Image by Nadine Primeau

Malnutrition

The Health Index

Malnutrition is a condition where the body does not receive enough energy, protein, or other nutrients (such as vitamins and minerals) from one's diet. The result can be the severe impairment of bodily functions. Malnutrition increases the risk of various diseases and even death.  Although it can occur at any age, it is most common among the elderly, who – for various reasons – do not always eat enough food.

It is important to note, however, that you do not have to be undereating to be malnourished. More and more nutrition experts think that, thanks to ultra-processed foods, many of us are now “overfed and undernourished”.  Junk food, ready meals, convenience foods, and snacks are highly palatable, available everywhere, and often cheaper than real food. Ultra-processed foods lack many vital nutrients, leaving people malnourished despite eating (more than) enough calories.

What are the causes?

Malnutrition occurs when:

  • Nutrient intake does not meet nutrient requirements for an extended period of time 

  • The nutrients supplied cannot be sufficiently utilised

  • There is an uncontrolled breakdown of body tissue

This can have various causes, and in individual cases, malnutrition is usually caused by more than one factor.  A very common reason is a loss of appetite. Many people suffering from chronic illnesses have no appetite and therefore eat very little, causing malnutrition in the long run. Such diseases include serious infections (such as tuberculosis or HIV), tumours and autoimmune diseases. The mental stress, anxiety and depression associated with such diseases can have an additional negative effect on appetite.

 

A premature feeling of fullness and changes in the senses of taste and smell can also play a role. Problems with the passage of food through the gastrointestinal tract are another possible cause of malnutrition. Such problems arise, for example, in chronic constrictions in the small intestine of Crohn's disease patients. In order to avoid symptoms as a result of these constrictions, many people affected eat very little.  Constrictions caused by a malignant tumour,  for example in the oesophagus or stomach,  can also make it difficult to eat and thus lead to malnutrition.

 

On the one hand, such tumours can become a mechanical obstacle, but on the other hand they can also impede the mobility (motility) of the digestive tract. This can be the case, for example, with pancreatic cancer (pancreatic carcinoma), as well as after cancer-related removal, for example of the stomach or oesophagus (resection). In diabetes, the body produces no or not enough insulin (type 1), or the cells have grown resistant to the hormone (insulin resistance and type 2). Insulin normally enables the cells to absorb sugar (glucose) from the blood.

 

They use it to produce energy.  Untreated diabetes contributes to malnutrition. Insulin resistance can be caused by a poor diet, infections, tumours and cirrhosis of the liver, or steroid therapy.  A disturbed nutrient utilisation with subsequent malnutrition can also occur in other ways, such as increased protein breakdown in pancreatic and other tumour diseases.

Eating disorders and prolonged dieting, especially fad diets, can cause malnutrition.  Fashionable diets that are particularly popular among teenagers and young adults, such as veganism, can result in sub-optimal nutrition.  Factors such as poverty, social isolation, loneliness or grief contribute to the development of malnutrition, especially among many elderly people.  Loss of independence, for example as a result of a stroke or other illness, also plays a role: people who find it difficult to shop and prepare meals often neglect their food intake.  Often, changes that come with age, such as a decline in sensory perception or a change in the regulation of hunger and satiety, can also lead to malnutrition. The same applies to increasing forgetfulness, confusion, and dementia - some patients simply forget to eat.

What are the symptoms?

People with malnutrition may have one or several of these symptoms:

  • Weight loss, loss of fat and muscle mass

  • Hollow cheeks and sunken eyes

  • A swollen stomach

  • Dry hair and skin hair loss

  • Slow wound healing

  • Fatigue

  • Difficulty concentrating

  • Irritability

  • Depression and anxiety

  • Menstrual irregularities

  • Impaired fertility

How can a nutrition practitioner help?

A nutrition practitioner will ask questions about your overall health and health history, diet, lifestyle and exercise habits. They will look at your food diary to see whether your diet provides all the nutrients you need, taking into account extra requirements due to an illness or medication. Your nutrition practitioner may also recommend functional testing to assess your nutrition status. They will then develop a customised diet, supplement and lifestyle plan for you.

Find your Malnutrition

Specialist