Malnutrition and Disability

This article aims to highlight the link between malnutrition and disability, the causes and signs of malnutrition and most importantly how to prevent malnutrition from setting in.

For some, the idea of what a malnourished person looks like is someone who appears very frail with bones protruding. This misconception can lead to people missing the risk factors and identifying those suffering from malnutrition.

While weight can be a characteristic and risk factor for malnutrition, other factors are at play. Someone can appear to be of a perfectly healthy weight but only have white rice as their main dietary staple, which places them at risk of malnutrition.

Dietitians are trained to identify the causes and risk factors for malnutrition across all age groups and health statuses. Speech Pathologists assess an individual’s swallowing and feeding ability and recommend safe food and fluids for that individual to consume. Both these professions are key in both the prevention and management of malnutrition.

Malnutrition and Disability

Malnutrition can cause or contribute to a variety of different disabilities and disabilities can cause or contribute to malnutrition.

Malnutrition Contributing to Disability

Starting with pregnancy, malnutrition during this time can significantly impact the growth and development of a foetus. For example, low folate intake can lead to neural tube defects such as spina bifida. Other deficiencies such as iodine and iron during pregnancy can impact cognitive development.

Overall, malnutrition during pregnancy is linked with a higher rate of physical, neurological, and cognitive impairments in babies. Malnutrition in a child’s early years can also lead to sensory, physical and cognitive impairment. It is important to note that there are several factors that contribute to the development of different conditions and disabilities in children, with nutrition being just one aspect.

Disability contributing to Malnutrition

Individuals born with a disability or who acquire one later in life often face challenges with proper nutrition. There are several contributing factors:

• Feeding and swallowing difficulties affect the ability to eat and drink safely. Some people may need a modified diet, and this may impact on their ability to consume adequate nutrition. This may be a factor in various medical conditions including stroke, Cerebral Palsy, Huntington’s Disease, Multiple Sclerosis, Motor Neurone Disease, Down Syndrome, Intellectual disability, and Autism Spectrum Disorder (ASD).
• Mental health conditions can increase an individual’s risk of developing disordered eating behaviours and eating disorders which significantly increases the risk of malnutrition.
• Sensory impairments can impact one or more of an individual’s senses (for example Sensory Processing Disorder and ASD) and may also impact nutrition (for example taste, smell and feel) as the person may have specific food preferences or aversions (for example to a specific texture of foods).
• Increased nutrition needs can be long-term. This includes increased energy needs associated with degenerative neurological diseases. For example, Parkinson’s disease, Huntington’s Disease or periodic or specific problems such as managing pressure sores and wound healing.
• Access to proper nutrition and food for those living with a disability may be difficult. This can be linked to but is not limited to their financial situation, mental health, mobility limitations, access to transport, social isolation, access to technology for online shopping, geography and access and stability of informal and formalised supports.
• Nutrition education is linked to an individual’s access to and ability to understand nutrition-related information.
• Nutrition preparation may be difficult for those living with a disability as they may have reduced knowledge, skills and supports related to food preparation, storage, cooking, menu planning and suitable food choices.

Malnutrition Signs

Common signs to look out for that are known to increase an individual’s risk of malnutrition:

• Reduced appetite or changes to eating routine
• Refusal of entire food groups
• Weight loss (can be gradual or sudden)
• Disordered eating behaviours, not wanting to eat around other people
• History of an eating disorder
• Decreased interest in food or sudden change in food or drink preferences
• Regression of safe food and fluid level as this generally decreases the variety of food available
• A decline in swallow/feeding function
• Frequent illnesses such as recurring urinary tract infections.
• Delayed wound healing, particularly in the case of pressure sores
• Hair Loss and decrease in skin health
• Feeling cold
• Low energy levels

Prevention strategies for malnutrition

There are a number of malnutrition prevention strategies that can be put in place:

• Understanding disabilities and conditions which increase an individual’s risk of malnutrition
• Knowing if an individual has a history of disordered eating or eating disorders
• Understanding and recognising signs of swallowing/feeding difficulties at its early stages such as coughing, choking, food refusal, increased time of eating, pushing food around the plate, sudden changes in food preferences
• Understanding life stages/conditions that can lead to malnutrition such as acute illness, chronic illness, pressure sores, post-surgery
• Understanding conditions where nutrition needs can rapidly change over time such as Parkinson’s, Multiple Sclerosis, Dementia and Motor Neuron Disease.
• Referrals to Dietitians and Speech Pathologists are key for the prevention and management of malnutrition.

For more information on understanding malnutrition, be sure to speak with a qualified dietician, or you can phone the friendly team at Recovery station on 1300 588 851.

Until next time,

Hannah. | Dietician