Malnutrition in UK is under reported

British Specialist Nutrition Association| March 2018 |New Research for Nutrition and Hydration Week 2018 

Analysis of malnutrition data for 2015/16 by the British Specialist Nutrition Association (BSNA) shows that more than fifty per cent of hospital trusts in England are under-reporting malnutrition rates compared to accepted national estimates. In their report the BSNA highlight the extent of malnutrition: it estimates that 3 million people, (5 per cent of the UK population) are malnourished or at risk of malnutrition.  Deaths where malnutrition was named as a contributory factor are also increasing, having
risen by more than 30% from 2007 to 2016.

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This new research, argues that the costs and implications of not addressing malnutrition are higher than associated treatment costs. For instance an average of £7,408 per year is spent on care for a malnourished patient, this is more than three times the £2,155 for a well-nourished patient.  The costs of treating malnutrition and its affects, are estimated at £19.6 billion in England, a figure which represents approximately 15% of overall health and social care expenditure.

The report provides a summary of its findings:

  • Malnutrition remains a significant, growing yet largely preventable problem.
  • The number of deaths involving malnutrition is rising as are the reported primary and secondary diagnoses of malnutrition.This is despite significant effort to improve clinical practice, most notably NICE CG32 on Nutrition Support for Adults.
  • The cost of doing nothing significantly outweighs the cost of early intervention, such as dietetic support and provision of oral nutrition supplements (ONS) if appropriate.
  • Regional disparities exist in progress made by Trusts in this area.
  • There are fundamental inconsistencies in the way that data on malnutrition are collected and reported by individual Trusts, meaning that the overall incidence of malnutrition is likely to be significantly under recorded.

The BSNA calls for:

  1. Guidelines to be implemented and followed in all healthcare settings
  2. New clinical pathway- the introduction of a new, comprehensive jointly
    developed and delivered  clinical care pathway for the frail elderly, across
    all systems.
  3. Additional incentives-  perhaps through the introduction of a new
    Quality and Outcomes Framework (QOF) or equivalent on malnutrition.
  4. Recognition of the integral role of oral nutritional supplements (ONS)
    ONS should be accessible to all patients who need them, alongside support from dietitians. Nutritional intervention should only be used when appropriate and be reviewed regularly.

The infographic can be downloaded from BSNA here 

The full report is available from BSNA

BSNA |  Forgotten not Fixed: A Blueprint to Tackle the Increasing Burden of Malnutrition in England |


Calorie reduction programme

Steps to cut people’s excessive calorie intake have been unveiled by Public Health England (PHE), as part of the government’s strategy to cut childhood and adult obesity.


This report sets out the evidence on children’s calorie consumption and the details of the calorie reduction programme.

In terms of the evidence the report includes details of:

  • recommendations around calorie intakes, sources of calories and reported levels of intake
  • calculated estimates for daily energy intakes and excess calories consumed by children and adults
  • evidence on reformulation and portion size reduction; and public perceptions and attitudes to calories
  • estimated health economic benefits of a calorie reduction programme

For the calorie reduction programme, the reports sets out:

  • the overall ambition and structure of the programme
  • the food categories included
  • suggested mechanisms for action
  • timeline and next steps for PHE

Full report: Calorie reduction: the scope and ambition for action

Additional link: PHE news story

Preventing malnutrition in later life

State of the Nation: an overview of older people and malnutrition in the UK today | The Malnutrition Task Force. 

This report focuses on the scale and challenges of malnutrition in later life in the UK. Research shows that 1 in 10 people over the age of 65 are malnourished or at risk of malnutrition. This silent and often hidden condition can seriously affect an older person’s health and wellbeing and increase hospital admissions and long-term health problems.

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The report examines the causes and consequences of malnutrition in the UK. It also looks at economic costs and pressures, and whether the NHS and social care services are currently able to support older people at risk and how invested they are in this issue.

It brings together information, statistics and evidence from across the health and social care system to highlight what is happening to older people who are malnourished or at risk of malnutrition in England.

Full report: State of the Nation: an overview of older people and malnutrition in the UK today 

Child under nutrition project: A report about the current undernourishment of children in England

Patients Association, July 2017

TChild Nutritionhe Patients Association has issued a report suggesting that under-nutrition among children is not confined to the developing world, but is a problem in Britain today.

The project was undertaken by the Patients Association and funded by a non-restricted education grant from Abbott. A cross-section of health and care staff in four sites – Bradford, Cornwall, Tower Hamlets and Birmingham – were interviewed. Parents were also interviewed in Bradford and Cornwall.

The findings reveal examples of positive efforts in working with children and families across agencies, particularly by public health teams, community and acute health staff; but many are overstretched and unable to meet demand for the types of information and guidance that people need. The report’s recommendations include:

  • Awareness of under-nutrition should be raised among both professionals and the public
  • New and existing training and guidance for professionals should include the identification and treatment of under-nutrition
  • National guidance and a care pathway should be developed specifically for undernutrition.

Nutrition advice aimed at children also improves parents’ diets

Nutrition advice aimed at children also improves parents’ diets, according to research published today in the European Journal of Preventive Cardiology | ScienceDaily


For the current study, parental dietary intake was assessed by a one-day food record biennially from the child’s age of nine to 19 years. Weight, height, blood pressure, serum lipids, glucose and insulin of the parents were measured repeatedly from the child’s age of seven months until 20 years.

The investigators found that the child-oriented dietary counselling increased the intake of polyunsaturated and monounsaturated fats and decreased the saturated fat intake of intervention mothers and fathers compared to control parents between the child’s ages of nine and 19 years.

In addition, the child-oriented dietary counselling tended to decrease serum total and LDL concentrations in intervention mothers compared to control mothers. There was a similar trend in fathers but it was not statistically significant.

‘Pro-vegetarian’ diet could halve chance of obesity

Study describes benefits of the ‘flexitarian’ diet: basically vegetarian, with meat and fish consumed occasionally | The Guardian Health


A diet which reduces or even excludes meat and animal produce in favour of vegetables, fruit and grains could halve people’s chances of becoming obese, according to new research.

A study carried out in Spain describes the benefits of what researchers call a “pro-vegetarian” diet which does not exclude meat and dairy products but reduces them. It has also been called a “flexitarian” diet – basically vegetarian, with meat and fish consumed occasionally.

Some 16,000 university graduates were tracked from 1999 for 10 years, by which time 584 were obese, according to findings presented at the European Congress on Obesity in Porto, Portugal.

Read the full news story here

A realist review to explore how low-income pregnant women use food vouchers

Ohly H, et al. (2017) BMJ Open. 7:e013731


Objectives: To explore how low-income pregnant women use Healthy Start food vouchers, the potential impacts of the programme, and which women might experience these impacts and why.

Conclusions: This realist review suggests that some low-income pregnant women may use Healthy Start vouchers to increase their consumption of fruits and vegetables and plain cow’s milk, whereas others may use them to reduce food expenditure and save money for other things.

Read the full article here