What is malnutrition? Tips for care and treatment

What is malnutrition?

Malnutrition refers to when a person’s diet does not contain the right amount of nutrients required for good health. For older people, this is of particular concern. As we get older, our eating habits can change – putting us at more risk of becoming malnourished. It is estimated 1.3 million people over 65 suffer from malnutrition, with the vast majority (93%) living in their own homes without the support to prevent it.
If you notice a change in an older person’s sense of taste or smell, alteration in food preferences, or simply a reduced appetite, it is vital to ensure that their dietary requirements are still being met.
That’s why you need to know how to spot the signs of malnutrition early and understand how you can help care for someone who is at risk of, or living with malnutrition.

What causes malnutrition?

Understanding what could be causing an older person to not be receiving the nutrients they need is the next step to caring for them. There are several causes of malnutrition: ranging from health conditions, to physical and social factors or side effects of medicines. Each can lead to a poor diet, reduced appetite or issues with the body absorbing nutrients from food.
Common health causes include:

• Conditions which cause long term loss of appetite such as sickness bugs, cancer or liver disease
• Dementia is a condition that can cause the person to forget to eat
• Mental health conditions such as depression, and schizophrenia
• Some medicines can also cause unwanted side effects such as nausea and loss of appetite

Physical and social factors can include:

• Poor fitting dentures or painful teeth
• Low income
• Reduced mobility which makes it more difficult to cook and get to the shops
• Limited knowledge of nutrition and cooking

How can malnutrition affect the body?

Malnutrition can have a number of damaging effects on the body, including:

• Decreased mobility and stamina as a result of muscle wasting
• Reduced muscle and tissue mass
• Slower immune response which increases the risk of getting infection
• Difficulty staying warm as a result of having less muscle and tissue mass, increasing the risk of hypothermia

For the most part, this damage occurs because malnourishment slows down the inner workings of the body, causing basic functions to not work as they should, or as effectively.

Spotting the signs of malnutrition

The first way to care for someone with malnutrition is being able to recognise the signs. The main symptom of malnutrition is unintended weight loss, although this is not always obvious. Some other signs to look out for include:

• Unintentionally losing 5-10% of their body weight (within three to six months)
• Their body mass index (BMI) falling under 18.5
• Clothes, belts and jewellery becoming looser over time

Other symptoms may include:

• reduced appetite or a lack of interest in food and drinks
• chronic fatigue
• feeling weaker
• poor concentration
• often feeling cold
• poor mood or depression

If you notice these symptoms in a loved one, please encourage them to seek medical advice.

What are the main treatments for malnutrition?

If a loved one is diagnosed with malnutrition or undernourishment, you may be given advice to follow at home. Alternatively, they may be referred to a dietitian for further support. Depending on the severity of the malnourishment, the following options may be advised as forms of treatment:

• changes to diet or adding of supplements to the diet
• home care for those with mobility issues to help prepare meals
• Using a home meals delivery service (such as Wiltshire Farm Foods) to ensure they have delicious, nutritious whenever they’re needed

You can find more information and support on the NHS website.

How to prevent malnutrition

If you believe your loved one is at risk of becoming malnourished, taking these social and psychological factors into account may reduce this risk:

• Encourage social dining – whether this be through family meals or encouraging said person to attend lunch clubs organised in your local community
• Serve them their favourite foods to try and encourage eating
• Choose foods that remind loved ones of a happy time e.g. childhood or holidays

There are also medical or physical factors you should be aware of to increase their intake of nutrients:

• Check whether a reduced appetite isn’t a side effect of any medication they are taking
• Encourage them to be involved in the cooking process; seeing and smelling the food may stimulate appetite
• Make sure they are comfortable in the dining area. Are they sat up properly? Do they have their glasses on?

Managing malnutrition at home

A change in diet is the best way to manage malnutrition at home. The British Dietetics Association (BDA) recommends encouraging snacking between meals, particularly on high protein, high energy snacks, to increase nutritional intake. The BDA guidelines suggest 3 meals and 3 snacks a day.

To start with, introducing drinks such as milkshakes and adding whole milk to tea or coffee is an easy way of increasing calorie intake. You can also consider fortifying existing foods by

• adding butter, cream, cheese or whole milk to mashed potato or sauces
• adding cream to porridge
• having puddings with creamy yoghurt
• adding cream to soups if cooking at home

Energy dense meals could make a real difference

Large meals can be intimidating to those with reduced appetites, or for those living with dementia. This can make it hard to ensure those with reduced appetites are getting the nutrition they need.

Energy dense meals, such as apetito’s Mini Meals Extra range, provide a delicious main meal that’s packed with nutrition, just in a smaller and more manageable portion. Containing a minimum of 501-514 calories and 20-27g of protein each, this makes them an ideal way to manage malnutrition, without compromising on taste.