Malnutrition can be developed due to insufficient intake of macronutrients (protein, carbohydrates and fats), increasing energy needs in the acute illness due to malabsorption - insufficient utilization of nutrients that enter through food or increased loss of nutrients, as a result of complications due to primary disease or a combination of the two or more of the mentioned factors as well as various diets and conscious or unconscious starvations of bodies.
If, for any of these reasons, we do not have enough food that will satisfy our daily energy needs, our body uses its own reserves. When these reserves are depleted, the body is forced to break down the protein, first from muscle tissue, and then from the internal organs, which can have serious health consequences. Constant hunger can be accompanied by various changes in the body, such as weight loss, biochemical disturbances, weakness, fatigue, decrease in muscle strength, reluctance, disorders of the menstrual cycle in women, disorder of the immune system and such. Diabetes, chronic diseases of the digestive system, various surgical procedures in the digestive system, interfere with the absorption of fat-soluble vitamins, vitamin B12, calcium and iron. Decreased absorption can lead to conditions such as anemia and osteoporosis. Celiac disease, pancreatic insufficiency, cancers and other diseases can lead to malabsorption syndrome.
We treat malnutrition with the help of appropriate individual diet therapy whose primary objective is to achieve optimal body weight with the help of a proper, balanced diet. In malnourished patients, diet therapy should be prescribed individually, adapted to the cause and degree of nourishment.
Assessment of nutritional status is based on a detailed history which recognizes factors that could contribute to the existence of malnutrition. This means a loss of weight, appetite, gastrointestinal symptoms as well as data on chronic diseases and medications. By detailed examination of the eating habits and their changes, access to energy, protein and micronutrient intake is obtained. We require laboratory findings that point to biochemical changes in the body or the lack of certain micronutrients. After that, the following anthropometric measurements are performed: body height, body weight, BMI determination index (body mass index), which helps determine the degree of malnutrition. Bioelectrical impedance, which is based on a different tissue conduction, is used to measure the percentage of water, muscle mass, fat and bone tissue in the body.
When there is malnutrition BMI <18.5, it is recommended to have a balanced diet with more frequent meals. There are seven food groups whose intake is necessary, along with varied diet, for the body in order to perform its functions smoothly. Its primary objective is the proper combination of food and intake of protective substances. Nutrition in malnourished patients should be hyper energetic, hyper protein, rich in carbohydrates, minerals and vitamins, with a moderate fat content. There are 6 introduced meals every 2-2.5 hours, meal before sleep (nighttime snack) is required. Complex carbohydrates (white sugar, confectionery, white bread, too much dough) are not desirable in any kind of under-nourished people. Proteins (meat, fish, eggs, dairy products) are the main source of energy in malnutrition, because our goal is to increase body weight and muscle mass instead of fat in the subcutaneous tissue.
A specialist professional nutritionist dietician, Tijana Valenta