Malnutrition can affect people across all age groups, but one group in particular is highly represented – older people. We have an ageing population in New Zealand, and most love their independence so want to stay living in their own homes as long as possible. Massey University research shows that more than one-third of older people who live in the community are at risk of malnutrition. There are a few of reasons why this happens:
• They eat less because they think it is a logical thing to do as their physical activity reduces.
• Eating becomes a chore, especially for those living alone or caring for a sick spouse.
• Metabolism drops, reducing appetite.
• Side effects of some medications may reduce appetite.
• Illness and chewing difficulties can reduce the desire to eat.
Not eating enough makes it difficult to maintain a healthy weight. Reduced energy and protein intake causes weight loss that leads to loss of muscle mass and strength. Both of which we need to maintain to reduce the risk of falls and fractures. Eating less may also lead to nutrient deficiencies such as low iron, zinc, vitamin A and iodine.
Health consequences of malnutrition include reduced immunity and delayed wound healing, which affect recovery and rehabilitation if illness or injury occur. Recovery has high nutrient requirements that may not be reached. Vulnerable people may experience longer hospital admissions, higher mortality rates and are more likely to need long-term residential care. Malnutrition can also have negative cognitive effects such as altered mood, attitude, and reduced socialisation.
The good news is that malnutrition, and its associated poor health outcomes, can be prevented or the decline slowed by identifying and addressing risk factors early. If there is an older person that you know who is living alone (or that person might be you) please look out for:
• Unintentional weight loss – clothes or dentures are loose
• Reduced appetite or trouble swallowing
• Lack of interest in shopping for food or cooking for themselves
• New medications have been introduced
If you have any concerns that someone may be malnourished, have a chat with them. They might be struggling to do the shopping, or it’s too difficult or tiring to cook. Finding options to simplify mealtimes can help. Share a meal – making time to eat with others is good for wellbeing. Encourage them to contact their doctor or nurse. They may need professional help to assess nutritional status and to help them become well-nourished again.
If appetite is low, here are four simple tips for extra energy and protein:
• Smaller meals more often – aim for quality over quantity
• Prioritise meat and full-fat dairy products, or high quality plant proteins
• Drink tea/coffee/water between meals – hydration is important, but don’t fill up on them at meals
• Add a knob of butter or a cheesy sauce to your vegetables