Carol Slager Times correspondent
When I hear the word malnutrition, visions of mothers and their children from African countries appear in my mind. Poverty, disease and hunger are common there due to famine, drought or armed conflict.
But malnutrition can happen to anyone, anywhere. It occurs when there is an imbalance between the nutrients the body needs to function and the nutrients it receives. It can occur in people who are malnourished or overnourished.
Malnutrition is an epidemic in older adults in the United States, although it is underrecognized and undertreated. The causes of this epidemic are many. Chronic illness and disease require more nutrients for healing, but there is often a reduction in food intake as appetite declines. This increases the nutritional deficit.
The desire for food also decreases as taste and smell disappear, as these senses can gradually decline with age. Medications and dietary restrictions can reduce. Difficulty chewing and swallowing may occur. Impaired gastrointestinal function prevents proper nutrient absorption. Those challenged with dementia may forget to eat. Financial considerations can limit food. Many older adults living alone who are lonely and depressed lose interest in cooking and eating.
Consequences of malnutrition include a weakened immune system; loss of body protein, resulting in impaired healing; increased risk of infection; and muscle wasting (sarcopenia) often accompanied by osteoporosis. Physical weakness leads to a loss of independence; increased risk of falls and fractures; and poor quality of life. Hospital or nursing facility stays increase, as does the risk of infections and other complications, with longer recovery times. All diseases, trauma, operations and diseases increase the risk of mortality.
Other symptoms may include fatigue, poor appetite, dental problems, involuntary weight loss, irritability, depression and easy bruising. Chronic malnutrition can occur regardless of whether thin or heavy people.
Diagnosis is possible with physical examinations including various routine examinations of body weight, body measurements, hand grip strength, blood tests for micronutrient status, evaluations of food intake, mobility, weight loss, body mass index, dementia and depression. Scans to measure bone density (DXA), details of soft tissues, blood vessels and bones (CT) and estimation of body composition taking into account body fat and muscle mass (BIA) can also determine the severity.
The first step in treating malnutrition is to be aware that it exists. If you or a loved one is experiencing sudden, unintended weight loss and/or loss of appetite and decreased food intake, it may be time to check with your health care team to determine the cause. Malnutrition can be prevented and treated.
A number of foods can be added to our diet to increase calories as well as fat, protein, carbohydrates and taste, texture and essential nutrients. Some of these foods are protein powder, cheese, powdered milk, olive oil, nut butter, and eggs.
- Add cheese to salads, soups, toast, vegetables and potatoes.
- Spread nut butter on toast or add to a protein shake.
- Use milk or cream to make soups and oatmeal instead of water.
- Add hard-boiled eggs to salads.
- Blend avocado into a smoothie for an extra creamy texture (without the avocado taste).
- Sprinkle nuts or seeds on salads, soups and fruit.
- Mix flavorless protein powder into a variety of foods and smoothies.
- Choose cereals, grains, milk, bread and orange juice fortified with additional nutrients to prevent deficiencies.
Smaller meals or snacks can provide more calories and nutrition than larger meals. Difficulty with digestion, chewing or getting full quickly can hinder the ability to finish a meal. By eating less often, energy and nutritional needs can be met. If there are problems with chewing and/or swallowing, eat pureed, mixed and soft foods. Again, this offers the option of adding complementary foods to increase calories and nutrients.
While ensuring proper nutrition can be a challenge with age, understanding the individual’s specific needs is the first step in creating a plan that offers a simple and effective way to improve energy, nutrition and overall quality of life.
Carol Slager is a licensed pharmacist, author, blogger and health coach in Northwest Indiana. Follow her monthly in Get Healthy and at inkwellcoaching.com. Opinions expressed are those of the author.