Malnutrition: Why it's often undiagnosed, and possible signs to look for

Have you been experiencing unexpected weight loss? Feeling weak or tired? No appetite?

Don't brush off these symptoms. They could be signs of malnutrition, which can affect those who are underweight (undernourished) as well as overweight (overnourished). It is a condition that can occur when your body does not get the proper amount of nutrients.

Moreover, malnutrition is a state of overnutrition or undernutrition-with or without inflammatory activity-that causes changes in body composition and diminished function and can lead to longer hospital stays, higher medical costs, increased mortality and a greater likelihood of readmission.

Each day, some 15,000 cases of malnutrition go undiagnosed, according to the American Society of Enteral and Parenteral Nutrition.

The signs are not always obvious.

"Malnutrition can go unnoticed in people who are at a normal weight or overweight. This is a big reason why it's important to interview the patient and complete a thorough, what we call nutrition-focused physical exam," says Margaret Ifarraguerri, a clinical dietitian at Sinai Hospital of Baltimore. "If we can detect malnutrition earlier, we can provide nutrition intervention a lot sooner and ideally improve clinical outcomes."

A number of causes and risk factors are associated with malnutrition:

• acute and chronic illnesses (such as malabsorption [inability to absorb nutrients], cancer, and conditions that cause nausea or make it difficult to eat or swallow)        
• social/environmental/behavioral circumstances (low income, difficulty obtaining food, mobility problems, etc.)
• a lack of specific nutrients (you can develop malnutrition even if you lack only a single vitamin in your diet)

"Statistically speaking, older adults, African Americans, and/or low-income individuals tend to be at the highest risk for malnutrition," Ifarraguerri says.

Symptoms of malnutrition in adults may include:

• unplanned weight loss
• loss of appetite
• an inability to eat (or being able to eat only small amounts)
• fatigue or weakness

Children may be showing signs of malnutrition if they have slowed, or a decline in, weight gain and/or inadequate nutritional intake for a prolonged period of time. You should speak with your child's doctor if you notice any of these signs. "When evaluating for malnutrition, we as dietitians assess for adequacy of protein-energy intake, weight loss, loss of subcutaneous fat stores and muscle wasting," Ifarraguerri says.

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