Malnutrition means poor nutrition. Most commonly this is caused by not eating enough (undernutrition) or not eating enough of the right food to give your body the nutrients it needs.
A balanced diet should provide enough nutrients like calories, protein and vitamins, to keep you healthy. Without this, you may not be getting all the nutrients you need and this can lead to malnutrition.
Malnutrition can result in:
unplanned weight loss
a low body mass index (BMI)
vitamin and mineral deficiencies
This can leave you feeling tired, weak and affect your ability to recover from an illness.
Symptoms of malnutrition
Malnutrition can be difficult to recognise. It can happen very gradually, which can make it very difficult to spot in the early stages.
Common signs and symptoms of malnutrition include:
loss of appetite and lack of interest in food or fluids
unplanned weight loss - this might cause clothing, rings, watches or dentures to become loose
tiredness or low energy levels
reduced ability to perform everyday tasks like showering, getting dressed or cooking
reduced muscle strength – for example, not being able to walk as far or as fast as usual
changes in mood which might cause feelings of lethargy and depression
poor growth in children
increased risk of infection, recurrent infections, taking longer to recover and poor wound healing
difficulty keeping warm
Speak to your GP if:
you have any of the symptoms of malnutrition
you notice a drop in weight or you've lost weight without trying
Conditions that cause malnutrition
Sometimes, medical conditions cause your body to need more nutrients. Some medical conditions can lead to your body being unable to absorb or use nutrients. These may include:
Some types and combinations of medication can increase your risk of developing malnutrition. Always check your medicines information and speak to a healthcare professional for advice if you have a concern. Do not stop taking your medication without advice from a healthcare professional.
Other causes of malnutrition
Physical, social and ageing issues can also cause malnutrition.
Physical issues can contribute to malnutrition. For example:
if your teeth are in a poor condition, if your dentures do not fit, or if you have a sore mouth, eating can be difficult or painful
you may lose your appetite as a result of losing your sense of smell and taste
you may have a physical disability or other physical impairment that makes it difficult for you to cook or shop for food yourself
Social issues that can contribute to malnutrition include:
living alone and being socially isolated
having limited knowledge about nutrition or cooking
alcohol or drug use
low income or poverty
reliance on food banks
As we get older we might become more likely to experience malnutrition. This might be because of how we feel, and physical and social factors. The risk also increases because we're more likely to have one or more medical conditions as we get older.
If you've lost weight or your appetite is poor, you can make simple changes to your meals, snacks and drinks to help treat malnutrition.
Choosing nutrient-dense food and drinks can help improve your calorie intake. This might not be suitable for everyone, especially those with other conditions like dysphagia. Ask your GP, dietitian or nurse for further advice if you're unsure.
You should speak to a healthcare professional if you've had to limit the fat and sugar you eat in the past due to a health condition like high cholesterol or diabetes.
Ways to increase your calories
Try the following ideas to help you to increase the amount of calories and protein in your diet.
eat ‘little and often’ – 3 small meals a day with 2-3 snacks in-between meals
include protein like meat, fish, chicken, eggs, beans or lentils in each meal
add high calorie ingredients like full cream milk, cheese, butter, ghee, olive oil and cream to meals and drinks
include puddings after your lunch and dinner like creamy yoghurts, custards, rice pudding, milk puddings or ice-cream
try ready meals if you don’t feel like cooking
choose nourishing milky drinks like malted drinks, hot chocolate, milky coffee and milkshakes
choose high sugar drinks like fruit juice, smoothies, fizzy drinks or squash (you can also add egg powder to juice to increase its nutrients)
try including 1 pint of full cream milk each day – you can fortify (add extra nutrients to) this by adding 4 tablespoons of dried milk powder – and use this in drinks, cooking, cereals and puddings
do not have drinks just before meals because this can make you feel fuller quicker
do not choose low fat, sugar-free, diet foods and drinks – for example skimmed milk
If you're using vegan alternatives to cheese, butter, cream or milk, try to choose the highest calorie option.
Oral nutritional supplements (ONS) are a range of liquid and powder products that help support better nutrition.
They contain calories, protein, vitamins and minerals to help increase your intake. They're designed to be taken alongside your diet and the ‘food first’ advice above to promote progress with your weight.
Tube feeding (enteral feeding)
Depending on how severe your symptoms are, your healthcare professional might recommend a “feeding tube”.
There are different types of tubes. Which one is best for you depends on your diagnosis and symptoms.
The most common types of feeding tube include:
nasogastric – through your nose and into your stomach
nasojejunal – though your nose and further into your digestive tract
percutaneous endoscopic gastrostomy (PEG) - a tube is placed directly into the stomach via your abdomen
Depending on your condition alternative routes of nutrition may be considered.
The Scottish Dietetic Prescribing Support Group