Exploring the Warning Signs of Malnutrition in Adults

Overview

Malnutrition refers to the insufficiency of energy, protein, and other essential nutrients, which leads to detrimental impacts on the body’s physical attributes (shape, size, and composition), functionality, and clinical outcomes.

Types of Malnutrition

Different types of malnutrition encompass undernutrition and overnutrition. 

Undernutrition occurs when an individual does not consume sufficient protein, calories, or micronutrients, leading to low weight-for-height (wasting), height-for-age (stunting), and weight-for-age (underweight). 

On the other hand, overnutrition arises from excessive intake of specific nutrients like protein, calories, or fat, which can result in overweight or obesity. 

Warning Signs of Malnutrition

1. Weight Loss

It is important to note that malnourishment can lead to weight loss in most individuals. However, it is possible for someone to maintain a healthy weight or even be overweight while still being malnourished. 

This can occur when the body does not receive an adequate amount of essential nutrients, such as certain vitamins and minerals, through the diet. 

There are several indicators that may suggest malnourishment, including unintentional weight loss of 5 to 10% within a span of 3 to 6 months, having a body mass index (BMI) below 18.5 (although individuals with a BMI below 20 may also be at risk), and noticing that clothes, belts, and jewellery become looser over time. 

If you have experienced significant unintentional weight loss in recent months, it is advisable to consult a general practitioner (GP). Additionally, if you have concerns about a friend or family member who has lost a significant amount of weight, it is important to discuss your concerns with them and encourage them to seek help.

2. Experiencing fatigue and irritability

Feeling exhausted, lacking energy, and having a strong urge to sleep that hampers regular daily tasks.

3. Slow healing time for wounds

Insufficient protein levels can impede the production of collagen, thereby prolonging the healing time for wounds. It is crucial to maintain adequate protein levels to facilitate optimal wound healing rates. Additionally, ensuring an appropriate overall energy intake is essential, as the body may prioritize using protein for energy instead of utilizing it for wound healing purposes.

4. Depression

Depression, known as a mood disorder, is characterized by a continuous sense of sadness and lack of interest. Referred to as major depressive disorder or clinical depression, it impacts one’s emotions, thoughts, and behaviours and can result in various emotional and physical challenges.

5. Persistent Coldness

The persistent feeling of coldness in one’s body is also indicative of many medical conditions.  

6. Loss of appetite

An individual may experience a diminished desire to eat, which is commonly referred to as a decreased appetite or poor appetite. This condition, medically known as anorexia, can result in a lack of interest in food or drink.

7. Poor concentration

A person with poor concentration finds it hard to focus and might be easily distracted.

Consequences of Malnutrition in Adults

• Decreased muscle strength and vulnerability
• Weakened immune response
• Elevated susceptibility to falls
• Diminished clinical outcomes, such as increased mortality rates
• Compromised psycho-social well-being, including anxiety, depression, and altered cognitive function
• Hindered wound healing
• Delayed recuperation from illness and surgical procedures

Diagnosis

The physician can identify the presence of malnutrition by observing the patient’s overall appearance, behaviour, body fat distribution, and organ function. 

To gather more information, patients may be requested to keep a record of their dietary intake over a specific period. X-rays can be utilized to assess bone density and detect any gastrointestinal issues, as well as potential damage to the heart and lungs.

Blood and urine tests are employed to evaluate the patient’s levels of vitamins, minerals, and waste products.

Treatments

Dietary changes and supplements

A dietitian can provide guidance on making dietary changes that can be beneficial for you. They can develop a personalized diet plan that ensures you receive an adequate amount of essential nutrients.

Additionally, they may suggest the following:

• Adopting a healthier and more balanced diet
• Incorporating “fortified” foods that contain additional nutrients
• Including snacks between meals
• Consuming calorie-dense beverages
• Opting for supermarket deliveries at your doorstep

If these measures prove to be insufficient, the healthcare professional may recommend taking dietary supplements. However, it is crucial to seek advice from a healthcare professional before starting any supplements.

Regular appointments will be scheduled to monitor the effectiveness of the dietary changes in improving your nutrition. Your diet may need to be further adjusted to enhance its efficacy.

If you are unable to consume an adequate amount of food to meet your body’s nutritional requirements, such as due to dysphagia (swallowing difficulties), alternative methods of receiving nutrients may be necessary.

Feeding tubes

These methods can include:

1. Utilizing a tube that is inserted through your nose and into your stomach (nasogastric tube).

2. Insert a tube directly into your stomach or intestines through the skin on your abdomen (percutaneous endoscopic gastrostomy – PEG – tube).

3. Administer a nutrient solution directly into your bloodstream through a tube in a vein (parenteral nutrition).

Typically, these treatments are initiated in a hospital setting but can be continued at home if you are in good health.

Conclusion

Malnutrition can impact individuals across all age groups, genders, and health conditions, although it is more prevalent in developing nations where food scarcity is a pressing issue. However, in developed countries, the number of individuals diagnosed with this condition is steadily increasing.

Various factors like dietary choices, alcoholism, mental health issues, and digestive disorders are often identified as the primary causes in such industrialized nations.

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