Nutrition for Life / Diet, Nutrition and Metabolism

Disease related malnutrition: prevalence and consequences

‘Malnutrition can be defined as a state of nourishment in which a deficiency, excess or imbalance of energy, protein, and/or other nutrients causes measurable adverse effects on tissue/body form (body shape, size, and composition) and physiology, function, and clinical outcome’ (adapted from Harris and Haboubi1)
Malnutrition versus disease related malnutrition

Malnutrition (under nutrition) is a significant but often hidden problem. In the European community, it is estimated that 33 million people are at risk of becoming malnourished2.

It is well documented that these patients have poorer outcomes, e.g. they are3 three times more likely to get an infection and 35% less likely to survive the full month after hospital admission4. Furthermore, disease-related malnutrition negatively affects a patient’s quality of life. Patients can suffer from fatigue, loss of appetite, emotional and social functioning among other symptoms.

All of these affects can result in higher healthcare costs. The management of a malnourished patient is twice as expensive as a non-malnourished patient with 61% of patients who are malnourished increasing their hospital stay5.

On average 1 in 4 patients admitted to hospital suffer from disease-related malnutrition (DRM)3.


Undernutrition is often linked to an underlying condition or disease. Disease-related malnutrition is a condition characterized by inadequate intake of energy, protein, and/or micronutrients as a result of a diverse number of diseases or their treatment2.

In the EU alone, disease-related malnutrition is estimated to cost governments €170 billion annually.6

Disease related malnutrition occurs when patients do not consume adequate quantities or quality of food from their diet or do not reach the right levels of nutrients to compensate for the specific nutritional needs created by the disease. Disease-related malnutrition can affect individuals at any life stage including infants and children, however the prevalence of malnutrition is significantly higher in the elderly and particularly common in healthcare settings7–9. One third of older people in hospital7–12 and more than one third of people living in care homes7,11,13–15 are considered to be at risk.

Medical nutrition has been shown to be a safe and effective way to help patients to reach their nutritional targets.

If patients are unable to meet their nutritional needs through their regular diet, they may benefit from taking medical nutrition products to either supplement their diet or as a sole source of nutrition if necessary. Dietary management with medical nutrition has been shown to be a safe and effective way to help patients to reach their nutritional target and improve patient outcomes including alleviating disease symptoms, aiding recovery from illness, regaining strength and improving quality of life. Dietary management of patients with medical nutrition also lowers patient care costs due to reduced complications, fewer hospitalisations and a reduced length of hospital stay.

1.
Harris, D. and N. Haboubi, Malnutrition screening in the elderly population. J R Soc Med, 2005. 98(9): p. 411-4.
2.
MNI MNI – Medical Nutrition Industry – www. Medicalnutritionindustry.com.
3.
Stratton R, et al. Wallingford: CABI Publishing, 2003.
4.
Cereda, E., et al., Nutritional status in older persons according to healthcare setting: A systematic review and meta-analysis of prevalence data using MNA((R)). Clin Nutr, 2016. 35(6): p. 1282-1290.
5.
Khalatbari-Soltani, S. and P. Marques-Vidal, The economic cost of hospital malnutrition in Europe; a narrative review. Clin Nutr ESPEN, 2015. 10(3): p. e89-e94.
6.
Ljungqvist, O. and F. Man, Under nutrition: a major health problem in Europe. Nutr Hosp, 2009. 24(3): p. 369-70.
7.
Russell C and Elia M. Redditch, BAPEN. 2008.  .
8.
Russell C and Elia M. Redditch, BAPEN. 2011.
9.
Russell C and Elia M. Redditch, BAPEN. 2012.
10.
Imoberdorf, R., et al., Prevalence of undernutrition on admission to Swiss hospitals. Clin Nutr, 2010. 29(1): p. 38-41.
11.
Kaiser, M.J., et al., Frequency of malnutrition in older adults: a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc, 2010. 58(9): p. 1734-8.
12.
Vanderwee, K., et al., Malnutrition and nutritional care practices in hospital wards for older people. J Adv Nurs, 2011. 67(4): p. 736-46.
13.
Suominen, M.H., et al., How well do nurses recognize malnutrition in elderly patients? Eur J Clin Nutr, 2009. 63(2): p. 292-6.
14.
Lelovics, Z., et al., Results of nutritional screening in institutionalized elderly in Hungary. Arch Gerontol Geriatr, 2009. 49(1): p. 190-6.
15.
Parsons, E., R. Stratton, and M. Elia, An audit of the use of oral nutritional supplements in care homes in Hampshire. Proceedings of the Nutrition Society, 2010. 69(OCE2).