Malnutrition Flashcards
Define malnutrition
MALNUTRITION IS A STATE IN WHICH A DEFICIENCY OF NUTRIENTS SUCH AS ENERGY, PROTEIN, VITAMINS AND MINERALS CAUSES MEASURABLE ADVERSE EFFECTS ON BODY COMPOSITION, FUNCTION OR CLINICAL OUTCOME.
What does malnutrition mean?
A lack of nutrients / inappropriate nutrients
LINKED TO
An effect on body composition and function
The worldwide prevalence of obesity nearly _______ between 1975 and 2016.
Tripled
______fold increase in childhood and adolescent obesity in four decades
Tenfold
______ people affected globally by malnutrition
500 million
Name an example of a place in the world where malnutrition is deadly
Somalia – displaced persons camps
- Crude mortality rate 5 per 10.000/day = 18% in a year
- 74% of children <5yrs died during study (240d)
- 81% deaths due to measles and diarrhoeal illness
Malnutrition affects ______ people in Britain at any one time
3 million
Which hospital wards have the highest levels of malnutrition?
- Oncology
- Care of elderly/stroke
- Medical
- Other
- Surgical
- Orthopaedic/trauma
Which diseases have the highest Prevalece of malnutrition in relation to underlying disease?
>40% pts with GI/liver disease
Up to 80% GI malignancy
- Oesophageal 57%
- Gastric 65%
- Pancreatic 85%
Colorectal 33%
What are the 4 mechanisms of malnutrition?
- Inadequate intake
- Impaired nutrient digestion and processing
- Excess losses
- Altered requirements
How does impaired nutrient digestion and processing cause malnutrition?
Impaired nutrient digestion and processing
= malabsorbtion
Dysfunction of
- stomach
- intestine
- pancreas
- liver
How can excess losses cause malnutrition?
- Vomiting
- NG tube drainage
- Diarrhoea
- Surgical drains
- Fistulae
- Stomas
What are the possible reasons for increased metabolic demands?
- inflammation
- cancer
- wounds
- burns
- brain injury
What type of starvation is this?
Uncomplicated fasting
12-24 hours
What type of starvation is this?
Uncomplicated fasting
7 days
Complete the diagram
What is the impact of malnutrition in healthy people?
- Decreased skeletal muscle mass and function day 5
- 18% loss (and above) of mass leads to physiological disturbance
–Cardiac 45% reduction in CO
–Respiratory / diaphragmatic muscle mass and contractility
–Gut and immune function
What percentage of weight loss is fatal in a healthy person?
•Approximately 40% weight loss is fatal
What are the negative effects of malnourishement on patients?
- Attend their GP surgery more often
- Are admitted to hospital more frequently
- Stay in hospital longer
- Succumb to infections
- Often discharged to long-term care
- Die
What is the cost of malnutrition to the NHS?
- Health costs exceeding GBP 13 billion annually
- Identifying and treating malnutrition presents the fourth biggest potential saving in the NHS today
___% of patients are malnourished at admission to hospital
40%
- On average 200 lost ______% of their weight during hospital stay
- Those referred for nutrition support put on _____% during their stay
6%
10%
How do hospitals cause malnutrition?
- Inadequate / unpalatable / unsuitable food
- Can’t reach food / can’t feed themselves
- Altered taste / poor appetite
- NBM
- Starved for Ix
- And then again if the Ix gets cancelled
- Starved before and after surgery
What are the possible medical causes of indaequate intake?
- Poor diet
- Poor appetite/Anorexia/Taste disturbances
- ‘Nil by mouth’ for investigation or medical reasons
- Starved before diagnostic procedures – and often cancelled
- Starved before and after surgery
- Pain/Nausea
- Dysphagia
- Depression
- Physical disability and inability to feed self
- Unconsciousness
