Malnutrition

Also called Undernutrition

Around 3 million people in the UK, most of them living at home. Almost entirely preventable, and routinely missed.

What it is

Malnutrition in the UK is not a story about famine. It is a story about older people who cannot get to the shops, people with dysphagia on textures nobody enjoys, people with dementia who forget to eat, and people whose illness has taken their appetite.

Around 3 million people in the UK are malnourished or at risk, and roughly 93% of them live in the community rather than in hospital.

It is measured with MUST, the Malnutrition Universal Screening Tool, which takes five minutes and is frequently not done.

Signs you might notice

Unintentional weight loss. Clothes, rings and dentures becoming loose.

Reduced appetite, or meals left half eaten.

Tiredness, weakness, low mood, and taking longer to recover from every illness.

Wounds that will not heal. Pressure ulcers. Recurrent infections.

An empty fridge, or food in it that has gone off.

How it can affect day-to-day life

The consequences compound quietly. Malnourished people fall more, get infections more often, stay in hospital longer and recover less well from surgery.

In dementia, the problem is usually not appetite but the mechanics: recognising food, using cutlery, being distracted, or not being able to see a beige meal on a white plate.

In learning disability services, weight loss gets recorded shift by shift and joined up by nobody.

Supporting someone well

Weigh people regularly and record it somewhere that shows a trend. A single weight tells you nothing; three months of weights tells you everything.

Food first, before supplements. Full-fat milk, butter, cheese, cream added to ordinary meals adds calories without adding volume, and volume is exactly what a poor appetite cannot manage.

Little and often. Six small things beat three meals nobody finishes.

Fix the mechanics: contrasting crockery, adapted cutlery, good lighting, a quiet room, dentures that fit, and enough unhurried time.

Make it social. People eat more in company, and that is one of the most reliable findings in this field.

Check the mouth. Sore gums and bad teeth stop people eating and nobody looks.

Fiducia Together links the dietary register, meal planning and weights in one system, so a downward trend reaches the person doing the review rather than sitting in a kitchen folder.

Where to get help

Ask a GP or nurse for a MUST screening and a dietitian referral.

BAPEN publish the MUST tool free, and Age UK can help with shopping, meals and befriending.

Unintentional weight loss always needs a cause found, not just calories added.