What is malnutrition?

Malnutrition is a serious health condition that happens when you do not have enough of the right nutrients to meet your body’s needs.

It can happen over time if you do not have enough or eat the right types of food, or if your body cannot absorb enough nutrients from food.

Malnutrition is common in Australia. People most at risk are:

• older people
• people with an eating disorder
• people with a poor appetite
• people with medical conditions such as cancer, HIV or kidney failure, as they need more of some nutrients.

Research shows that up to 1 in every 2 older Australians living in aged care or at home are either at risk of malnutrition or are malnourished.

People who eat a lot of food or are living with overweight can also have malnutrition. For example, people who eat poor diets may live with obesity, but also lack the vitamins and minerals they need for good health. People who were malnourished before they were born or as babies are more likely to have overweight or obesity in later life.

What are the symptoms of malnutrition?

The symptoms of malnutrition are:

• losing weight or muscle
• pale skin and wounds that do not heal
• confusion
• hair loss
• weakness
• falls
• dental problems

What causes malnutrition?

Malnutrition is often caused by a combination of several different factors.

Older people may develop malnutrition if they have health problems that make it hard for them to eat, such as dementia or dental problems. They may lose their appetite, find it hard to swallow, or may have chronic diseases or take medicines that affect their diet.

Some people deliberately restrict their diets, leading to malnutrition. Others do not have access to nutritious food, either because they cannot afford it or it is not available where they live. Being isolated and lonely, with poor health, depression and grief can all affect how people eat and contribute to malnutrition.

When should I see my doctor?

If you or someone close to you develops any of the symptoms of malnutrition, or if you’re worried about access to food or a low appetite, you should see your doctor.

To find your nearest general practitioner (GP), dietitian or after-hours medical service, use the healthdirect Service Finder tool.

How is malnutrition diagnosed?

Health professionals diagnose malnutrition by:

• asking questions about weight and appetite
• measuring body mass index (BMI)
• asking if there is good access to healthy food (for example, if cost is a problem)

They may use a screening tool to identify people who are at risk. Your doctor may also recommend blood tests to check if some nutrients are lacking in your diet.

How is malnutrition treated?

Malnutrition can be treated with the help of a dietitian, who will work with you and sometimes other health professionals to help you know what foods you need.

A dietitian can also help with practical suggestions, for example, how to cook or prepare foods that you are able to eat, fit in with your medical needs and lifestyle and are to your taste.

Treatment involves ensuring your diet has enough energy (kilojoules), protein, vitamins and minerals. For most people, the best way is through eating small, frequent meals that are high in nutrients.

You may need nutritional supplements as well.

A doctor may also suggest changing your medicines or visiting the dentist. A speech pathologist can help if you have problems with swallowing.

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

• Eat small meals and healthy snacks throughout the day — cheese, yoghurt, nuts and dried fruit are good options.
• Use full cream milk and include milky drinks as part of your diet.
• Add oil, cream and margarine to food in cooking.
• Boost soups and stews with milk powder, cream or grated cheese.

Can malnutrition be prevented?

The best way to prevent malnutrition is to spot signs early on. If you are worried about a loved one, watch for weight loss (noting how their clothes fit), watch them eat, and be on the alert if they develop problems with their teeth or have a fall.

You can encourage someone to eat by making it a social event, ensuring the food they have is to their taste (for example, if they live in a group home or an aged care facility), and by helping them to do some exercise to boost their appetite.

If the cost of food is an issue, you could consider helping them draw up a budget, buying food on sale, or splitting the cost of bulk purchases with a friend or neighbour. Read more on how to eat healthily on a budget.

What are the complications of malnutrition?

Malnutrition can result in illness, pressure ulcers, infections, falls and fractures. It can mean time spent in hospital, or sometimes be life threatening.

Older people with malnutrition may not be able to look after themselves at home. They can develop sarcopenia, which means they lose muscle mass and strength. Malnutrition weakens the immune system and makes it more difficult for wounds to heal. Often, people with malnutrition lose their appetite, making the problem worse.

Resources and support

• Find out about healthy eating using the Australian Dietary Guidelines.
• Find an Accredited Practising Dietitian from the Dietitians Association of Australia.
• If you need help to get food, you can contact Food Bank to find a charity in your area that can support you.
• Meals on Wheels delivers nutritious food to people at home.

Call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.