Understanding and Reducing Disease-Associated Malnutrition

August 30th, 2021

“Depending on the source you use, as many as 30 to 50% of older adults admitted to the hospital have some degree of malnutrition,” notes Su-Nui Escobar, DCN, a registered dietitian and member of the Academy of Nutrition and Dietetics. There are two primary causes:

  1. Lack of access to food, often because of transportation or affordability issues
  2. Conditions that inhibit appetite, burn more calories, limit taste and smell, reduce the uptake of key nutrients or make it difficult to eat because of swelling, surgeries, etc. This called disease-associated or disease-related malnutrition

“Every cell in the body and brain needs essential nutrients for normal function and to survive,” explains Susan Roberts, PhD, senior scientist and professor of nutrition at the USDA Nutrition Center on Aging at Tufts University. “Over time, inadequate nutrition has multiple harmful effects throughout the body that culminate in symptoms of every kind, ranging from muscle loss to weak bones to increased risk of cancers, heart disease and diabetes.”

Failure to stay adequately nourished can cause a loss of independence if family caregivers or healthcare professionals see evidence that seniors aren’t able to thrive on their own.

What diseases are related to malnutrition?

Some of the medical conditions that may cause malnutrition in older adults are:

  • Mobility issues that may make it hard to shop and cook
  • Arthritis, which can cause difficulty when cooking or holding utensils when eating
  • Alzheimer’s disease and other cognitive impairments that may lead to forgetting to eat or create challenges to ordering food or shopping for and preparing meals
  • Depression, anxiety and loneliness, which can suppress appetite, prompt a desire to avoid eating alone and reduce the enjoyment of fixing and eating food
  • Catabolic conditions like diabetic ketoacidosis, renal disease and chemotherapy or radiation, can increase caloric burn
  • Oral cancers, dental problems and other conditions impacting the mouth and throat, which impair chewing and swallowing

“Nutrition, along with movement, is essential to maintain a better quality of life and to prevent and or slow disease progression,” Escobar says. “Furthermore, it will improve the outcomes if older adults go to the hospital or have elective surgery.”

4 Ways to Reduce the Risk of Disease-Associated Malnutrition in Seniors

We can lower the likelihood of developing of disease-related malnutrition and mitigate its impact with a few key strategies.

  1. Talk to your healthcare provider. The first step in avoiding disease-related malnutrition is understanding how specific conditions impact the ability to stay properly nourished. Talk to your or your loved one’s healthcare provider about the diseases and medications on good nutrition and share this information with family members so they understand and can support better nutritional habits. Bonus tip: Ask the pharmacist about over-the-counter and prescription medications that might also have short- or long-term nutritional impacts.
  2. Pay attention to eating habits. Aim for well-balanced meals throughout the day. If more calories are needed, Escobar suggests high-calorie meals, “something as simple as a shake made with milk or alternative, fruit, and a nut butter can work.” And since low levels of protein can lead to muscle loss, “include chicken, beef or other sources of animal or plant proteins source or find alternatives. For example, a simple soup made with beans or lentils can go a long way.” If you or your loved one loses interest in food, it’s time to see the doctor, Roberts cautions.
  3. Watch the weight. Unexplained weight loss should always be a concern. “Often times seniors are not worrying about this themselves and might be quite pleased to lose weight easily after years of struggling with weight management,” Roberts explains. Weekly weigh-ins can help spot a trend toward weight loss. Bonus tip: If you or your loved one can’t or won’t step on a scale, Roberts says paying attention to how clothes fit is almost as good. “See your doctor if they get loose,” she adds.
  4. Recognize symptoms. Beyond unexplained weight loss and a lack of interest in or difficulty swallowing food, Roberts and Escobar recommend looking for fatigue, weakness and low or no energy; eating less than 75% of usual meals for more than 7 days; swelling of the extremities; and infrequent urination.

“When you notice any of the symptoms above, if your love one has a chronic disease or any time you sense something is off with eating,” Escobar says, it’s time to seek professional care. “Good nutrition can be the difference between a weak, sick person and a happy, strong one.”

Don’t disregard professional medical advice, or delay seeking it, because of what you read here. This information is not intended as a substitute for professional consultation, diagnosis or treatment; it is provided “as is” without any representations or warranties, express or implied. Always consult a healthcare provider if you have specific questions about any medical matter, and seek professional attention immediately if you think you or someone in your care may be experiencing a healthcare condition or medical emergency.