Malnutrition refers to either over or undernutrition.
It is often confused with starvation, however, malnutrition simply refers to someone whose nutrition is poor to the extent that there is something missing. This could be either a macro or micronutrient.
Common causes of malnutrition
A significant contributing factor in malnutrition is lack of education.
Many people don’t receive much information in school about nutrition. Most of what they do learn comes from their parents and in many cases parents, despite doing their best, are not well-informed about nutrition either.
Other contributing factors include:
- Cultural background
- Social circumstances
- Location impacting access to food
- Financial considerations impacting access to food
- General health
There are many other reasons for malnutrition, including age and disability. For example, later in life people tend to only want smaller, less frequent meals. It can be harder to get a full day’s nutrition into only two small meals.
For people living with disabilities, functional issues such as difficulty swallowing or behavioural challenges can make it difficult for them to consume enough nutrition.
A Dietitian always needs to consider not just what goes on to someone’s plate or what supplements are prescribed, but to what extent those foods or supplements are actually taken in.
There is a range of tools used to identify malnutrition.
The first are observational and include:
- Observing and recording intake
- Observing and recording what is offered, and what is left on the plate after a meal
The second identifiers are physical. They relate to anthropometry and blood tests and they include:
- Growth charts for children
- Nutrient deficiency
- Protein breakdown in the body (indicated by the presence of C-reactive protein)
What are the most important things for people to understand about malnutrition?
Without enough nutrition, the human body will start to break down body fat to use it as energy. This is a key indicator for malnutrition.
There are a few key factors for individuals and carers to be aware of when it comes to nutrition. These include:
- Mild forms of malnutrition are generally straightforward to correct
- When significant changes in eating behaviours persist for two weeks or more, weight should be checked
- A weight change of five kilograms across a two-week period is considered significant
- It can be unsafe to feed somebody who is significantly malnourished or borderline starving; instead, they need to have appropriate foods reintroduced slowly to avoid Refeeding Syndrome
A recent success story: making simple changes to increase nutrition
Community Therapy just received a lovely email from a client we recently began helping.
The client has autism and had developed some restrictive behaviours around eating.
Our clinician recommended a very small change to his breakfast, and he emailed to let us know of the success that change has brought.
Our initial assessment had revealed very mild malnutrition, so the initial aim was to help him put on two kilograms. It was only necessary to increase his caloric intake by a small percentage in order to reach that target.
He was eating a lot of plain rice crackers for breakfast, without anything else. There was no need to remove the rice crackers (they were not detrimental to his eating) however he did require something else to ensure his body was getting the nutrition it needed.
In discussions, he revealed that he enjoyed milkshakes, so a plan was put in place to introduce a protein-drink with his breakfast. Since implementing this change, he has started to gain a little bit of weight (1.5kg) and is tracking well to meet his 2kg goal.
Is there a ‘one size fits all’ approach, or do different people require different interventions to achieve optimal nutrition?
Recommended interventions will vary significantly from client to client.
In some cases, it might involve creating a meal plan, in other cases, it may be developing an elimination diet.
There are many different factors that impact someone’s physical health, and a Dietitian will take these into account.
A Dietitian will also help by establishing goals for the client. For example, a client may be doing well nutritionally but need help managing the symptoms of intolerance. Another client may simply want to optimise their health.
Each client’s current situation and goals will inform a carefully tailored and individualised plan.
Who can I turn to for help?
Fill out our referral form online and our Dietitians at Community Therapy will organise a home visit appointment at a time that suits. They will undertake an initial assessment to understand what is needed and how they can help.
A Dietitian can then provide support through practical advice and information about foods and their role in nutrition.
Every food has its pros and cons. For example, rice crackers are a simple carbohydrate food. So while they are not necessarily an unhealthy choice, they are not going to provide the full range of nutrition that the body needs.
Clients are often surprised to hear that we don’t approach foods as ‘good’ and ‘bad’. All foods – including chips, chocolate and beer – have nutritional value. It is simply a matter of determining the level of intake that is healthy and safe.
Accredited Practicing Dietitians have access to a range of databases to provide accurate information. These can be significant not just for determining which foods should be consumed, but also in determining the optimal portion size for a particular person. Dietitians also have access to databases reflecting the diversity of foods consumed in Australia.
Do you know someone that would benefit from a Dietetics home visit?
Community Therapy is ready to help. Please note that:
- We are NDIS registered
- We are mobile, please view our locations here
- We are fully licensed and insured
- We were established in 2016