Malnutrition is a common health problem and it is estimated there are about 3 million people who are malnourished in the UK at any time with many more at risk of becoming malnourished.

What is malnutrition?

Malnutrition is a state of nutrition in which a deficiency or excess (or imbalance) of energy, protein and other nutrients causes measurable adverse effects on tissue / body form (body shape, size and composition) and function and clinical outcome. The term malnutrition does include obesity, however BAPEN is focussed on the problem of “undernutrition”. The term “malnutrition” is used on this website to mean “undernutrition”. For further information on obesity please go to NHS Choices website

What are the symptoms of malnutrition?

Malnutrition can often be very difficult to recognise, particularly in patients who are overweight or obese to start with. Malnutrition can happen very gradually, which can make it very difficult to spot in the early stages. Some of the symptoms and signs to watch out for include:

  • Loss of appetite
  • Weight loss – clothes, rings, jewellery, dentures may become loose
  • Tiredness, loss of energy
  • Reduced ability to perform normal tasks
  • Reduced physical performance – for example, not being able to walk as far or as fast as usual
  • Altered mood – malnutrition can be associated with lethargy and depression
  • Poor concentration
  • Poor growth in children

Who is at risk of malnutrition?

  • Older people over the age of 65, particularly if they are living in a care home or nursing home or have been admitted to hospital
  • People with long-term conditions, such as diabetes, kidney disease, chronic lung disease
  • People with chronic progressive conditions – for example, dementia or cancer
  • People who abuse drugs or alcohol

There are also social factors that can increase the risk of malnutrition including:

  • Poverty
  • Social isolation
  • Cultural norms – for example, hospitals and care homes may not always provide food that meets particular religious or cultural needs and so increase the risk of malnutrition whilst a person is away from their normal environment

Physical factors can also increase the risk of malnutrition. For example:

  • Eating may be difficult because of a painful mouth or teeth
  • Swallowing may be more difficult (a stroke can affect swallowing) or painful
  • Losing your sense of smell or taste may affect your appetite
  • Being unable to cook for yourself may result in reduced food intake
  • Limited mobility or lack of transport may make it difficult to get food

It is also important to realise that if an older person is less able to feed themselves and becomes malnourished, this will make them more susceptible to disease, which in turn will make their nutritional state worse and impair recovery.

Older people with malnutrition have more hospital admissions and usually stay in hospital for longer. See here for some useful malnutrition materials:

BAPEN have a self-screening tool, available at: If you or someone you know may be at risk of malnutrition, take the test.

The Nutrition Wheel is a simple interactive version of the Patients Association Nutrition Checklist and is intented to act as a nutrition conversation starter as well as to help identify those at risk of malnutrition.

Order yours here:

See video here: 

5 steps to help yourself

If you suspect malnutrition you should consult a healthcare professional as soon as possible. In the meantime there are a few things you can do to try and slow any further weight loss.  See here: