Prevalence of Malnutrition in Various Political,Economic,and Geographic Settings

Abstract

Background: Disease-related malnutrition (DRM) represents a critical public health concern. Therefore, Fight Against Malnutrition (FAM) should be a state priority, but the degree to which this is true appears to differ considerably among European countries. The aim of this study was to put the problem into perspective by comparing the prevalence of malnutrition in countries from opposite parts of the continent. Methods: Six countries—Croatia, Estonia, Greece, Lithuania, Poland, and Turkey—participated in the study. A short questionnaire was used to assess DRM: its prevalence, the current situation in hospitals, regulations for reimbursement, and general healthcare circumstances. Data from ESPEN’s NutritionDay 2006 were used to broaden the perspective. Results: At admission in October 2012, 4068 patients were assessed. The study was performed in 160 hospitals and 225 units with 9143 beds. The highest proportions of patients with 3 or more points on the Nutritional Risk Screening 2002 were observed in Estonia (80.4%) and Turkey (39.4%), whereas the lowest were in Lithuania (14.2%). The provision of nutrition support was best in Turkey (39.4% required intervention, 34.4% received intervention) and Poland (21.9% and 27.8%, respectively). Nutrition support teams (NSTs) are active in some countries, whereas in others they virtually do not exist. Conclusion: The prevalence of malnutrition was quite high in some countries, and the nutrition approach differed among them. It could be the result of the lack of reimbursement, inactive or nonexistent NSTs, and low nutrition awareness. Those facts confirmed that the continuation of FAM activities is necessary.

Keywords

malnutrition disease-related malnutrition Fight Against Malnutrition

Get full access to this article

View all access options for this article.

References

Ljungqvist

van Gossum

Sanz

de Man

. The European fight against malnutrition. Clin Nutr. 2010;29:149-150.

Norman

Pichard

Lochs

Pirlich

. Prognostic impact of disease-related malnutrition. Clin Nutr. 2008;27:5e15.

Bistrian

Blackburn

Hallowell

Heddle

. Protein status of general surgical patients. J Am Med Assoc. 1974;230:858-860.

Hill

Blackett

Pickford

. Malnutrition in surgical patients. An unrecognised problem. Lancet. 1977;1:689-692.

White

Guenter

Jensen

Malone

Schofield

; Academy Malnutrition Work Group; A.S.P.E.N. Malnutrition Task Force; A.S.P.E.N. Board of Directors. Consensus statement: Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition: characteristics recommended for the identification and documentation of adult malnutrition (undernutrition). JPEN J Parenter Enteral Nutr. 2012;36(3):275-283.

National Alliance for Infusion Therapy and the American Society for Parenteral and Enteral Nutrition Public Policy Committee and Board of Directors. Disease-related malnutrition and enteral nutrition therapy: a significant problem with a cost-effective solution. Nutr Clin Pract. 2010;25:548-554.

Jensen

Bistrian

Roubenoff

Heimburger

. Malnutrition syndromes: a conundrum vs continuum. JPEN J Parenter Enteral Nutr. 2009;33:710-716.

Jensen

Mirtallo

Compher

. Adult starvation and disease-related malnutrition: a rational approach for etiology-based diagnosis in the clinical practice setting from the International Consensus Guideline Committee. JPEN J Parenter Enteral Nutr. 2010;34:156-159.

McWhirter

Pennington

. Incidence and recognition of malnutrition in hospital. Br Med J. 1994;308:945-948.

10.

Kondrup

Johansen

Plum

. Incidence of nutritional risk and causes of inadequate nutritional care in hospitals. Clin Nutr. 2002;21:461-468.

11.

Leistra

Neelemaat

Evers

. Prevalence of undernutrition in Dutch hospital outpatients. Eur J Intern Med. 2009;20(5):509-513.

12.

Neelemaat

Kruizenga

de Vet

Seidell

Butterman

van Bokhorst-de van der Schueren

. Screening malnutrition in hospital outpatients. Can the SNAQ malnutrition screening tool also be applied to this population? Clin Nutr. 2008;27(3):439-446.

13.

Schindler

Pernicka

Laviano

. How nutritional risk is assessed and managed in European hospitals: a survey of 21,007 patients findings from the 2007-2008 cross-sectional nutritionDay survey. Clin Nutr. 2010;29:552-559.

14.

Kondrup

Allison

Elia

Vellas

Plauth

. ESPEN guidelines for nutrition screening 2002. Clin Nutr. 2003;22(4):415-421.

15.

Korfali

Gundogdu

Aydintug

. Nutritional risk of hospitalized patients in Turkey. Clin Nutr. 2009;28:533-537.

16.

Organisation for Economic Co-operation and Development. OECD health data 2013: how does Greece compare. http://www.oecd.org/els/health-systems/Briefing-Note-GREECE-2013.pdf. Accessed January 9, 2013.

17.

World Health Organization. World health statistics 2012. http://www.who.int/gho/publications/world_health_statistics/2012/en/index.html. Accessed January 9, 2013.

18.

Draft for the rearrangement of ESY Health Care Units [in Greek]. http://s.enet.gr/resources/article-files/protash-anadiata3hs.pdf. Published July 1, 2011. Accessed September 17, 2013.

19.

Lochs

Allison

Meier

. Introductory to the ESPEN Guidelines on Enteral Nutrition: Terminology, definitions and general topics. Clin Nutr. 2006;25(2):180-186.

20.

Elia

. Detection and Management of Undernutrition in the Community. A Report by the Malnutrition Advisory Group (a standing committee of the British Association for Parenteral and Enteral Nutrition). Maidenhead, UK: BAPEN; 2000.

21.

Elia

. Screening for Malnutrition: A Multidisciplinary Responsibility. Development and Use of the Malnutrition Universal Screening Tool (‘MUST’) for Adults. Redditch, UK: BAPEN; 2003.

22.

Russell

Elia

. Nutrition Screening Survey in the UK in 2008: Hospitals, Care Homes and Mental Health Units. Redditch, UK: BAPEN; 2009.

23.

Kruizenga

Wierdsma

van Bokhorst

. Screening of nutritional status in the Netherlands. Clin Nutr. 2003;22(2):147-152.

24.

Meijers

Schols

van Bokhorst-de van der Schueren

. Malnutrition prevalence in the Netherlands: results of the annual Dutch National Prevalence Measurement of Care Problems. Br J Nutr. 2009;101(3):417-423.

25.

Russell

Elia

. Nutrition Screening Survey and Audit of Adults on Admission to Hospitals, Care Homes and Mental Health Units. Redditch, UK: BAPEN; 2008.

26.

Chourdakis

Kraus

Tzellos

. Effect of early compared with delayed enteral nutrition on endocrine function in patients with traumatic brain injury: an open-labeled randomized trial. JPEN J Parenter Enteral Nutr. 2012;36(1):108-116.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.07 MB