Nutrition and Hydration

24 April 2020

Chido Muchaneta, Clinical and Professional Educator

 National statistics

One in ten people over 65 years in the UK are malnourished.

 What is malnutrition?
Malnutrition is a serious condition that happens
when your diet does not contain the right amount
of nutrients, ‘poor nutrition’ and can refer to:
• Undernutrition – not getting enough nutrients
• Over nutrition – getting more nutrients than
needed
Undernutrition can occur in those that are not
underweight but do not have enough of some
nutrients so do not have a balanced diet.

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 BMI and how to calculate
Resources:
• What is BMI
https
://www.nhs.uk/common-health-questions/lifestyle/what-is-th
e-body-mass-index-bmi
/

• Calculating BMI
https://www.nhs.uk/live-well/healthy-weight/bmi-calculator/

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 Symptoms of malnutrition
Weight loss

Most people who are malnourished will lose weight, but it's possible to be a
healthy weight or even overweight and still be malnourished. For example,
this can happen if you're not getting enough nutrients, such as some types of 
vitamins and minerals, through your diet.

You could be malnourished if:

• you unintentionally lose 5 to 10% of your body weight within 3 to 6 months
• your BMI is under 18.5 (although a person with a BMI under 20 could also
be at risk)
• clothes, belts and jewellery seem to become looser over time
• You should see a GP/ Doctor if you have unintentionally lost a lot of weight
over the past few months, as it may be a symptom of an underlying health
condition
• If a friend or family member has lost a lot of weight, talk to them about your
concerns and encourage them to get help.

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 Other symptoms

Other symptoms of malnutrition include:

• reduced appetite
• lack of interest in food and drink
• feeling tired all the time
• feeling weaker
• getting ill often and taking a long time to recover
• wounds taking a long time to heal
• poor concentration
• feeling cold most of the time
• low mood or depression

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What is a balanced diet?

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What is the current NHS advice?
Visit the NHS Eat well page to read what the
latest advice is:
https://www.nhs.uk/live-well/eat-well/the-eat
well-guide
/

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 Malnutrition: snacking
Snacking (eating small amounts regularly) to
manage patients who are malnourished or at risk
of malnourishment.
• A good option for patients with poor appetite or
feeling full too quickly.
• Snacks high in fat, protein and carbohydrates
are good options.
• Mixed messages: snacking often seen negatively
but is often essential for this patient group.
Importance of hydration

~ 70% of the body

is water

~ 93% of blood is
water
 Dehydration urine colour chart
OK

The darker
the urine the
less well
hydrated the
patient is

Dehydrated
 Hydration recommendation
6 to 8 glasses (1.5 litres) minimum of fluids everyday
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 Recommended fluid intake

Optimal fluid intake can be calculated as

below for adults:

• Over 60 years 30ml per KG

• 59 years and under 35ml per KG

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 Monitoring fluid intake
• Monitoring fluid intake and urine out put differs based on
setting
• In a formal clinical setting this should be recorded and
documented
• Drinks taken should be recorded, daily intake can then be
compared with the recommended fluid intake and advice
given accordingly
• Every time the catheter bag is emptied the urine should be
measured and recorded.
• Reduction in urine output can be a sign of underlying heath
concern – examples can be urinary tract infection, renal
impairment, dehydration or sepsis (consider NEWS)

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 Food safety
• Food hygiene and safety should apply in
any settings where food is consumed, but
particularly where there are vulnerable
individuals who may suffer nutritional harm.
• It is important to maintain nutritional
vigilance at all times to ensure optimum
health outcomes
• Eat well, live well…

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Five keys to safer food