Malnutrition is a serious condition that occurs when a person does not receive the right amount of nutrients. Find out more about the types, symptoms, causes, and risks of malnutrition.

What is Malnutrition?

Malnutrition is a condition caused by an inadequate, excessive, or imbalanced intake of nutrients. There are various types of malnutrition, the main two being undernutrition, or not receiving enough nutrients, and overnutrition — receiving more nutrients than you need.

This article focuses on undernutrition, which older adults, especially those with acute illnesses, are vulnerable to due to a range of risk factors. Poor appetites or diets coupled with additional nutritional requirements due to medical conditions can result in inadequate nutritional intake.

Symptoms of Malnutrition 

Some common signs and symptoms associated with undernutrition include:
Lack of appetite or disinterest in food or drink
Fatigue and irritability
Difficulty concentrating
Constantly feeling cold
Loss of fat, muscle mass and body tissue
Constant illnesses and longer recovery time from illnesses
Higher risks of complications post-surgery

Those experiencing severe undernutrition may also exhibit these symptoms:
Difficulty breathing
Thin and dry skin
Hollowed cheeks and sunken eyes
Hair loss 

Risk Factors for Malnutrition

Individuals with certain types of medical conditions are at higher risk of undernutrition. 

These conditions include:
AIDS (acquired immunodeficiency syndrome)
Swallowing impairment or difficulty swallowing
Stomach and digestion complications, like malabsorption or maldigestion
Chronic obstructive pulmonary disease
Presence of wound or pressure ulcers
Trauma and burns
Mental health conditions such as depression or dementia

If you suspect that a loved one may be at risk of suffering from malnutrition, then you should bring him or her to a dietician to be assessed and diagnosed. There are a few ways to tell if someone is at risk of malnutrition, including:
An unintentional loss of 3kg or more in the past six months
A loss of appetite or reduced food intake in the past five days or more

Managing Diet and Malnutrition 

You can take steps to address and effectively manage poor appetite through some dietary strategies. Often, increasing your physical activity may improve your appetite and thus encourage higher food intake. Be sure to consult a dietician on optimal ways of addressing poor dietary intake. 

Help your loved one improve his or her overall nutritional intake by following these guidelines.

1. Aim to have small, frequent meals throughout the day

Have six small meals rather than three large meals
Eat more when your appetite is good, whether it is in the morning, afternoon or evening  
If you are not able to finish an entire meal, have a milky drink, small snack or dessert instead

2. Make every mouthful count

Choose high-energy foods and drinks such as cream-filled biscuits instead of a plain biscuit

3. Prepare energy-dense meals

Include foods rich in protein and energy, like chicken, fish, egg, milk, cheese, yoghurt, custard, nuts or legumes in each meal or snack

4. Have ready-to-go high-energy snacks or drinks handy

These may include three-in-one cereals, milk, nuts and drinks rich in nutritional supplements

5. Drink between or after meals 

Try to include some fruit juices or high-protein drinks between or after meals to avoid feeling bloated after a meal 

6. Enjoy your meals and eat a variety of food

Vary your meals so that eating does not become a chore
Eat with your family or friends so that meal times are enjoyable occasions

7. Discuss nutritional supplements with your dietician

Supplemental nutrition drinks may be recommended by your dietician to boost your energy, protein and micronutrient intake. This may help to compensate for any weight loss or loss of appetite
There are many options available for nutritional supplements depending on your taste preferences. Before incorporating these supplements into your diet, discuss your plans with your dietitian

Recipes to Boost Energy Levels

1. Banana Smoothie (Serving size: one)

1 cup (250ml) of full-cream milk or commercial nutritional supplement
1 medium-ripe banana or other fresh fruits
1 scoop of ice cream
Honey and sugar to taste
Blend all ingredients together and serve.

2. High-Energy Milo or Coffee (Serving size: one)

1 cup (250ml) of full-cream milk or commercial supplement
2 teaspoons of Milo or 1 teaspoon of instant coffee
1 scoop of vanilla or chocolate ice cream
Mix ingredients well and serve hot or cold.

3. Chinese Rice Porridge (Serving size: two)

1 cup of white rice, rinsed
6 cups of water
2 eggs or 1 square tofu
2 teaspoons of sesame oil for each serving
1 tablespoon of fried shallots for each serving
Put the rice and water in a large and deep saucepan, and bring the ingredients to a boil
Boil the ingredients for another 20–30 minutes over medium heat. Stir the mixture occasionally
Cover the saucepan but leave a small gap; simmer the mixture over as low a temperature as possible until all rice grains are broken and the porridge becomes pasty
Add 2 eggs into the saucepan just before serving
Sprinkle fried shallots and pour sesame oil over the porridge before serving

You can create different variations of porridge, such as shredded chicken porridge, sliced fish porridge, century egg and lean pork porridge or peanut porridge too.

Malnutrition Resources: Getting More Information

Consulting a Dietitian

To speak to a dietitian, please call 6357 8322 to schedule an appointment.

It is recommended that you consult a dietitian for an evaluation of your current eating habits and assessment of your specific dietary needs for your health conditions. A personalised nutrition plan and specific advice can be developed and dished out to meet your nutritional needs.

Consulting a Doctor

You will need to obtain a referral from your doctor for a consultation with a dietitian.

Disclaimer: This page has been produced to provide general information on nutrition. It is not designed to replace any treatment or advice by a dietitian or doctor.
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