What is malnutrition?

Malnutrition is a serious health condition that develops when someone does not have enough nutrients to meet their body’s needs.

It can happen over time if someone does not have enough food, if they do not eat the right types of food, or if their body cannot absorb enough nutrients from food.

Malnutrition is common in Australia. Those most at risk are the elderly, those who have eating disorders, people with a poor appetite, and people with medical conditions such as cancer, HIV or kidney failure that mean they need more nutrients.

Research shows that up to half of older Australians living in aged care or at home are either at risk of malnutrition or are malnourished.

People who eat a lot of food or are overweight can also have malnutrition. For example, people who eat very poor diets may be obese, but they lack the vitamins and minerals they need for health. People who were malnourished before they were born or as babies are more likely to be overweight or obese in later life.

What are the symptoms of malnutrition?

The symptoms of malnutrition are:

• losing weight
• losing muscle
• pale skin
• confusion
• hair loss
• wounds that do not heal
• weakness
• falls
• dental problems

What causes malnutrition?

Malnutrition is often caused by several different factors in combination.

In older people, it can start because they have health problems, such as dementia or dental problems that make it difficult to eat. They may lose their appetite, find it hard to swallow, or may have chronic diseases or take medications that affect their diet.

Some people deliberately restrict their diets, leading to malnutrition. Others do not have access to nutritious food, either because they cannot afford it or it is not available where they live. Being isolated and lonely, with failing health, depression and grief can all affect people’s diets and contribute to malnutrition.

How is malnutrition treated?

Health professionals diagnose malnutrition by asking questions about weight and appetite, measuring body mass index (BMI), and asking about the person’s personal situation. They may use a screening tool to identify people who are at risk.

Malnutrition can be treated by a dietitian, who will work with the person and sometimes other health professionals to help them eat the foods they need.

Treatment involves ensuring the person’s diet has enough energy (kilojoules), protein, vitamins and minerals. The best way is through eating small, frequent meals that are high in nutrients.

Some people may need nutritional supplements as well.

A doctor may also suggest altering medications or visiting the dentist. A speech pathologist can help if the person has problems with swallowing.

If you or someone you know has malnutrition, the following tips can help:

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

Can malnutrition be prevented?

The best way to prevent malnutrition is to spot signs early on. If you are worried about a loved one, watch for weight loss (noting how their clothes fit), watch them eat, and be on the alert if they develop problems with their teeth or have a fall.

You can encourage someone to eat by making it a social event, adding herbs and spices to bland food and by helping them to do some exercise to boost their appetite. If the cost of food is an issue, you could consider drawing up a budget, buying food on sale, or splitting the cost of bulk purchases with a friend or neighbour.

What are the complications of malnutrition?

Malnutrition can result in illness, time spent in hospital, pressure ulcers, infections, falls and fractures. It can sometimes be life threatening.

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

Resources and support

• Find out about healthy eating using the Australian Dietary Guidelines.
• 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.