Malnutrition
Malnutrition occurs over time if someone does not meet their nutritional needs. People become malnourished if they don’t eat enough, or the right types of food, or if their body can’t absorb all the nutrients from food.
Some groups of people are at higher risk of malnutrition. These include with people with:
- A poor appetite
- Illnesses that increase nutritional needs such as kidney failure, respiratory disorders, HIV or cancer
- Eating disorders
- Elderly people
In aged care homes, underweight, frailty and malnutrition are often bigger problems than being overweight. We know malnutrition is linked with poor health. Malnutrition can increase the risk of hospitalisation and length of hospital stay, pressure ulcer development, infection, falls and fractures and ultimately, reduced quality of life.
Symptoms of malnutrition include weight loss, muscle wasting, hair loss, pale skin, mental confusion and poor wound healing.
Our Accredited Practising dietitian can help with identifying malnutrition and offering practical dietary advice to help patients meet their nutritional needs and improve their health.
Eating a variety of food will help to meet nutritional needs, but some dietary areas are particularly important. These include:
- Energy (kilojoules) – to help promote weight gain and health
- Protein – to build and repair body cells
- Vitamins and minerals – for body cells to use other nutrients and function normally
A range of interventions are available to effectively manage and reduce malnutrition.
Food First
While the temptation can be to reach for a commercial oral nutritional supplement as a first step, it is best to find ways to increase oral intake from familiar and preferred foods first. Dietary counselling focuses on food fortification (adding nutrients to existing foods to increase their nutritional value) at this stage. The advantages of this approach are that the range of foods are less likely to create taste fatigue, food is more familiar and it can be more cost effective.
Oral Nutritional Supplements (ONS)
The use of ONS can be a valuable adjunct to the nutritional management in the event that dietary measures alone are insufficient. There are many types of supplements available (including powders, puddings, milk based drinks and fruit based drinks). They have many different uses and nutrient (including protein, carbohydrate, fat and fibre) content. ONS has proven clinical benefits in improving weight and reducing health complications associated with malnutrition (such as pressure ulcers, poor wound healing and infections, mortality and hospital admissions). It is important to consult a dietitian for use of ONS to ensure that it is not over-prescribed (which can cause reduced intake of normal food) and to help manage patient preferences (such as taste and texture) to maximise compliance. Our Accredited Practising Dietitian can also assist with ordering ONS products for you.
Once residents have already commenced on supplements, it is important to regularly monitor the outcomes and effectiveness of the supplement (eg. Resident’s weight, function). When a resident is able to maintain their weight, gain weight or are no longer at risk of malnutrition, it is advisable to refer to a dietitian if they are not involved already, so that supplements can be reviewed and potentially ceased.
Enteral & Nutrition (Tube Feeding)
Enteral nutrition refers to any method of feeding that uses the GI tract to deliver nutrition. Tube feeding is a special liquid food mixture containing all the necessary nutrients, vitamins and minerals, given through a tube into the stomach or small intestine. Dietitians can assist with monitoring weight and malnutrition, offering troubleshooting advice for gastrointestinal side effects of the tube feeding formula, and assist with ordering products for you.