Healthy aging amid COVID-19: Nutricia uncovers “missed opportunities” and rampant malnutrition

16 Nov 2020 --- Malnutrition presents a significant problem in elderly populations during the COVID-19 pandemic. According to a paper released by Nutricia, part of Danone, and the Global Coalition on Aging, policymakers and industry must focus on helping this vulnerable stratum of society build its “health capital” to reduce infection rates and increase resilience against the virus.

The report highlights a number of “missed opportunities” in addressing the COVID-19 pandemic and the role nutrition plays in overall health. 

It also underscores the importance of nutrition in improving prospects of COVID-19 recovery. Notably, elderly people often become malnourished due to health incidents such as disease, which are “neglected issues” open for improvement.

“As the world continues to contend with the serious effects of COVID-19 on societies, health systems and economies as well as individual health, it has become increasingly clear that one’s health status upon contracting COVID-19 is crucial for success coming out of it,” Melissa Gong Mitchell, executive director of Global Coalition on Aging, tells NutritionInsight. 

“The value of building one’s health capital has generally been understood, but the importance of nutrition to overall health, in particular as people grow older is not as broadly recognized.”

Many other health issues such as frailty, cognitive decline and sarcopenia (loss of muscle mass) are often wrongly ascribed to aging as a natural process when they are commonly a direct result of poor nutrition, says the report. 

“We must redouble our efforts”
Additionally, lockdowns and social restrictions implemented to combat the COVID-19 virus have compounded the already severe malnutrition issue in the elderly. 

“In this time of COVID-19 when many activities, especially for older people, have been constrained, we must redouble our efforts to support health before – and resilience after – a serious health incident,” reads the report. 

Not only will this aid the most at-risk group through the pandemic, it says, but also ensure lasting protection against other forms of illness once the pandemic has passed. 

Ninety-five percent of COVID-19 related deaths have occurred in those aged 60 or over. Screening for nutrition must be “integral”
Nutricia and the Global Coalition on Aging now recommend ensuring nutrition and diet are assessed and controlled effectively for patients not living in health professionals’ direct care. 

“The current pandemic reinforces the need to ensure adequate screening and management of malnutrition in older people who live at home independently is an integral part of care systems,” says Mitchell. 

Assessing the role and potential risk that nutrition is playing in a patient’s health at an early stage is also essential. 

“It should be a priority for policymakers and healthcare professionals to address the risk of malnutrition at an early stage because of the effects it can have on disease progression and health outcomes later.” 

Creating personalized plans and conducting interventions on patients’ nutrition are also recommended, as is integrating nutritional planning into rehabilitation programs for the recovery of older people. 

“Such integrated care pathways are necessary not only in the current context of the pandemic but more broadly in our aging societies in which maintaining functional ability will enable the two billion people over 60 by 2050 to live longer healthier, and more active lives.” 

Elderly people at more risk 
Research highlighted in the report shows elderly age groups are far more susceptible to serious cases of COVID-19. 

In Europe, 95 percent of deaths resulting from infection with the virus occurred in people aged sixty or older. Over 50 percent occurred in those aged eighty or older. 

Thirty-six percent of patients are malnourished before being discharged from hospital. In the US over 80 percent of deaths have occurred in those aged sixty-five and older. 

Comorbidity with other illnesses is also a leading cause of COVID-19 deaths, to which these age groups are particularly susceptible. 

Eighty percent of fatalities involve at least one other underlying condition such as cardiovascular disease, hypertension, diabetes or cerebrovascular disease, notes the report. 

Malnutrition is often high among those admitted to hospital for the virus, according to studies referenced in the report. 

Thirty-one percent of patients are malnourished upon entering hospital and, more importantly, 36 percent are marked malnourished before being discharged. This may indicate a lack of attention to nutrition in hospitals. 

“Every effort should be made to try to avoid or at least reduce underfeeding in hospital to limit the deleterious consequences of malnutrition on patient outcomes, including morbidity, poor recovery, hospital length of stay and readmissions, health care cost and mortality,” says Dr. Riccardo Caccialanza, head of the clinical nutrition and dietetics at the research hospital foundation (IRCCS). 

“This is crucial for older patients who are disproportionately affected by COVID-19.” 

Industry opportunities
Besides calling for greater emphasis on nutrition in hospitals and screening for outpatients, the report also highlights a number of important ingredients implicated in malnutrition directly mitigating the “burden of disease.”

“Beyond protein and energy, vitamins (including A, B6, B12, C, D, E and folate) and trace elements (zinc, iron, selenium, magnesium and copper) and omega 3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid) play important and complementary roles in supporting the immune system,” reads the report. 

“Inadequate intake of these nutrients can lead to a decrease in resistance to infections and, as a consequence, an increase in disease burden.”

By Louis Gore-Langton