Each year, the American Society for Parenteral and Enteral Nutrition (ASPEN) observes Malnutrition Awareness Week to bring attention to this under-recognized issue. This year’s theme is “Nutrition Care is a Patient Right.” Gus Gear is proud to be an official Ambassador of MAW 2023, joining the fight against malnutrition.
All too often, however, nutrition is overlooked or delayed in the course of a patient’s care, with significant implications for clinical outcomes, risk of hospital readmission, and overall cost of hospitalization. Only half of patients with malnutrition receive appropriate treatment.
Malnutrition is defined in adults as an acute, subacute, or chronic state of nutrition, in which a combination of varying degrees of overnutrition or undernutrition with or without inflammatory activity have led to a change in body composition and diminished function.1 Pediatric malnutrition (undernutrition) is defined as an imbalance between nutrient requirements and intake that results in cumulative deficits of energy, protein, or micronutrients that may negatively affect growth, development, and other relevant outcomes.2
Many disease states or their treatments are associated with increased risk for malnutrition, including critical illness, end stage kidney and liver diseases, congenital heart defects, cancer, failure to thrive, prematurity or low birth weight, inflammatory bowel disease (IBD), gastroparesis, and short bowel syndrome, among others. If malnutrition is overlooked, and nutrition support therapy is delayed, consequences include loss of muscle mass, increased length of ICU and/or hospital stay, and increased mortality (death) risk. In children, growth may be impaired as well.3
In those who rely on enteral (tube feeding) or parenteral (intravenous or IV) nutrition, disruption of therapy due to device-related complications can predispose patients to malnutrition, especially if they are unable to consume or absorb nutrients from eating by mouth.
Feeding tube complications include clogging, tube dislodgement, hypergranulation, leaking, exit site infections, poorly fitted tubes, and medical line entanglement. The lack of access for feeding and/or pain and discomfort caused by these issues can lead to missed feedings and malnutrition, especially when they occur during a hospital stay.
For those who are dependent on parenteral nutrition, complications including line breaks and infections disrupt nutrition therapy. Parenteral nutrition therapy may be held as the medical team attempts to resolve the complication. Multiple line breaks and/or line infections over time may reduce IV access sites available for nutrition and other life-saving therapies. Malnutrition can develop if the complication is not resolved quickly.
You might be thinking, what can I do to protect myself and my loved ones from malnutrition?
For more information and inspiration from the patient and caregiver perspective, check out these patient stories.
1Soeters PB, Schols AM. Advances in understanding and assessing malnutrition. Curr Opin Clin Nutr Metab Care 2009;12(5):487–94.
2Mehta NM et al. Defining Pediatric Malnutrition: A Paradigm Shift Toward Etiology-Related Definitions. JPEN J Parenter Enteral Nutr. 2013;37(4):460-81.3Guenther P et al. Malnutrition diagnoses and associated outcomes in hospitalized patients: United States, 2018. Nutr Clin Pract. 2021;36(5):957-69.