Basics concepts in nutrition: Epidemiology of malnutrition

Abstract

Malnutrition (both undernutrition and overnutrition) is a public health problem and major national initiatives are needed to improve both the prevention and the treatment of undernutrition and overnutrition. The prevalence of overnutrition is widespread and continues to increase in Europe and beyond. Undernutrition, most commonly caused by disease (disease-related malnutrition) is also a significant problem, particularly in health care settings (e.g. hospitals, care homes), occurring in patients with a wide variety of acute and chronic illness. Routine and regular screening for risk of malnutrition (both over- and undernutrition) in individuals in hospitals, care homes and in out patient clinics and general practice is essential. A universal, simple, evidence based screening tool to detect both undernutrition and overnutrition is recommended for use in all adults across all settings. The screening process needs to be multidisciplinary and the results of screening must be linked to appropriate action including a nutritional care plan. Effective treatment of obesity that helps people lose weight can lead to significant health benefits. Similarly, the use of nutritional support to treat undernutrition can improve body structure and function and improve clinical outcome, decreasing complication rates and mortality. If we succeed in effectively treating both undernutrition and overnutrition, substantial cost savings will be made by health care systems worldwide. © 2008 European Society for Clinical Nutrition and Metabolism.