Posted by ProPortion Foods Blog on Jan 7, 2020 in Malnutrition
Malnutrition occurs when someone does not receive enough dietary nourishment to sustain their physical health needs, leading to wasting.
The most common, and most obvious symptom is weight loss; technically, it is defined as unintentionally losing 5-10% of body weight over three to six months – and a high percentage of that comprises lean muscle tissue which is a critical problem in itself.
Health bodies are calling for mandatory nutrition standards across residential aged care facilities, including staff training and awareness. While the issue is complex and needs a multi-pronged approach, a simple start is prioritising quality food in aged care budgets.
Important strategies to prevent and treat malnutrition are regular meals and snacks containing protein and energy, a variety of food from the key food groups, and regular drinks to avoid dehydration. Where patients have difficulty eating or swallowing, high energy, high protein drinks can be given between meals.
Challenging conventional wisdom, diet quality is even more important for preventing frailty than food quantity or protein intake, according to a recent study in the US. The authors found four studies showing that a Mediterranean diet reduced frailty risk – an eating pattern high in plant foods such as vegetables, fruit, legumes and healthy fats contained in extra virgin olive oil, nuts and seeds. It is low in processed foods, confectionary and red meat.
So giving custard and ice cream to patients at risk for malnutrition might not be the ticket for boosting protein and energy intake, but rather generous amounts of extra virgin olive oil for cooking and salads, a handful of nuts each day for those who can chew them, avocado, salmon, eggs and full fat dairy products such as yoghurt and cheese.
Barriers and catalysts of eating also need to be identified and addressed, and every effort made to help older people enjoy food and the enhanced wellbeing that it delivers.
Ultimately, if meals and food choices are appealing, older people are more likely to eat. The environment is very important. Cooking smells, communal eating, pleasant, relaxed surroundings and attractive food presentation can all stimulate appetite.
As Maggie Beer says, “It’s all about giving equal measures of pleasure and nutrition. Without pleasure, what is there in life?”
Our Cost of Malnutrition report outlines the problem of malnutrition and its various costs – both financial and physical – and offers a guide to its identification and management.
Download your free report HERE.
Posted by ProPortion Foods Blog on Dec 16, 2019 in Malnutrition
Malnutrition is a silent epidemic, often called the “skeleton in the hospital closet” because it tends to escape detection and treatment.
This is surprising given that more than one in three hospitalised older adults and nearly one in thirty community dwelling people over 60 are malnourished. In aged care, malnutrition afflicts up to two thirds of residents.
Longer hospital stays also mean bigger costs and less beds for other patients. In Australia, around 5,400 cases of complications arising from malnutrition each year result in an average 21.3 extra days in hospital, each episode costing up to $44,176 extra. That amounts to nearly $240 million per year.
In the Netherlands and UK, studies have estimated the direct cost of malnutrition in residential aged care as the equivalent of AUS$174 million to $2.76 billion per year.
So, what are facilities investing in older adults’ diets? A 2018 study found that Australian residential aged care spent a mere $6.08 per person each day on food, a drop from the previous year and less than international budgets. In fact, it was shamefully lower than the $8.25 spent on prisoners by Australian corrective services.
Ironically, prioritising good nutrition could result in substantial cost savings for healthcare.
A systematic review of interventions to target malnutrition found they only cost 2.30 British pounds – AUD$4.34 – daily per person to implement and achieved several positive outcomes including improved dietary intake, nutritional status and weight gain.
Other American research found that multi-disciplinary nutrition support for home-based patients at risk for malnutrition drastically reduced hospital admissions and saved millions of dollars in annual health care costs. After 90 days of receiving the program, hospitalisation decreased by 24% in the first month, nearly 23% after two months and 18% after three months. Healthcare costs dropped by US$1,500 per patient over 90 days, amounting to more than US$2.3 million.
Importantly, savings outweighed the costs of implementing the program by sixfold.
Our Cost of Malnutrition report outlines the problem of malnutrition and its various costs – both financial and physical – and offers a guide to its identification and management.
Download your free report HERE.
Posted by ProPortion Foods Blog on Nov 15, 2019 in Malnutrition
“Malnutrition can have dire consequences for an older person’s health”
– Royal Commission into Aged Care Interim Report
20-65% of aged care residents are malnourished, and nearly 75% are at risk of malnourishment.
Loss of muscle mass and strength bear the brunt of poor nutrition, leading to frailty and sarcopenia, an age-related disease of accelerated muscle wasting that increases risk of falls and fractures, a prevalent problem that can spiral out of control with related complications.
Muscle mass comprises more than half of overall body tissue and its loss impacts not only physical strength and mobility but also muscles used by the lungs to breathe and by the heart to keep beating, escalating poor health and mortality. Low muscle mass has also been linked to other problems including increased risk of insulin resistance and type 2 diabetes.
An unintentional loss of 15% body weight causes steep declines in muscle strength and lung function. If the loss reaches 23% this results in a further staggering 70% decrease in physical fitness, along with loss of muscle strength and increased depression risk.
These put a large strain on independence and quality of life, and the resulting fatigue and apathy create a vicious cycle, delaying recovery and exacerbating appetite loss.
Malnutrition also compromises the body’s immune system, increasing risk of infection and disease, delaying wound healing, causing complications and impeding general recovery. This results in being confined to bed for longer which also compounds the risk of pressure ulcers.
Our Cost of Malnutrition report outlines the problem of malnutrition and its various costs – both financial and physical – and offers a guide to its identification and management.
Download your free report HERE.
Posted by ProPortion Foods Blog on Jul 22, 2019 in Cognition, Diabetes, Malnutrition, Nutrition, Obesity
In 2008 the Australian government released its Closing the Gap Strategy, which laid out plans to achieve health equality for Aboriginal and Torres Strait Islander people by 2030.
How is it tracking?
Not well, according to a 10-year review by the Australian Human Rights Commission – if anything, the gap has grown.
Of all Australian population groups, Aboriginal and Torres Strait Islander people still suffer the worst health outcomes, and their lives are about 10 years shorter than the rest of the populace.
According to Robert Tickner from the Australian Red Cross, “It is a national disgrace that, despite our reputation as one of the world’s most bountiful food producers, so many Australians cannot get adequate, nutritious and affordable food.”
Poor nutrition is a key contributor to the overburden of health issues faced by Indigenous Australians, which include overweight and obesity, malnutrition, heart disease, type 2 diabetes, chronic kidney disease and tooth decay.
These diseases contribute to at least three-quarters of their mortality gap.
Food insecurity is a big part of the problem. Much of this is due to poverty. Many Indigenous Australians also live in remote communities where healthy food is hard to come by. What is available is expensive because of transport costs.
As a result, fresh fruit and vegetable intake is very low, and “discretionary foods” make up 41 percent of their daily energy intake. Sugar consumption – largely from sweetened drinks – is nearly 50 percent more than the World Health Organisation’s recommendations.
Combined with easy access to unhealthy food and drinks, poor education and nutrition literacy is also part of the problem.
Many community-based programs have helped, the most successful being those with multi-level strategies that encourage community involvement at every stage of their development and implementation to make sure they are culturally appropriate and address local needs.
Some programs have focussed on improving the food supply through local retail outlets, school and community gardens, food provision by community organisations, and community store nutrition policies.
Nutrition education can also help, if delivered in conjunction with making healthy food accessible through cooking education, budgeting advice, and group-based lifestyle programs.
But these are band aid solutions to the overarching problem: there have been no nationally coordinated nutrition ventures since the National Aboriginal and Torres Strait Islander nutrition strategy and action plan expired in 2010.
The situation can be traced to many historical factors; indeed, all the evidence suggests that before European settlement Indigenous Australians enjoyed good health and a varied diet of nutritious fresh plant and animal foods.
Now they suffer socioeconomic disadvantage with low income and unemployment, institutional racism, low access to primary health care and poor quality, overcrowded housing, all of which contribute to ill-health and mortality.
Health equality is a basic human right. Treating diseases and improving nutrition and food security are important, but the review argues that underlying structural factors also need to be tackled before Australia can close the gap.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4977265/
https://www.smh.com.au/national/aboriginal-malnourishment-a-national-disgrace-20081030-gdt0s8.html