Malnutrition Warnings Ignored

Australian health bureaucracies have ignored important local study findings on malnutrition in the elderly contributing to the current crisis in the hospital system.

President of the Gut Foundation Prof Terry Bolin said recent revelations about the high rate of malnutrition at Sydney's Royal North Shore Hospital were no surprise to dieticians whose research has largely been ignored.

Prof Bolin has urged action on a 2006[i] study carried out at The Prince of Wales Hospital which showed that 80% of the elderly who presented for admission were either actually malnourished or at risk of malnutrition.

By implementing basic intervention measures in a randomised study group dieticians were able to halve the length of hospital stay in elderly patients from 19 to 10 days. Applying a nutritional care plan the dieticians simply made sure patients received their meals, ate them and that they were appropriate for the patient's condition.

Prof Bolin, a conjoint Associate Professor of Medicine at the University of New South Wales said, "Malnutrition has a major impact on mortality, morbidity, length of stay and rates of readmission. These findings excited considerable interest in nutritional circles but not a flicker within the health bureaucracy. Hospitals cannot be blamed for the onset of malnutrition, although they might compound it. The important role they should play is to recognise it, and intervene with dietary measures to prevent its progress.

"Action to prevent malnutrition in hospital patients and the elderly population does not require enormous funding but does require some vision to recognise the importance of food and health.

"What we need is a set of practical guidelines for detecting under- nutrition or the risk of developing under-nutrition in a health care setting, such as those proposed by the European Society for Clinical Nutrition and Metabolism (ESPEN[ii])", Prof Bolin said.

The ground-breaking Australian study was carried out in collaboration between the Gut Foundation, The Prince of Wales Department of Nutrition and Dietetics and the Department of Geriatric Medicine.

A parallel study examined the potential for poor absorption of food and found it to be present in one in five of the elderly possibly contributing to the development of malnutrition.