Malnutrition in hospitals: Studies reveal patients face higher gaps in nutritional care across Europe

Recent studies from Germany and Italy have revealed significant gaps in patient nutritional care, which may have an impact on their ability to fight disease. The latest WHO Europe factsheet on this issue reveals an urgent need to improve nutrition in hospitals.

New findings in Thieme Connect reveal unequal nutritional and medical care in German hospitals. The study underlines malnutrition affects 20 to 30% of hospitalized patients, which means higher morbidity and mortality risk.

The survey of 182 physicians found that only 53% of acute care hospitals had a nutrition team, often because there was a gastroenterology department. 

Hospital nutrition teams address common issues, including malnutrition, parenteral or enteral nutrition and the transition process.

Regular screening for malnutrition is carried out in 83% of hospitals with nutrition teams and 47% of hospitals without nutrition teams, finds the survey. Also, only 57% of clinics automatically involve their nutrition teams if malnutrition is detected in patients.

According to the study, hospitals without nutrition teams cannot carry out nutrition screening procedures due to staffing shortages. Researchers recommend that hospitals with nutrition teams screen for malnutrition more frequently. They call for better funding and standardization to improve the situation.

IBD patients impacted

A separate prospective study in Nutrients discovered that roughly one-third of Inflammatory Bowel Disease (IBD) patients suffered from sarcopenia and malnutrition. 

WHO Europe underlines that only one-third of patients who cannot eat receive oral nutritional supplements or artificial nutrition.Sarcopenia is a musculoskeletal disease that often impacts the elderly, and IBD, including Crohn’s disease and ulcerative colitis, are chronic inflammatory conditions in the intestine.

The research was carried out in Italian hospitals and suggests physicians caring for IBD patients should be aware of the need to evaluate patients’ nutritional statuses so they can achieve a better quality of life.

The paper explains that malnutrition could be caused by a number of factors, including abdominal pain and diarrhea that reduce food intake. In addition, patients may avoid certain foods that can trigger their symptoms, which in turn can cause nutritional deficiencies.

“Hospitalization (due to disease flares or complications) often involves fasting or dietary restrictions that contribute to nutritional deficits. Surgical interventions, in particular ileal resection, are also associated with malnutrition, so early nutritional support in patients undergoing abdominal surgery is required,” details the paper. 

“In addition, we should keep in mind that obesity is also quite frequently observed in patients with IBD, with an estimated prevalence ranging between 15% and 40% that parallels the high frequencies observed in Western countries.” 

Europe-wide issue 

WHO Europe’s latest factsheet on disease-related malnutrition states that acute or chronic diseases, including non-communicable diseases, may cause it.

It finds malnutrition affects 30 to 50% of hospitalized patients. Vulnerable groups with noncommunicable diseases, cancer or diabetes and older adults are at higher risk.

Also, about 40% of inpatients in the European Region were seen to unintentionally lose weight, and half of them ate poorly and were at risk of malnutrition. WHO underlines that almost half of inpatients do not receive nutritional care and only one-third of patients who cannot eat receive oral nutritional supplements or artificial nutrition.

“Non-communicable diseases, from cardiovascular diseases and diabetes to chronic respiratory diseases and cancer, cause nearly 90% of deaths and are responsible for 85% of years lived with disability in the WHO European Region,” adds the intergovernmental organization.

“We need to recognize disease-malnutrition as a serious challenge for countries’ health systems and to take steps to tackle this problem at all levels. Medical schools and healthcare professionals need better training in nutritional care. At the same time, governments should recognize the importance of nutritional care and integrate it into primary, outpatient and inpatient settings,” says Dr. Kremlin Wickramasinghe, WHO Europe’s regional adviser on Nutrition, Physical Activity and Obesity.

Nutrition Insight recently spoke to Danone’s chief scientific and medical officer about causes, impacts and solutions to disease-related malnutrition, an often overlooked condition that weakens patients’ ability to fight infections and diseases. The company stressed the importance of nutritional care in treating patients, aiming to provide “health through food to as many people as possible.”