Malnutrition Flashcards
Define Malnutrition
state of nutrition in which a deficiency or excess of energy, protein and other nutrients causes measurable adverse effects on tissue/body form, body function and clinical outcome
What is the prevalence of malnutrition in the UK
+ 30% of adults on admission to hospital3-7 and about 34% of those in hospital wards
+35% of adults admitted to care homes in the previous 6 months
and about 35 % of those resident in care homes
+18% of adults on admission to mental health units
+ 15% or more of adults attending hospital outpatients
+ 12–14% of adults in sheltered housing
+ 10% of adults visiting their general practitioner (GP)
+ 5% of the adult population of England
+ With an aging population the problem is expected to to increase further since the prevalence of malnutrition increases with age.
What is the cost of malnutrition to the UK?
Around £19.6 billion in 2011-12
How much does it cost to care for someone who is undernourished?
Estimated health and social care expenditure per capita of the population is £2,417.For those malnourished or at risk, the expenditure rises to £7,408 per person in the population
Causes of Malnutrition:
+ Reduced intake when food is available
+ Reduced intake due to inadequate availability
+ Increased requirements
+ Lack or recognition and treatment
+ Inadequate nutritional intake to meet nutritional requirements
What are disease states when reduced intake when food is available?
Anorexia Difficulty feeding Difficulties chewing Enforced fasting Taste changes
What are the physical consequences of malnutrition?
+ Impaired immune function
+ Delayed wound healing
+ Muscle weakness (including respiratory and cardiac muscles)
+ Altered GI function
What are the physiological consequences of malnutrition?
+ Apathy and depression
+ Adverse effects on learning and behaviour
+ Poor libido
+ Impaired appetite
What are the functional consequences of malnutrition?
+ Increased risk of mortality and morbidity
+ Longer hospital stays
+ Greater requirement for health care post discharge
What are the clinical consequences of malnutrition?
\+ Ventilation \+ Liver fat change - functional decline \+ Impaired wound healing \+ Impaired gut integrity and immunity \+ Anorexia \+ Loss of Strength \+ Hypothermia \+ Poor renal function \+ Decreased Cardiac Output
What is the increase in mortality if malnourished after hospitalisation?
44% in malnourished patients after 9 months vs. 18% in nourished
What is the effect of disease on nutritional status?
Three phases Ebb, flow and anabolic process
Whats the Ebb phase?
Ebb depression of metabolic function and reduction in energy expenditure
Whats the flow phase?
Flow phase metabolic rate rises and reserves of fat are mobilised, muscle mass provide amino acids for the wound healing and gluconeogensis
Whats the anabolic phase?
Anabolic phase catabolism eventually declines and is coupled with a increase in appetite. This is the time to nutritional therapy to restore muscle mass
