MALNUTRITION: A Hidden Epidemic in Older Adults

What is malnutrition?

Malnutrition occurs when the body doesn’t get the right balance of nutrients and calories that it needs to stay healthy. Malnutrition doesn’t just happen to people who suffer from hunger or who don’t have access to healthy food. Malnutrition can happen to anyone.

Malnutrition is an imbalance between the nutrients your body needs to function and the nutrients it gets. It can mean undernutrition or overnutrition. You can be malnourished from an overall lack of calories, or you might have a protein, vitamin or mineral deficiency. You might also have more excess calories than your body knows what to do with.

Older adults are at risk.

Malnutrition disproportionately affects older adults. Approximately two-thirds of older adults are either at risk of becoming or are malnourished. Older adults are at risk because as we age, our dietary needs can change, our sense of taste and smell may weaken, digestive systems may slow, chewing or swallowing problems may develop and the ability of our bodies to absorb nutrients can decline.

How is malnutrition treated?

Undernutrition is treated with nutritional supplements. This might mean individual micronutrients, or it might mean refeeding with a custom, high-calorie nutritional formula designed to restore everything your body is missing. Severe undernutrition can take weeks of refeeding to correct. But refeeding can be dangerous, especially in the first few days. Your body changes in many ways to adapt to undernutrition. Refeeding asks it to change back to its old way of operating, and sometimes that change is more than it’s prepared to handle.

Overnutrition is generally treated with weight loss, diet and lifestyle changes. Losing extra weight can help reduce your risk of developing secondary conditions such as diabetes and heart disease. Weight loss treatment may include diet and exercise plans, medications or medical procedures. Weight loss can be rapid or it can be long and gradual, depending on the path you take. But after you lose weight, it’s the lifestyle changes you stick with that will help keep it off. This may involve long-term support systems such as counseling, behavioral therapy, support groups and education in nutrition.

How do you prevent malnutrition?

Malnutrition is a global problem. In both the developed world and the developing world, poverty and a lack of understanding of nutrition are the leading causes. We can help control the disease of malnutrition with better worldwide education and support for the disadvantaged, including access to clean water, nutritious whole foods and medicine. Children and elders who may not be able to advocate for themselves are especially at risk and may need closer attention paid to their diet and health condition.

The best way to prevent malnutrition is to eat a well-balanced diet with a variety of nutritious whole foods in it. If you have enough of all the nutrients your body needs, you will be less likely to overeat trying to satisfy those needs. Some micronutrient deficiencies are common even with a fairly standard diet. A blood test is one way to find out if you could benefit from micronutrient supplements. Your healthcare provider can help you determine the correct dose to take.

What is the prognosis?

Malnutrition is treatable, but some effects can linger. Effects of severe undernutrition, such as blindness from vitamin A deficiency, soft bones from vitamin D deficiency and stunted growth from protein-energy undernutrition in children may not be reversible, even after rehabilitation. Secondary effects of long-term overnutrition, such as insulin resistance and carotid artery disease, may last even after weight loss. However, with earlier intervention and good follow-up support, people can make full recoveries.

When should I see my healthcare provider?

Contact your healthcare provider if:
  • You have recently lost or gained more than ten pounds unintentionally.
  • You have symptoms of anemia, such as weakness, faintness, apathy and fatigue.
  • You think you might have an eating disorder.
  • You suspect child or elder abuse or neglect in your community.

Side note:

Most people think of malnutrition as undernutrition — a deficiency of overall calories or of certain nutrients that the body requires. Undernutrition is one face of malnutrition, but overnutrition can also be detrimental to your health. Nutritionists now define malnutrition as a mismatch between the nutrients you need and the nutrients you get. By this definition, malnutrition is quite common. It’s also a significant contributor to disease, disablement and death worldwide. Malnutrition needs to be fought on many fronts, including education, infrastructure and policy measures. At home, you can help prevent malnutrition by eating a well-balanced diet.