What is malnutrition?

Malnutrition is a serious health condition that happens when you don't get enough of the right nutrients for your body's needs.

It can happen over time if:

• you don't eat enough food
• you don't eat the right types of food
• your body can't absorb enough nutrients from food

Malnutrition is common in Australia. People most likely to have malnutrition are:

• older people
• people with a poor appetite
• people with medical conditions such as cancer, HIV or kidney failure, as they need more of some nutrients
• people who follow restrictive diets (they eat a limited variety of foods)
• people with an eating disorder

Half of older Australians are either at risk of malnutrition or are malnourished due to undernutrition.

If you eat a lot of food or are living with overweight, you can also have malnutrition. People who eat poor diets may live with obesity, but also lack the vitamins and minerals needed for good health.

If you were malnourished as a baby, you can be more likely to be overweight or obese later in life.

What are the symptoms of malnutrition?

The symptoms of malnutrition in people who are underweight are:

• losing weight or muscle
• pale skin and wounds that do not heal
• confusion
• hair loss
• weakness
• falls
• dental problems such as bleeding gums or wobbly teeth

Symptoms of malnutrition in children can be:

• being underweight, overweight or obese
• changes in bowel habits (needing to poo) or constipation
• pale skin or lethargic (feeling tired)
• tooth decay
• poor growth

What causes malnutrition?

Malnutrition can be caused by many different factors. Reasons for malnutrition can be:

• deliberately limiting your diet
• not having access to nutritious food, either because of cost or it isn't available where you live
• being isolated and lonely — because meals are often a social event
• having poor health
• having depression
• dealing with grief

Children and teenagers can also become malnourished when they:

• are not eating enough fruits and vegetables
• have allergies and intolerances such as to lactose or gluten
• decide to try a diet or restrict certain foods without getting advice
• make frequent unhealthy food choices towards junk food like lollies and chocolate

Older people may become malnourished due to health problems, such as dementia, or dental problems that make it hard for them to eat.

Other causes of malnutrition in older adults can be:

• loss of appetite
• finding it hard to swallow
• having a chronic disease or taking medicines that affect their appetite

When should I see my doctor?

See your doctor if you or someone you know shows symptoms of malnutrition, especially losing weight without trying to, or if you're worried about food access or a low appetite.

How is malnutrition diagnosed?

Health professionals diagnose malnutrition by:

• asking questions about weight history and appetite
• doing a physical assessment including measuring body mass index (BMI)
• asking if you have good access to healthy food (for example, if cost is a problem)

They may use a screening tool to check if you're at risk of malnutrition. Your doctor may also recommend blood tests to check if some nutrients are lacking in your diet.

How is malnutrition treated?

Malnutrition can be treated with the help of a dietitian. They will work with you and sometimes other health professionals to help you understand the foods you need.

Treatment involves making sure your diet has enough energy (kilojoules), protein, vitamins and minerals. For most people, the best way is through eating small, frequent meals that are high in nutrients.

You may need high calorie nutritional supplements as well.

Your doctor may also suggest changing your medicines or visiting the dentist. A speech pathologist can help if you have problems with swallowing.

If you, or someone you know has been told they are underweight, the following tips can help:

• Eat small meals and healthy snacks throughout the day — cheese, yoghurt, nuts and dried fruit are good options.
• Use full cream milk and include milky drinks as part of your diet.
• Add oil, cream and margarine to food in cooking.
• Boost soups and stews with milk powder, cream or grated cheese.

You can help your child to make healthy food choices that avoid malnutrition. You can:

• plan and prepare meals with your child to teach them about healthy eating
• lower the number of treats in your house and provide healthy alternatives
• stop buying sugary drinks
• introduce fruits and nuts into your child's diet
• if your child has food intolerances, make sure they have appropriate foods to replace any nutrients they may be missing out on

What are the complications of malnutrition?

Malnutrition can result in:

• illness
• pressure ulcers
• infections
• falls
• fractures

It can mean time spent in hospital and can sometimes be life-threatening.

Older people with malnutrition may not be able to look after themselves at home. They can develop sarcopenia, which means they lose muscle mass and strength.

Malnutrition weakens your immune system and makes it more difficult for wounds to heal. Often, people with malnutrition lose their appetite, making the problem worse.

In children malnutrition can lead to:

• behavioural problems
• sleep problems
• problems with emotional and psychological development
• problems concentrating at school

Malnutrition during childhood can increase the chances of health problems in your child as they become an adult.

Can malnutrition be prevented?

The best way to prevent malnutrition is to spot the signs early on.

If you are worried about a loved one, watch out for:

• weight loss (noting how their clothes fit)
• how and what they eat
• new problems with their teeth or trouble swallowing
• falls

You can encourage someone to eat by:

• making it a social event
• ensuring the food they have is to their taste (for example, if they live in a group home or an aged care facility)
• helping them to do some exercise to boost their appetite
• providing healthy food options

If the cost of food is an issue, you could consider:

• making and sticking to a budget
• buying food on sale
• splitting the cost of bulk purchases with a friend or neighbour

Resources and support

You can get help for malnutrition.

• Find an Accredited Practising Dietitian from the Dietitians Association of Australia.
• If you need help to get food, you can contact Food Bank to find a charity in your area that can support you.
• Meals on Wheels delivers nutritious food to people at home.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.