The public health focus on healthy eating and reducing the UK’s obesity crisis is undoubtably necessary for children and young to mid-life adults, but the messaging gets a little more complex when it comes to those in later life and, in particular, people with underlying health conditions or frailty. The challenge is the focus on the obesity and weight management is drowning out the discussion of other issues.
One of those issues is malnutrition or, more accurately, under-nutrition, which is estimated to affect over three million adults in the UK.
Good nutrition and hydration play a critical role in the management of many medical conditions ranging from diabetes and heart disease to allergies, autoimmune disorders and kidney disease. Eating and drinking well can also help reduce slips, trips and falls and even help manage the symptoms of dementia. The right nutrition can help set the patient on the road to recovery, help control the symptoms of an on-going condition and even improve the efficacy of some medicines.
Conversely, a poor diet can delay recovery or lead to complications. For those who are overweight or obese the focus must rightly be on healthy choices and reducing calories intake, while increasing amounts of fibre and nutrients in the diet. However, for those who are malnourished, it is important to focus on increasing calorie intake and energy dense diets.
Therefore telling 3 million people that high calorie food is good for them is a challenge. It is also a challenge to identify people at risk, particularly because people very often don’t self-identify as malnourished. This can often lead to a situation where vulnerable people are eating less than they require. They mistakenly believe they need to reduce their food intake in response to healthy eating and obesity messages.
According to Nice, improving the identification and treatment of malnutrition is estimated to have the third highest potential to deliver cost savings to the NHS. [i].
Starting the conversation with Malnutrition Awareness Week
UK Malnutrition Awareness Week takes place between 14th
October and is all about promoting awareness to people at risk, their friends and family and professionals in the health and care sector.
We need better awareness within both the community and care settings, alongside improved screening so that people are aware and empowered to act. The Malnutrition Taskforce is leading this approach with clear messaging around the signs to look out for and tools to detect malnutrition. A resource pack is available from the Malnutrition Taskforce website with a number of self-screening tools that have been developed for use in the community:
These tools are simple to use and can help give an indication if someone is at risk of malnutrition and can be used to start conversations about weight loss, eating and drinking and provide basic advice and signposting to help support the person to improve their nutrition and wellbeing.
Simple signs to look out for from the Malnutrition Taskforce
Is mum’s wedding ring looser? Have you noticed Dad doing his belt up a notch tighter? Do your neighbour’s clothes seem looser? These small signs might suggest that an older person is getting thinner and it’s time to act.
Someone who isn’t eating enough will often lack energy, they might be cold, dizzy, lethargic or constipated. They may have low mood. Perhaps they’ve lost their appetite and interest in food. These are all signs that somebody might not be eating enough, and their health could be at risk.
If someone suddenly loses their appetite, becomes thinner, or steadily loses weight unintentionally for a while, it is important to speak to a GP. A GP can rule out any serious illness, and you can raise any other issues – like difficulty swallowing.
If serious illness is ruled out, the messages are clear: if you’re malnourished or at risk of malnutrition it’s ok to add higher calorie food to your diet, things like a slice of cake, cheese and full fat milk. People might also choose to eat smaller meals, packed with more calories.
In most cases, malnutrition can be prevented with the right support in the community or care settings. Raising awareness of undernutrition, its causes and the simple steps we can all take to combat the issue is key to improving the health and wellbeing of 3 million people in the UK.
See Guidance – Commissioning Excellent Nutrition and Hydration 2015-2018: https://www.england.nhs.uk/wp-content/uploads/2015/10/nut-hyd-guid.pdf