You may think you’re eating well but you could be malnourished
BY BEN WEST
When you look at harrowing images of starving children in Africa it is easy to believe, with obesity rates in Britain ever shooting up, that malnutrition doesn’t happen in the UK.
Malnutrition may not be anything as prevalent as the tragic extent sometimes seen in developing world refugee camps, yet the condition – caused by not having enough to eat, not eating enough of the right things, or the body’s inability to use the food that one does eat – can be caused by a number of factors, and many more Brits may be in danger of malnutrition than they think.
Malnutrition has been increasing sharply in the UK in recent years. BAPEN, a charitable association raising awareness of malnutrition, estimates that there are now more than three million people in the UK who are either malnourished or at risk of malnutrition.
Eating the wrong foods
The overweight and obese can be victims of malnutrition. The average British diet provides copious amounts of calories in high sugar and fat food products such as pizza, chocolate and chips at the expense of more nutritious foods including fruit and vegetables.
Food companies often exploit the human inclination towards sugary and fatty foods, offering cheap but often nutritionally sparse products. This leads to not enough of the micro-nutrients like vitamins and minerals essential for long-term health, helping the body function effectively and strengthen everything from bones to organs, being consumed.
We’re often not aware just how innutritious many of our foods and drinks are. To give an example: as Jeremy Paxman memorably, indeed hilariously, demonstrated once on Newsnight in the presence of President of Coca-Cola Europe, James Quincey, a cup of coke contains the equivalent of 23 sugar sachets, while a supersize cup, the bigger coke container you’d get at the cinema, contains an outrageous 44.
It can be especially difficult to diagnose malnutrition in overweight people as it can be difficult to pinpoint that they are not getting the balanced diet they require. Factors like muscle wasting, appetite loss and body mass index are indications, and hospitals have screening tools, a scoring system based on a series of questions and observances, to identify those at risk.
Smoking
Smokers can be in danger of replacing nutritious foods by smoking a cigarette instead, and a smoker’s requirements for vitamin C is double that of a non-smoker.
Dieting
As we get older, excess weight becomes increasingly difficult to shift, increasing our temptation to diet. However, yo-yo or extreme diet plans can soon
trigger malnutrition. Severely restricting food intake, avoiding whole food groups, or basing one’s diet on only one or two foods in an attempt to lose weight is likely to cause deficiency in a range of nutrients.
Dieting is fine as long as you ensure that you are getting enough important nutrients – by including plenty of fruits and vegetables, modest helpings of fish, lean meats, eggs, reduced fat dairy foods and starchy foods such as bread, rice, potatoes and pasta, whilst simultaneously cutting down on fatty and sugar foods.
Medical conditions
Eating disorders like anorexia or bulimia and some medical conditions, such as inflammatory bowel diseases (IBD) like Crohn’s Disease and ulcerative colitis, can cause malnutrition.
Crohn’s can trigger malabsorption of dietary elements such as lipids and carbohydrates.
Many sufferers tend to eat less generally because symptoms can be less severe if they do not eat. Issues with ulcerative colitis include inadequate nutrient intake because of malabsorption of nutrients, decrease of food intake, and an inability to tolerate solid foods.
Sandwich generation
Those in their 50s and 60s are very often caught between caring for elderly parents while still supporting their children, and these groups are at risk of malnutrition too.
The young
Children’s nutritional requirements differ from adults: their energy and nutrient needs are high in relation to their body size. However, because of their smaller overall and stomach size compared with adults, children should ideally not eat bulky meals, such as a high content of high-fibre foods, otherwise foods that are important sources of nutrients that are critical for growth may be neglected.
The elderly
Malnutrition in the elderly is common: increasing age can mean foods increasingly difficult to chew, swallow, or digest, and older people may also suffer from a smaller appetite. Restricted mobility may inhibit regular shopping trips for fresh, varied foods, while inadequate pension/financial provision may impact on nutritional choice.
Alcohol
Chronic, heavy alcohol drinking can also lead to malnutrition. The high calorie alcohol displaces food. Carbohydrates may be in abundance, but not proteins, vitamins and minerals. Signs of vitamin and mineral deficiency may begin to show, through such things as skin lesions, bleeding gums and poor wound healing. Low body weight and wasting muscles can follow.
Furthermore, the damage alcohol can do to organs can prevent the absorption and metabolism of nutrients that are being consumed. And being a toxin, the alcohol needs to be deactivated by the liver. The detoxification process uses up thiamin, zinc and other nutrients, which can deplete the body’s reserve of nutrients.
Vegetarianism and veganism
An unbalanced vegetarianism diet – for example lots of cheese and potato dishes but a lack of pulses, nuts, seeds, soya products, eggs, dairy products, breads and dark green vegetables – can result in a lack of essential nutrients, resulting in malnutrition.
Vegans need to take even more care to ensure that they are obtaining the correct nutritional mix, especially an adequate intake of vitamin B12, vitamin D, calcium, selenium and iodine. Human nutrient requirements, except vitamin B12, can be met by a diet composed completely of plant foods, and vitamin B12 can be obtained from yeast extract, fortified bread and certain breakfast cereals.
Depression
Depression is another factor that can promote malnutrition. Some people turn to food for comfort – and comfort foods are often not the healthiest choices – while others lose their appetite, resulting in a deficiency of important foods and subsequent nutrients.
Healthy, well balanced diets help promote good mental health. Foods like fruits, vegetables, wholegrain cereals, pulses, nuts and seeds provide vitamins and minerals that are important in nourishing the brain and combatting depression.
A healthy diet doesn’t have to be costly
Knowing what to do with basic ingredients that are cheap to buy is a great way to combat the threat of malnutrition on a budget. Buying fruit and vegetables in season, buying at markets rather than at shops, searching out the many supermarket offers and own brand goods and bulking up meat and fish dishes with vegetables and pulses can really push costs down.
Tinned and frozen fruits and vegetables can be cheaper than fresh ones yet are equally as nutritious.
What are the warning signs of malnutrition?
These depend upon which nutritional deficiencies a person has, although may include frequent tiredness, dry, scaly skin, swollen and bleeding gums, decaying teeth, lack of concentration, low weight, poor growth and muscle weakness. There can be poor immune function, which can cause the body to have trouble fighting off infections, as well as making a person more prone to infections.