutrition and Associated Risk Factors Among Disabled Children. Special Considerations in the Pediatric Surgical "Fragile" Patients. https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2019.00086/full
INDEPTH Network. (June 3, 2008). Anthropometric status indicators. https://www.indepth-network.org/Resource%20Kit/INDEPTH%20DSS%20Resource%20Kit/Anthropometric_status_indicators.htm
Article by Expert Author Stephanie Bennett