What is Malnutrition?
Malnutrition occurs when the body doesn’t get the appropriate amounts of macronutrients (protein, carbohydrate, and fat) or micronutrients (vitamins and minerals) it needs to function. It can occur in both children and adults. Malnutrition impacting adults is prevalent around the world and is divided into two broad types: undernutrition and overnutrition.
More than 460 million adults are undernourished2, which often stems from chronic diseases or conditions, like cancer and Alzheimer’s disease, that can impact appetite, make eating difficult, change metabolism or require dietary restrictions. 3 Older adults are also hospitalized more frequently and are more likely to be in long-term care facilities, which can add to their risk of undernutrition. As many as half of hospitalized older adults could face malnutrition.4
Approximately 1.9 billion adults worldwide are overweight.2 This is due to decreased physical activity and poor dietary intake. Poor dietary habits may be due to a limited knowledge of good nutrition or a lack of access to nutrient-dense foods, with adults choosing high-calorie, nutrient-poor, and inexpensive foods rather than more nutritious options which may be more expensive.
While overnutrition can lead to serious conditions like type 2 diabetes and obesity, both overnutrition and undernutrition can cause loss of muscle mass and strength that make it challenging for older adults to lead active and healthy lives. In fact, people over the age of 40 may lose up to 8% of their muscle mass per decade, and this rate of loss can double starting at age 70.5,6,7,8
Unfortunately, the COVID-19 pandemic has put older adults at an even higher risk for malnutrition and muscle loss. Increased poverty, unemployment and rising food prices have restricted their access to nutritious food, while social isolation and shelter in place mandates have led to sedentary lifestyles as well as declines in physical and mental health among older adults.9,10,11
Addressing Malnutrition in Older Adults: Find, Feed, Follow
It is more important now than ever before to prioritize nutrition for older adults. Whether seeing patients in person or evaluating them remotely, healthcare providers can use a simple but comprehensive three-step screening model to identify undernutrition or overnutrition and quickly determine if further support is needed from a dietitian or other supportive services.
- Find: Ask a few simple questions to help identify adults who are malnourished or at risk, such as: Has your food intake reduced lately? Have you lost weight without trying? Have you experienced a recent illness or injury? Have you noticed weight gain within the past 3-6 months?
- Feed: Create a customized nutrition plan and recommend a nutritional shake so patients get the nutrients they need.
- Follow: Educate on the importance of good nutrition and follow up to ensure they are sticking to their nutrition plan.
Making sure older adults are properly nourished requires action from families, caregivers, and communities as well. It’s important for family members and caregivers to keep a close eye on the habits of their loved ones, including how often they’re eating throughout the day, the nutritional quality of their meals and snacks, and their adherence to nutrition plans put in place by their healthcare team.
Showing support for the older adults in our lives can be as simple as dropping off healthy groceries and meals throughout the month or checking in regularly with a phone call to make sure they’re following the doctor’s orders.
Prioritizing Healthy Aging Globally
Recent events have shown how important it is to support the health and wellbeing of older adults. Prioritizing good nutrition and overall health can help older adults live actively and independently. As populations continue to age worldwide, it will be important for countries across the globe to put policies, social services, new technologies and healthcare practices in place to support the health of aging adults, starting with proper nutrition.
1. World Health Organization. Malnutrition. https://www.who.int/news-room/q-a-detail/malnutrition,
2. Alliance for Aging Research; https://www.agingresearch.org/campaign/malnutrition/.,
3. Sriram K, Sulo S, VanDerBosch G, et al. J Parenter Enteral Nutr. 2016;1-8.,
4. Grimby G, et al. Clin Physiol. 1982;3:209-218.,
5. Flakoll P, et al. Nutrition. 2004;20:445-451.,
6. Baier S, et al. JPEN J Parenter Enteral Nutr. 2009;33:71-82.,
7. Janssen I, et al. J Appl Physiol. 2000;89:81-88,
8. Batsis J, et al. J Am Geriatr Soc. Mar 2021; 69(3): 572–580.,
9. Mueller A, et al. Aging (Albany NY). May 2020; 12(10): 9959–9981.
10. Kaiser Health News; https://khn.org/news/article/as-pandemic-eases-many-seniors-have-lost-strength-may-need-rehabilitative-services/.
11. Kaiser Health News; https://khn.org/news/article/as-pandemic-eases-many-seniors-have-lost-strength-may-need-rehabilitative-services/.