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ARTICLE

Malnutrition

Woman exercising

ARTICLE

Malnutrition

Malnutrition

Whitepaper: Benefits of Dairy Proteins in the Nutritional Support of Cancer Patients

Malnutrition refers to deficiencies or excesses in nutrient intake, imbalance of essential nutrients or impaired nutrient utilisation.

It occurs when people cannot consume the nutrients they need to stay healthy.

Malnutrition is a global health concern affecting more than one billion people. It is caused by various factors including starvation, imbalanced diet, ageing, illnesses, and side effects of medical treatment. Causes are multi-factorial and interlinked, occurring alone or in combination. People with certain medical conditions, lower socio-economic status and certain demographics, such as the elderly, are at higher risk of malnutrition.

 

Malnutrition is more likely to occur in older age 
There are many factors that may increase the risk of becoming malnourished in older age such as:
  • Reduced ability to smell and taste food
  • Poor absorption of nutrients
  • Poor dentition
  • Reduced appetite or loss of appetite
  • Difficulties with preparing food

Malnutrition increases the risk of progressive decline in health, decreased physical strength, activity levels and even cognitive functions. At some point this may lead to losing the ability to continue the daily activities without help of another person.

Hospitalised elderly patients have a high prevalence of malnutrition. To identify individuals at risk, malnutrition should be routinely screened in all hospitalised and institutionalised patients such as in care homes and elderly homes to prevent malnutrition from progressing and improve nutritional status.

A nutrient rich diet can play a critical role in addressing malnutrition.
 
Disease-related malnutrition 

Disease-related malnutrition is a type of malnutrition when the inadequate nutrient intake is a result of a disease or its treatments. It persists in healthcare settings, despite great advances in medical care. Patients often experience their nutritional status worsening during hospital stays due to missing mealtimes, pre-surgery fasting, changes in appetite, and general unwellness.

Malnutrition is associated with higher hospitalisation as well as higher morbidity and mortality rates. Malnourished patients have slower recovery times that often results in longer hospital stays, as well as higher readmission rates after discharge. This can greatly increase medical costs for patients, and overall health burden for countries.

There is an opportunity to improve nutritional status with the small feeding windows in chronic disease by making high-density nutrition more palatable, and therefore making it easier for hospital-bound people to meet their dietary requirements. Proper dietary management provides both energy and immune support, which is especially important in individuals suffering from disease related malnutrition.


 

Concepts

Nutritional deficiencies should not be seen as inevitable consequence of older age or illnesses. There is an opportunity to improve nutritional status.

Oral nutritional supplements are Foods for Special Medical Purposes (FSMP) designed and developed according to strict guidelines to provide energy and nutrient dense solutions in liquid or powdered form. They are developed based on scientific and clinical evidence with the levels and sources of nutrients modified to meet the special requirements of the patient group.

In addition to the technical challenges (feasibility, nutritional validation, shelf-life stability), it is crucial to develop products that are well tolerated and accepted by consumers in order to improve the total nutritional intake. 

 

Looking for product solutions for the dietary management of malnutrition but not sure where to start?

                 

1.     World Health Organization (WHO)  who.org

2.     Kaiser MJ et al. J Am Geriatric Soc 2010; 58(9):1734-1738.

3.     Leij-Halfwerk et al. Maturitas, 1029: 80-89

4.     Cereda et al, Clin Nutr. 2016; 35(6):1282-1290

5.     Barrett ML, Bailey MK, Owens PL, U.S. Agency for Healthcare Research and Quality, Published 2018

6.     Sorensen J, Kondrup J, Prokopowicz J, et al. EuroOOPS: an international, multicentre study to implement nutritional risk screening and evaluate clinical outcome. Clin Nutr 2008; 27(3): 340- 9.

7.     Schneider SM, Veyres P, Pivot X, et al. Malnutrition is an independent factor associated with nosocomial infections. BrJNutr 2004; 92(1): 105-11

8.     Stratton RJ, Green CJ, Elia M. Disease-related malnutrition: an evidence based approach to treatment. Wallingford: CABI Publishing; 2003

9.     Lim SL, Ong KC, Chan YH, et al. Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality. Clin Nutr 2012; 31(3): 345-50

10.  Carol Evans RNP, SM, MA, Malnutrition in the Elderly: A Multifactorial Failure to Thrive Perm J. 2005 Summer; 9(3):38-41

11.  Russell C, Elia M. Nutrition Screening Week in the UK and Republic of Ireland in 2011. Hospitals, care homes and mental health units. Redditch, 2012.

12.  Russell C, Elia M. Nutrition Screening Survey in the UK in 2008: Hospitals, Care Homes and Mental Health Units. Redditch, 2009.

13.  Schindler K, Pernicka E, Laviano A, et al. How nutritional risk is assessed and managed in European hospitals: a survey of 21,007 patients’ findings from the 2007-2008 cross-sectional nutritionDay survey. Clin Nutr 2010; 29(5): 552-9.

14.  Meijers JM, Schols JM, van Bokhorst-de van der Schueren MA, et al. Malnutrition prevalence in The Netherlands: results of the annual Dutch national prevalence measurement of care problems. Br J Nutr 2009; 101(3): 417-23.

15.  Russell C, Elia M. Nutrition screening survey and audit of adults on admission to hospitals, care homes and mental health units. Redditch, 2008.

16.  Russell C, Elia M. Nutrition Screening Week in the UK and Republic of Ireland in 2010. Hospitals, care homes and mental health units. Redditch, 2011.

17.  Imoberdorf R, Meier R, Krebs P, et al. Prevalence of undernutrition on admission to Swiss hospitals. Clin Nutr 2010; 29(1): 38-41.

18.  Nitenberg et al. (2000) Nutritional support of the cancer patient: issues and dilemmas. Crit Rev Oncol Hematol. 34:137-68

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This information is intended for B2B customers, suppliers and distributors, and is not intended as information for final consumers. Regulatory jurisdictions globally approach product claim requirements differently. In developing claims for final product labels, manufacturers should seek guidance to assure compliance with the appropriate regulatory authority.