•    Malnutrition occurs when the body’s nutritional needs are not met
•    Malnutrition is linked with poor health and reduced quality of life
•    Malnutrition is not easily identified which leads to increased risk in both community and acute settings
•    Older people are especially at risk for malnutrition
•    An Accredited Practising Dietitian (APD) can help prevent and treat malnutrition

5 minute read

What is malnutrition?

Malnutrition occurs over time if someone does not meet their nutritional needs. People become malnourished if they don’t eat enough, or the right types of food, or if their body can’t absorb all the nutrients from food.

Malnutrition is linked with poor health. It can affect quality of life and lead to poor medical outcomes.

Malnutrition is a major public health issue in Australia, particularly for older Australians. Research shows around 50% of older Australians in aged care and in the community are either at risk of malnutrition or are malnourished. 

Screening and monitoring for malnutrition is an important tool. Early detection can prevent the need for major treatments.
 

What are the symptoms of malnutrition?

Symptoms of malnutrition include:
•    Loss of appetite 
•    Unexplained weight loss
•    Loss of strength, increased difficulty performing daily tasks 
•    Muscle wasting
•    Hair loss
•    Pale skin
•    Fatigue
•    Mental confusion
•    Poor wound healing
 

Who is at risk for malnutrition?

Some people have special nutritional needs and need to choose foods more carefully to prevent malnutrition. These include people with:

•    A poor appetite and/or gastrointestinal symptoms (e.g. nausea or constipation)
•    Illnesses that increase nutritional needs (e.g. kidney failure or cancer)
•    Illnesses that lead to poor nutrient absorption (e.g. Crohn’s disease) 
•    Disordered eating

Older people are especially at risk for malnutrition. This may be due to other chronic conditions, dental problems, psychological distress and/or dementia, certain medications, social isolation, financial difficulties with the rising cost of living and limited access to food, and shopping or cooking difficulties. 

Many believe that unplanned weight loss is normal as we age, but this misconception along with poor awareness of malnutrition in community dwelling older adult populations is partly to blame for high levels of malnutrition amongst older people.  

Older people with malnutrition have a higher risk of falls, infection and pressure wounds. They may take a longer time to recover from illness or injury and can need more help with day-to-day tasks. They are also more vulnerable to disease and being admitted to hospital.     

   
People who are hospitalised, especially older people, are at increased risk of malnutrition due to increased energy and protein requirements (e.g. for wound healing). They may also experience appetite loss, due to surgery or medications, difficulty eating and drinking, reduction in physical activity, isolation and separation from family. 
 

How is malnutrition treated?

An Accredited Practising Dietitian (APD) can work with people who are either at risk of malnutrition or are malnourished. They can offer practical and personalised dietary advice to help them meet their nutritional needs and improve their health.

A multidisciplinary approach can be beneficial to address the multiple risk factors associated with malnutrition (e.g. referral to a Accredited Exercise Physiologist for exercise support). 

Eating a variety of foods will help to meet nutritional needs, but some areas are particularly important. These include:
 

Energy (kilojoules) – to help promote weight gain and health

Examples of foods which are high in energy include:

•    Full cream dairy products (for example, milk, yoghurt, cream and cheese)
•    Ice cream
•    Margarine, butter and nut butters
•    Full fat salad dressing
•    Oil
•    Pastries
•    Chips

You can include extras in your diet according to your individual needs. These include foods such as cream, chocolate, lollies, ice cream, cakes and biscuits. 
 

Protein – to build and repair body cells

Examples of foods which are high in protein include:

•    Meat
•    Fish
•    Chicken
•    Eggs
•    Full fat dairy products (for example, milk, yoghurt and cheese)
•    Nuts and seeds 
•    Soy products (i.e. tofu)
 

Vitamins and minerals – for body cells to use other nutrients and function normally

Eating a healthy, balanced diet means not only getting important vitamins and minerals, but also fibre, protein and antioxidants.

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

•    Eat small frequent meals and snacks throughout the day. For example, aim for 6 small meals a day instead of 3 large meals
•    Consume drinks between meals, rather than excessive amounts with meals. Drinking milk-based drinks (such as milkshakes and smoothies) and fruit juices are more nutritious than water, tea or coffee.  
•    Add oil, cream, margarine and grated cheese to recipes and into sauces or dressings, or onto cooked foods such as vegetables 
•    Add skim milk powder to soups, stews and drinks. Or make a high protein milk by mixing together 500ml full cream milk with ½ cup skim milk powder. Refrigerate and use in place of your ordinary milk
•    Snack on cheese and crackers, yoghurt, peanut butter or cheese-based dips on toast, nuts and dried fruit 
•    Avoid sugar-free or diet foods and drinks (for example, diet drinks and sugar-free jellies) 
•    Look for easy to make frozen or chilled meals such as crumbed fish or chicken and chips, lasagne, quiche, pies and vegetable patties 
•    Choose dairy based desserts such as creamed rice and custards, frozen fruit pies, ice cream and cheesecakes
•    Make meals and the mealtime environment more enjoyable (for example, encourage social interaction where possible, offer comfortable seating, adequate lighting etc.) 
•    Provide help to those who have difficulty eating
 

How can malnutrition be prevented?

• Eat a healthy and balanced diet.
• Consume a variety of foods from the main food groups in the Australian Guide to Healthy Eating.
• Speak to your dietitian or GP if you have any malnutrition symptoms.
• Health professionals and aged care facilities should conduct regular malnutrition screening using an appropriate screening and assessment tool.