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Malnutrition

Malnutrition is defined as both the deficiency and excess or imbalance of energy, protein and other nutrients.1 For healthcare providers, identifying and treating undernutrition or inadequate intakes of energy, protein and nutrients is important. Over one-third of Canadian adults over the age of 65 are at nutritional risk.2 Furthermore, ~45% of patients over age 65 and ~35% of patients under age 65 were malnourished on admission to hospital.3

 

Risks of Malnutrition3

  • Increased risk of morbidity
  • Decreased wound healing
  • Increased risk of infections
  • Decreased quality of life
  • Increased length of stay if admitted to hospital and increased risk of readmission
  • Increased risk of frailty
  • Increased risk of falls
  • Unintentional weight loss

Risk Factors for Malnutrition23

  • Mobility deficits
  • Lack of social support
  • Female
  • Depression
  • Anxiety
  • Comorbidities
  • Polypharmacy
  • Poor appetite/skipping meals
  • Loneliness; no partner/widowed
  • Poor dentition
  • Cognitive impairment
  • Difficulties with activities of daily living (ADLs) or instrumental activities of daily living (IADLs)

How can healthcare providers help prevent and treat malnutrition in their patients?

  1. Nutrition Screening – the goal is to help identify those who are already malnourished, as well as those who are at nutritional risk. Screening tools, like the Nutri-eSCREEN, are available to help healthcare providers identify those at nutritional risks. Speak to a Registered Dietitian for more information about screening tools appropriate for your patient population.
  2. Referral of at risk patients – healthcare providers should consider a referral to a Registered Dietitian for patients identified at nutritional risk. Even patients not identified as at nutritional risk may benefit from a referral to a Registered Dietitian to help prevent malnutrition.
  3. Referral to appropriate food related services – healthcare providers should provide information about community programs, such as Meals on Wheels and grocery delivery programs, to help promote healthy eating.
  4. Provide appropriate educational materialsDietitians of Canada - Unlock Food has resources for healthy eating, including recipes, meal planning and grocery shopping, available on their website.
 
Date of creation: December 22, 2017
Last modified on: November 26, 2019

References

1World Health Organization. (2016, July 8). What is Malnutrition? Retrieved from
http://www.who.int/features/qa/malnutrition/en/
22. Ramage-Morin PL, Gilmour H & Rotermann M. (2017, September 20). Nutritional risk, hospitalization and mortality among community-dwelling Canadians aged 65 or older. Retrieved from
https://www150.statcan.gc.ca/n1/pub/82-003-x/2017009/article/54856-eng.htm
3The Canadian Malnutrition Task Force. (2017) Nutrition Care in Canadian Hospitals Study: Advancing Nutrition Care in Canada. Retrieved from
http://nutritioncareincanada.ca/