House Call: What is malnutrition?
Good nutrition can help you prevent infections, heal faster, and feel stronger. That is why United Hospital Center (UHC) and St. Joseph’s Hospital are official ambassadors of Malnutrition Awareness Week. Answering our questions concerning malnutrition is Wendy Phillips, MS, RD, CNSC, CLE, NWCC, FAND, Vice Chair of the Malnutrition Committee American Society for Parenteral and Enteral Nutrition (ASPEN).
1. Help us to better understand malnutrition, as Monday begins Malnutrition Awareness Week?
When we say that someone is malnourished, we’re referring to the fact that their body does not receive enough nutrients or the right balance of nutrients to function properly. This might be because someone isn’t able to eat enough food or when their body isn’t able to process the foods eaten. Many times another disease or medical condition causes the malnutrition, so both conditions need to be treated together. Diseases that are commonly associated with malnutrition include cancer, kidney disease, strokes, or problems with the gastrointestinal tract.
People who become malnourished often lose weight, body muscle, and/or body fat. This can make it more difficult to do their usual daily activities. These types of changes are important to recognize, so that a proper nutrition assessment can be completed to determine the presence and severity of malnutrition.
2. What is the impact of malnutrition and how often does it occur?
Malnutrition increases the risk that someone will need to be hospitalized, and will have to stay in the hospital for longer once they’re there. Every day that someone is in the hospital is another day that they’re not at home enjoying time with loved ones. They’re also more likely to get complications, such as infections or a longer time to heal after surgery. This leads to higher hospital costs.
It is not easy to know how many individuals in the United States are malnourished as it isn’t always reported while someone is in the hospital, but it is estimated that 1 out of every 3 patients may be malnourished, especially in the older population. It is also very difficult to identify malnutrition in people outside of the hospital. Regardless of setting, an older individual is more likely to be malnourished than someone younger. Older adults often report many reasons why they don’t want to eat including having to take many medications, food not tasting good, difficulty shopping and cooking, and generally not feeling well enough to eat.
Since the Healthy People 2020 report listed social determinants of health as predictors of health outcomes, increased attention has rightfully been given to the role of “food insecurity”, or the lack of resources to buy enough high-quality food, as a cause of
malnutrition. Sometimes folks need to choose either medications or food, and this too can lead to malnutrition.
3. How is malnutrition treated?
Malnutrition is treated by providing good nutrition. The best way to do this will vary depending on the malnourished individual and their ability to eat. Often, offering foods that are high in calories, protein and important nutrients and/or addressing the underlying causes of their food insecurity will be enough to correct the malnutrition.
Depending on the reason for the malnutrition, other treatment options can include providing oral nutrition “supplements” to help individuals consume more nutrients. Sometimes, enteral tube feeding or intravenous nutrition may be needed if the individual is unable to eat, such as people who have suffered significant strokes or have gastrointestinal diseases.
The old saying “Prevention is worth a pound of cure” is true when it comes to malnutrition. Raising awareness of malnutrition can lead to early recognition and may keep someone from becoming malnourished and experiencing those undesirable consequences. This is why the American Society for Parenteral and Enteral Nutrition, or ASPEN, developed Malnutrition Awareness Week.
The hope is that by having this awareness and intervention program every year, more and more individuals can learn about malnutrition and how it can be prevented or addressed. ASPEN has created several resources to help consumers spot and talk to their health care providers about malnutrition. They can be found at www.nutritioncare.org/malnutrition. These include “Ask About Your Nutrition” posters and “How to Spot and Talk About Malnutrition”, a guide to help you talk to your doctor about your nutrition.
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