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Malnutrition is a double-edged sword

Last year I celebrated Malnutrition Awareness Week in October with other healthcare professionals in USA, Canada and the U.K. While it isn’t October yet, it’s a really important to talk about malnutrition and the double-edged sword that it is.

But what is malnutrition anyway?

On hearing the word Malnutrition many of us will conjure up images of starving children, but there is much more to this word. Food provides the body with energy and nutrients that are important for growth, repair and staying active. However, in many countries, even those counted as high-income by their GDP, access to affordable nutrient-rich foods is a challenge. Foods such as fish, fruit, vegetables and nuts can be unavailable, inconvenient or unsafe. There can be pockets of food insecurity even in the most developed countries, and the pandemic has brought to light the plight of many, who were suffering in silence before.

Malnutrition is a condition caused by poor quality diets which do not provide the right amounts of nutrients to the body. Poor healthcare environments can also exacerbate malnutrition. According to the WHO, malnutrition covers 2 broad groups of conditions, undernutrition and overnutrition.

Elderly woman looking out through window thoughtfully
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Faces of Malnutrition

  1. Undernutrition which includes poor growth in children, wasting, stunting, frailty especially in the elderly, underweight;
  2. Micronutrient deficiencies i.e. inadequate supply of vitamins and minerals) or micronutrient excesses (likely in both under- and overnutrition);
  3. Overnutrition which includes overweight and obesity;
  4. Diet-related non-communicable diseases such as hypertension, diabetes and cardiovascular disease which accompanies excess weight/overweight.
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As the definition of malnutrition suggests, it can be multifaceted. Persons who are in low-to-middle income countries may be more susceptible to undernutrition and micronutrient deficiency due to a lack of access to nutritious foods. While in many middle-income and high-income countries the wider determinants of health make persons more likely to face overnutrition, undiagnosed micronutrient deficiencies and chronic non-communicable diseases. The causes of malnutrition can be above individual choice in the foods persons eat and have access to. Older adults are often very susceptible to undernutrition and may experience unintentional weight loss, which should be monitored as this puts them at risk for fractures and illness.

Why is awareness important?

MAW aims to educate healthcare professionals (HCPs) in recognising and treating malnutrition earlier and informing patients about the importance of discussing food choices with HCPs so that they can assess their nutrition status better. MAW also improves awareness of the importance of nutrition in patient recovery. Health inequality can play a role in the development of patient malnutrition, especially after discharge. More screening and better awareness can lead to more lives saved and lower healthcare costs. I’ve shared a few resources below from 2020’s MAW across the globe.

If you work in a clinical setting as an HCP or nutrition professional, it’s critical that we talk to our patients about malnutrition, access to food and weight loss. We also need to familiarise ourselves with appropriate screening tools and steer clear of weight bias in our consultations.

References and Resources

American Society of Parenteral and Enteral Nutrition Malnutrition Awareness Week (annually updated)

Resources from ASPEN on MAW

Canadian Nutrition Society – Canadian Malnutrition Task Force

Malnutrition Taskforce UK

NHS UK Overview of Malnutrition

World Health Organization on Malnutrition

Post Author: Christina

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