Malnutrition: Causes, Prevention and Treatment

Malnutrition can normally be prevented by identifying risk factors, testing your loved ones or patients using the MST, and modifying their diet accordingly.  If you’ve identified a loved one or patient at risk of malnutrition, it’s a good idea to try these nine helpful tips.

The top 9 ways to treat malnutrition

Quick Tips

1.Consume a high protein and high energy diet

2.Eat proteins and desserts first

3.Eat small, frequent meals

4.Make meals visually appealing

5.Food fortification

6.Make meals enjoyable

7.Use nutritional supplements between meals

8.See an Accredited Practicing Dietitian

9.Check weight monthly

1. Consume a high protein high energy (HPHE) diet

When a person is undernourished, you want to make sure they’re eating as many carbs, proteins and fats as possible.  A high protein high energy (HPHE) diet is a strategy for increasing the protein and energy content of food without increasing the volume of food. This can be very useful when someone has a small appetite.

Foods with high protein density include:

• Meat, like lamb, beef, chicken
• Seafood, particularly oily fish like salmon and sardines
• Legumes like baked beans, chick peas and lentils
• Dairy, like milk, cheese and yoghurt
• Nuts and seeds
• Eggs
• Food fortification powders like AdVital
• Nutritional supplements like Recover

Good sources of high energy food include:

• Full-cream dairy products
• Bread, cakes and pastries
• Breakfast cereals
• Eggs
• Potato, sweet potato and corn
• Mackerel
• Butter, margarine, salad dressing and various oils
• Jam, honey and golden syrup
• Nuts
• Nutritional supplements like AdVital and Recover

You can create meals with high energy by:

• Adding peanut butter to dishes
• Serving fruit with cream, ice cream or custard
• Frying or cooking in oils
• Adding cheese to dishes
• Drinking milk-based drinks (smoothies, flavoured milk, iced coffee) instead of plain tea and coffee
• Fortifying plain tea and coffee
• Adding butter to dishes
• Doubling the protein portion of dishes

2. Eat protein and dessert first

Because proteins (meat/fish) and desserts are high in both protein and energy, it’s a good idea to eat these first, especially if your patient or loved one gets full easily.  Vegetables normally aren’t as protein-rich, so they should be consumed last.

3. Eat small, frequent meals

Eat six to eight small meals and snacks throughout the day by aiming to eat every two to three hours.  Small, frequent meals can boost your nutrition intake, and can be useful if you feel full quickly or if your appetite has decreased.

Eating smaller meals more often also means a person’s energy intake is more balanced, which helps their body process nutrients more efficiently [12].

4. Make your meals visually appetising

In some situations, a lack of appetite can contribute to or be symptomatic of malnutrition.  If your loved one or patient isn’t enthusiastic about their meals, try putting extra effort into presentation.

Ghrelin, the hormone that regulates hunger, is stimulated by visual cues, so creating delicious, aesthetically appealing meals can actually help promote a better appetite [13].

This is particularly important for people on texture-modified diets – minced and pureed food doesn’t look particularly yummy!  That’s why products like Flavour Creations’ Shape It are so great.  Shape It is an instant moulding powder you can add to texture-modified foods to help them look completely natural, without compromising smell, flavour or texture.  Shape It is heat-activated, and, once it’s mixed into minced or pureed food, foods can be shaped to resemble their standard and recognisable appearance.  It’s that simple!

It’s also important not to overload your loved one or patient’s plate.  Meals that look overwhelmingly large can deter a person from even starting to eat.  If necessary, try serving meals on bigger plates with more white space – this helps the food itself seem smaller.

5. Eat fortified foods

Fortified or enriched foods are one of the easiest ways to combat malnutrition.  ‘Fortified’ or ‘enriched’ means that the food or drink in question has had additional protein, energy, vitamins and minerals added to it [14].  Some foods are fortified pre-packaging, but fresh-cooked meals can also be enriched with nutritional powders.  These powders can be mixed into food to boost protein, energy and vitamin levels.

Our favourite?  AdVital.  AdVital’s neutral-flavoured powder is packed with 15 grams of protein and 27 vitamins and minerals.  It’s designed to mix easily into everyday meals like cereal milk, scrambled eggs, pasta, porridge, soup or mashed potato, so you don’t need to worry about glugging down unpleasant-tasting smoothies or swallowing handfuls of tablets.

AdVital’s neutral flavour is one of its most impressive features.  Many fortification powders have unpleasant or noticeable tastes, which can affect appetite and meal enjoyment, and are only suitable for adding to certain types of food (like dairy).  Neutral-flavoured powder, by comparison, can be mixed into literally any food without changing the flavour, making it a versatile option for fighting malnutrition.

6. Make meals more enjoyable

Because malnutrition can be exacerbated by a lack of enjoyment or interest in food, it’s a great idea to make meals something to look forward to, rather than a chore to struggle through.  You can do this by:

• Adding a community aspect to meals.  Positioning meals as a time to interact with friends and families is useful for getting older people (particularly those in aged care) to the table.
• Making meal spaces welcoming and comfortable.  This might include adjusting temperature controls to a warmer level, making seating more comfortable, adding more light or offering an outdoor eating space.  If possible, consider adding a television so people can watch their favourite shows while eating.
• Providing easy-to-use plates and cutlery.  Plates and cutlery that are too heavy or awkward can reduce the ability and inclination to eat, particularly in people who are suffering from frailty or muscle weakness.
• Always remembering to tailor your approach to your loved one or patient’s personal preferences.  For example, if someone is self-conscious about eating, they might find it discomforting to eat in front of others, so a better idea would be to make their room a comfortable eating space.

7. Use nutritional supplements

Another strategy to fight malnutrition can be to bulk up meals with nutritional supplements.

Nutritional supplements work because they normally have high energy and protein.  This means that they contain a comparatively high amount of calories, which is exactly what malnourished people need to recover faster.

Some of them, like Recover by Flavour Creations, are specifically designed to help combat malnutrition in older people and hospital patients.  Clocking in at double the protein of other fruit-flavoured oral nutrition supplements, Recover’s small serving size and appealing taste make it perfect for people who are struggling to get enough protein.  It can be drunk between meals and is designed for all Australians – it’s dairy-, lactose-, fat- and gluten-free, and is both kosher- and halal-certified.

We recommend using supplements like Recover and AdVital in combination with a variety of other strategies.  Try getting your loved one or patient to eat six to eight small meals of high-protein high-energy foods (one of which can be enriched by AdVital), with two to three Recover drinks in between meals.

8. Get a referral to a dietitian

If none of the above tips are working and your patient or loved one has scored 2+ using the MST, it’s time to get a referral for an Accredited Practicing Dietitian.  You can make an appointment with a dietitian yourself, but getting a referral from a GP means you might be eligible to have Medicare cover the cost.

You can find accredited practicing dietitians using the Dietitians Australia website.

9. Monthly weight checks

Remember to keep re-screening, weighing and visually assessing your patient or loved one every month.  Doing this will help pick up significant weight changes, and will alert you if they’re at risk of becoming malnourished.