Malnutrition – A Hidden Health Crisis

Jan_blog_3_webA number of recent studies found that many elderly Americans and people with disabilities suffer from malnutrition that neither they nor their doctors are aware of. Yet malnutrition has severe consequences. Without the necessary fat, fiber, protein, vitamins and minerals, the body cannot effectively fight infection, heal wounds or move without pain. Malnutrition also threatens a person’s cognitive abilities and emotional wellbeing. As one commentator put it, malnutrition can “turn a manageable chronic condition into an acute medical crisis.”

Malnutrition is easily overlooked for many reasons. For example, while some people may appear to be underweight, this is simply not the case for most malnourished Americans. In fact, up to a third of malnourished people in the United States are actually obese.

Malnutrition is also overlooked because nutrition is not a big part of doctors’ medical training. Screening for malnutrition is not a standard practice in most physician’s offices and there is no widely used, uniform screening tool for the condition.

What causes malnutrition?

Many factors contribute to malnutrition, including:

  • Digestive changes in older people that reduce the body’s ability to absorb nutrients
  • Pain or weakness that make it difficult to feed oneself
  • Mouth pain, tooth loss or difficulty swallowing
  • Anxiety, depression or dementia
  • Cancer or other illnesses that induce nausea or metabolic changes
  • Medications that interfere with taste or cause confusion, dry mouth or other side effects
  • Financial or physical barriers to shopping or cooking

With such a diverse list of factors that can lead to malnutrition, it’s important to look at each person’s situation individually to figure out whether they are at risk and if so, what kind of intervention or support is called for. For example, if someone uses a cane, walker or wheelchair they may need help shopping or cooking. Another person may have difficulty swallowing or pain that makes it difficult to eat, requiring medical attention. Someone else may not have enough money for groceries and need help applying for food stamps or finding other ways to supplement their diet.

What can you do?

If you are over 65, have a disability or are a family caregiver for someone with a chronic health problem, it’s a good idea to talk with a healthcare provider about the risk of malnutrition. This is especially important if someone has recently been sick or injured, lost his or her appetite or lost weight without trying to. While screening for malnutrition may not be part of their primary care provider’s standard practice, awareness about this largely hidden health risk is growing within the medical community and the provider should be able to conduct a nutritional assessment that includes an evaluation of skin and muscle tone, body fat, weight, eating habits and lab tests that evaluate blood cells, organ function, and vitamin and mineral deficiencies

If you or someone you care for is obviously not eating enough healthy food, here are some things that may help:

  • Planning meals ahead of time, including shopping and cooking
  • Eating a substantial breakfast before taking your morning medication (check with a doctor or pharmacist first to see if this is okay with your particular medication)
  • Eating frequently – every two to three hours
  • Eating with other people, whenever possible
  • Stocking up on nutritious convenience foods, such as nuts, dried fruit, canned soup, cheese, yogurt, milk and fortified whole grain bread

If all you need is some encouragement, these strategies will help. However, if a medical or mental health condition is keeping you or a loved one from eating well, it is essential to seek help from a doctor, because whatever health challenges you may face, malnutrition can only make them worse.

The good news is that most nutritional deficiencies can be corrected. For most people, who are not at risk due to severe medical problems, malnutrition can be prevented with small, consistent dietary changes that may be as simple as eating more protein, taking a daily vitamin or enjoying a nutritional supplement. For people who have an illness that puts them at risk or who may already be malnourished, the condition can be reversed by replacing missing nutrients while treating the underlying medical condition.

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