We are constantly confronted with media reports focusing on the current ‘obesity epidemic’, and the dangers of consuming too much sugar, salt and fat are widely broadcast. However, this focus on the need to tackle obesity has overshadowed a hidden crisis that affects millions nationwide: malnutrition.
Dangers of malnutrition
Over three million people in the UK are malnourished or at risk of malnutrition, and our elderly population is particularly at risk – over one million of those affected are aged over 65. The danger of this can’t be overstated, because malnutrition has serious implications for the health issues older people often face: it has the power to exacerbate on-going health issues such as frail bones and muscles, wound healing or a weak immune system, and can lead to problems absorbing medication.
Malnourished people typically visit their GP twice as often as those who are getting a healthy, well-balanced diet. Malnutrition also contributes to a ‘revolving-door’ phenomenon amongst some hospital patients, who are discharged but subsequently become ill again as a poor diet inhibits their recovery at home – and are ultimately re-admitted to hospital.
Why are our elderly malnourished?
An elderly person might be under-nourished for various reasons: some older people living alone might not like to cook for just one person, or those who are frail might not feel confident going out of the house to the shops. However, one driving factor is the way we talk about diet and health, both in the media and in the health advice given by public bodies and the government.
With the current focus on tackling obesity, there is a tendency to apply a very prescriptive, ‘one size fits all’ perspective to our diets, but this risks confusing older people, who often need very different dietary advice from the rest of the adult population: for example, older people may need to eat more fat and sugar to maintain a healthy weight.
To tackle the problem of malnutrition amongst older people, The Malnutrition Task Force (MTF) was established in 2012. MTF aims to actively influence behaviours across the NHS, residential care and in the community to prevent and reduce malnutrition in older people. apetito, the parent company of Wiltshire Farm Foods, is one of the five founding partners of the MTF and has made a substantial financial contribution to its funding (along with Age UK, WRVS, BAPEN and Nutricia). Paul Freeston, apetito’s chief executive is also a member of MTF’s Steering Group.
What’s to be done?
There is a long way to go in fighting malnutrition in the elderly, but there are some tips those working with the elderly can bear in mind:
Spotting the signs: There are warning signs that might indicate an older person is malnourished. It can be difficult to gauge someone’s weight without forcing them onto a set of scales, but looking out for clues such as wedding bands that have become loose, or a noticeable decrease in upper arm circumference can give you an idea if the person has lost weight. You may also notice that an elderly person may seem more frail – when someone is malnourished they are likely to have deficiencies in several vitamins, such as zinc or vitamin D, that have knock-on effects for the rest of their health.
Debunk the myths: Healthcare professionals should work to combat false perceived norms, which are commonly held by older people: for example, that fat and sugar is bad for you and should be cut out of a diet where possible. It’s also worth emphasising that getting vitamins and minerals can come from a really wide range of sources, to suit all budgets: for example, frozen vegetables are just as full of nutrients as fresh (and sometimes more so), but many older people may think that only ‘fresh’ food is nutritious and therefore overlook alternatives.
Offer flexible advice: A personalised approach should be taken when delivering dietary plans or advice, which takes into account varying medical needs of older people. It’s important to consider the person’s ability to swallow and digest food when creating a dining plan for them; texture-modified foods may make eating much easier for someone suffering from a condition like dysphagia.
Tasty, tempting and varied food is also essential to engage older people in eating well. At Wiltshire Farm Foods, we have a number of processes in place to make sure that the dishes we develop meet the tastes and preferences of our customers: perhaps most importantly, we have customer panels, where we invite feedback and ask our customers what they’d like to see. One example is our ‘Extra Tender’ range, which we developed in response to feedback from customers about what they found most comfortable to cut up and eat.
Education, care and nutritious food are the tools we have to tackle malnutrition amongst our elderly population. Reducing and, ultimately, preventing malnutrition is an enormous challenge, but with the work of the Malnutrition Task Force, government support and the enthusiasm of those working in health and care, we believe that we can make a real difference to the quality of life of so many older people.
By Helen Willis BSc RD, apetito and Wiltshire Farm Foods Dietitian; member of the British Dietetic Association and the National Association of Care Catering