Nutrition Nuts and Bolts

By Shelly Najjar

The term malnutrition is often heard in news stories and international health organization fundraising brochures, but do you know what it means, why it’s important, and what you can do?

This week is Malnutrition Awareness Week (September 23-27, 2013), created by the American Society for Parenteral and Enteral Nutrition (ASPEN). ASPEN is a professional organization for clinical nutrition (nutrition for people in hospitals and other acute, chronic, and transitional care settings), particularly for parenteral (IV nutrition) and enteral nutrition (tube feedings). Although they are focusing on clinical recognition and treatment of malnutrition, this isn’t something that only affects people in hospitals. Malnutrition and its associated problems are seen around the world in a variety of settings.

What is malnutrition?

“Malnutrition” means unbalanced or inadequate nutrition (Source: Merriam-Webster Medical Dictionary). It can occur in many situations, including (but not limited to) the inability to digest and absorb nutrients, having an extended illness, limiting types of foods eaten (for example, not eating any fruits or vegetables), and not eating enough food due to lack of money. Technically, malnutrition can be either “overnutrition” (excessive intake that causes medical problems) or “undernutrition” (deficiency of one or more nutrients) (Source: White, et al). However, it is usually used to mean “undernutrition” or not eating enough (of a one or more nutrients, or of total calories) to maintain optimal health. While both overnutrition and undernutrition are important topics, the rest of this post will be mostly about undernutrition.

The method for diagnosing malnutrition vary slightly depending on which set of criteria are used. Some of the criteria sets are the International  Classification of Diseases Ninth Revision (ICD-9), the Tenth Revision (ICD-10), and the International Dietetics and Nutrition Terminology (IDNT). There are also some guidelines included in the AND/ASPEN Consensus Statement on malnutrition.

Why do we care?

The issue of malnutrition is important because adequate nutrition is essential for our bodies to work correctly. Exactly what the symptoms are depends on which nutrient is deficient (meaning: not meeting the recommendation for intake). Some issues that may be caused by malnutrition include decreased ability to fight off infections, delayed injury healing, and decreased ability to build and maintain muscle. It also can affect fertility, mental function, and overall growth and development (Sources: Nutrition in the Prevention and Treatment of Disease*; Nutrition therapy and pathophysiology* I get commissions for purchases made through those links*).

What can be done?

The treatment for malnutrition is to correct the nutritional deficiencies, whether they are single nutrient (one example: someone who lacks iron in their diet) or total calories (one example: someone who cannot keep food in their stomach due to treatments for cancer). If the deficiency is caused by another problem (for example, an intestinal disease), that problem will need to be treated. Doctors, dietitians, and nurses often help with the treatment of malnutrition.

Malnutrition can happen anywhere. It is often linked to poor diet quality when people cannot afford enough nutritious food. There are several ways you can help prevent malnutrition, and many resources for people who want some help getting food.

Help out:

Donate time (volunteer) or money to organizations that fight hunger, help provide nutritious food, or offer jobs and training so people can afford food. Do your research on organizations before you give, to make sure the organization is legitimate and your money will be used wisely. Some resources that may be useful are Charity Navigator, GuideStar, Better Business Bureau Wise Giving Alliance, and GiveWell.

Get help:

Communities, cities, states, and countries usually all have some form of food assistance programs available. Social workers, doctors, nurses, dietitians, community leaders, community agencies and organizations, schools, and local and state governments may offer help with finding food. Food assistance can include food banks, hot meals, or money for buying food (like Food Stamp programs, now called SNAP in the USA). If you are in the USA, you can use the Benefits Finder to find government benefits you may be eligible to receive.

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You may also be interested in…

• Hunger and Malnutrition (more detailed post from Nemours Foundation)
• What is malnutrition? (World Food Programme)
• Nutrition support 1: risk factors, causes and physiology of malnutrition
• What is a Registered Dietitian?

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Shelly Najjar, MPH, RDN is a Registered Dietitian Nutritionist and wellness coach at Confident Nutrition. You can find her on Facebook, Twitter (@ShellyNajjar), and LinkedIn.

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