What is Malnutrition?
According to the Dietitians Association of Australia malnutrition affects 10-30% of the population with research showing us that 50% of Australians in aged care facilities or in community care are at risk or are malnourished.
Malnutrition is defined by the World Health Organisation (WHO) as a deficiency or imbalance of the energy, nutrient or vitamin intake of a person that is necessary in maintaining a healthy organ function. This condition affects people across every country and is found in 1 in 11 people worldwide. As malnutrition is defined as a lack of the proper intake of nutrients, vitamins and minerals, this condition also extends to obesity and underweight people.
What Are the Different Types of Malnutrition?
Malnutrition can affect anyone and is caused by many different factors. There are two main types of malnutrition each of which have different causes, treatments and symptoms.
Undernutrition
This type of malnutrition occurs when someone isn’t consuming enough nutrients to sustain necessary function and growth. The causes of undernutrition are an inadequate intake of food or having a deficiency in nutrients. This type can also be caused by your body having trouble absorbing nutrients from food.
Macronutrient undernutrition refers to a deficiency in nutrients that the body needs in large amounts like proteins, carbohydrates and fats. This is also known as protein-energy undernutrition.
Micronutrient undernutrition is a condition where the body isn’t receiving enough vitamins and minerals needed for development and growth. Common forms of this are anemia, vitamin A deficiency and iodine deficiency.
Overnutrition
The second type of malnutrition occurs when an individual consumes more nutrients than their body needs. Overnutrition is caused by consuming too many calories like fats, sugars and salt and not consuming enough fibre, vitamins and minerals. The effects of having a diet like this is obesity & overweight, high blood pressure, heart disease, type 2 diabetes, stroke or cancer. Overnutrition affects those living in lower-income households because cheap and processed foods are often cheaper and middle aged or older individuals as they aren’t as active anymore.
Understanding the Root Causes of Malnutrition
Malnutrition is considered one of the largest global health challenges. Based on the different types, malnutrition has many different root causes making treatment a personal situation.
Undernutrition often occurs in people who have diseases like cancer or liver disease which can make eating enough food to absorb nutrients difficult. Other diseases like chronic diarrhea or being unable to swallow (dysphagia) can also cause undernutrition as there isn’t enough nutrients being absorbed by the body. Mental health conditions may also be a root cause of undernutrition for many people as some of these conditions discourage eating like depression and dementia. Poverty is another cause of malnutrition for many people. These people may be unable to afford food or don’t have access to nutritious foods resulting in undernutrition.
The root causes for overnutrition are similar to the causes of undernutrition but have different affects on those who are consuming more nutrients than your body needs. Poverty is responsible for overnutrition as cheaper food is often filled with more fats, carbohydrates and sugar. This leads to people consuming more of these macronutrients than required. Medical conditions that slow down your metabolism, like hypothyroidism can also be a root cause for overnutrition. Being inactive may also lead to overnutrition as you are consuming more without exercise.
Identifying the Warning Signs of Malnutrition
Malnutrition can be difficult to detect because this is a condition that gradually develops. As a carer, it’s important to recognize the warning signs that indicate if someone is experiencing undernutrition or overnutrition.
Here are the symptoms of malnutrition:
· Weight changes: unintentional weight loss or gain can be an indicator that your client is experiencing malnutrition. This generally occurs over a few months and requires monitoring. If the person you care for has lost/ gained 5% to 10% of their body weight over 3 to 6 months, they may be experiencing malnourishment.
· Appetite changes: having an increased or decreased interest in food and drink may indicate someone is experiencing malnutrition.
· Appearance: Skin, hair and nails are often a warning sign that someone is malnourished as these areas of a person’s appearance are supported by the nutrients and vitamins absorbed by the body. If skin is dry and easily bruised, hair is thinning and lackluster and nails aren’t growing or brittle, this could be a sign of malnutrition.
· Energy levels: if you or the person you care for are feeling tired, weak or lethargic, you/they may be malnourished.
· Immune system changes: Someone who experiences undernutrition will get sick often and take a longer time than expected to recover fully. This is because immune systems are significantly weakened due to the lack of essential nutrients in the body.
· Blood pressure: Another warning sign that your client may be experiencing malnutrition is if they have low blood pressure (undernutrition) or high blood pressure (overnutrition).
Risk Factors for Malnutrition: Who is Most Vulnerable?
Malnutrition can affect anyone. Often, those who have a lack of knowledge on nutrition, a lack of access to nutritional foods and the economic disadvantaged are more at risk of developing malnutrition. Particular people are more at risk to certain types of malnutrition.
Who is most at risk of developing undernutrition?
· Elderly – Our elderly population are most at risk of developing undernutrition. This is because as we age nutrition can deteriorate due to reduced mobility, reduced appetite, being in a care home or facility and a reduced absorption of essential nutrients.
· Poor/ Low Income Earners – Those living in poverty are likely to be malnourished as they will have less access to nutritional food.
· Children – Children require more nutrients than adults as they are growing and developing. Those who are disadvantaged or unwell are particularly at risk of developing malnutrition.
· Chronically Ill – There are lots of chronic illnesses that affect the body’s ability to absorb nutrients and calories. Many chronic illnesses also affect the person’s appetite.
Who is most at risk of developing overnutrition?
· Poor/ Low Income Earners – Similar to undernutrition, people in this group have easier access to cheap options like fast food, which doesn’t contain the best nutrients and are often higher in calories.
· Sedentary – Those who don’t move around during the day are more at risk of developing overnutrition. This includes those with desk jobs, older people who aren’t able to move as much and those with family or social commitments.
Treatment of Malnutrition
Malnutrition should be treated with the help of a dietitian. They will work with the patient and carer to establish practical ways to treat this. A dietitian can show people how to cook food that can be eaten by the person with malnutrition.
Carers can help by ensuring their client receives the right amount of energy, protein, vitamins and minerals. This can be done through careful food planning or through oral nutritional supplements. Nutritional products are designed to support overall health and wellbeing and address specific dietary requirements.
Flavour Creations’ Recover and Screamies ranges are protein supplements packed with protein to assist in healthy weight gain and supports wound healing. Their AdVital range is packed with 15 grams of protein and 27 vitamins and minerals to improve daily nutritional intake.
Nutricia’s range of nutritional supplements are created for specific groups. For example, their Souvenaid is for special medical purposes that supports memory function during the early stages of Alzheimer’s.
For those with dysphagia Flavour Creations has thickened drinks and foods that provide essential nutrients, proteins, minerals and hydration.
How to Prevent Malnutrition?
The best and most effective way to prevent malnutrition is by spotting the signs early. If you are caring for someone who is at risk of developing a form of malnutrition, keep an eye on their eating habits, ensure they are consuming balanced meals and be alert.
Malnutrition has become an epidemic across the globe with so many parts of our population affected by this condition. In Australia, the elderly population is particularly at risk and as carers, recognising the warning signs and putting in procedures to help prevent and treat your client is essential. Although the carer can do their best to prevent and help treat malnutrition, it’s important to know when to seek medical advice. If you notice symptoms are worsening, see a GP or dietitian for professional help.
Sources
World Health Organisation (WHO). (Mar 1, 2024). Malnutrition. https://www.who.int/news-room/questions-and-answers/item/malnutrition
Independence Australia. (n.d.). Malnutrition and Ageing. https://www.independenceaustralia.com.au/health-articles/nutrition/malnutrition-and-ageing/#:~:text=What%20do%20the%20statistics%20say,cent%20are%20also%20at%20risk
Nutricia. (n.d.). An Introduction to Malnutrition: What Every Australian Should Know. https://nutricia.com.au/fortisip/nutrition-corner/malnutrition-what-every-australian-should-know/#:~:text=In%20Australia%20and%20New%20Zealand%20alone%2C%20malnutrition,people%20with%20certain%20diseases%20such%20as%20cancer1.&text=Overall%2C%20only%201%20in%206%20people%20think,in%20Australia%20is%20at%20risk%20of%20malnutrition.
Cleavland Clinic. (n.d.). Malnutrition. https://my.clevelandclinic.org/health/diseases/22987-malnutrition
Australian Government Department of Foreign Affairs and Trade. (n.d.). Nutrition and Health in Australia's Aid Program. https://www.dfat.gov.au/sites/default/files/nutrition-and-health-in-australias-aid-program.pdf
NHS. (n.d.). Malnutrition. https://www.nhs.uk/conditions/malnutrition/#:~:text=Signs%20and%20symptoms%20of%20malnutrition,weight%20at%20the%20expected%20rate