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Dairy Nutrition Forum

Volume 8 Issue 2

A PUBLICATION FOR INDUSTRY AND HEALTH PROFESSIONALS

THIS ISSUE

Forum

Malnutrition: finding solutions through novel dairy research

November 2016

PAGES

Introduction................................................................................................ 1 Malnutrition: finding solutions through novel dairy research...................................................2 Key Points New resources...................................................................................... 4

Introduction

EDITORIAL

Ireland’s battle with obesity is no stranger to dramatic media attention or Government debate but, alongside this, the largely unrecognised issue of malnutrition is silently knocking on Irish society’s door. Worldwide, 795 million people are malnourished and with 98% of these living in developing countries, it is unsurprising that the majority of cases are driven by hunger or lack of access to nutritious food. Here in the developed world, however, where food is in abundance, malnutrition tends to be driven by inadequate nutrient intake caused by illness, poor dietary choices or loss of independent living. On any given day in Ireland, an estimated 145,000 people (4% of the population) are considered to be malnourished or at risk of malnutrition. Those over the age of 65 years, living alone or in care institutions are most at risk with the highest concentrations in hospitals (one in three patients). The figures are similar across the EU, where it is estimated that 10% of individuals over 65 years are malnourished. Malnourished patients typically exhibit higher rates of infection and mortality, with complications such as poorer wound healing, impaired respiratory function, muscle weakness and depression being common. These factors result in people with malnutrition being three times more likely to require hospital admissions and the average hospital stay of a malnourished patient is 30-70% longer. It has been estimated that malnutrition costs the Irish state €1.42 billion every year, which is greater than the costs associated with obesity and more than 10% of the annual health and social care budget. Unless urgently addressed, the costs associated with dealing with malnutrition could rise as our population ages. Given the significant societal and financial burden of malnutrition, any potential saving that can be made could have a substantial positive impact on our health system. For example, a 1% reduction in medical care costs could deliver €14.2 million in savings to the State annually.

In this edition of DN Forum, we address malnutrition, a silent crisis in our burdened healthcare system. Our expert review explores a novel dairy solution to malnutrition, which, surprisingly, is a condition that has a greater economic impact in Ireland than obesity. Together with our Food for Health Ireland (FHI) partners, Dr Jacqueline Lyons and Kenneth Howick from the Appetite Modulation Team at University College Cork, we provide an account of malnutrition in Ireland and a synopsis of some novel Irish research that sets out to combat this growing problem.

If detected early enough, malnutrition can usually be prevented or treated and, therefore, screening is a vital measure in combating this issue in developed countries. The Malnutrition Universal Screening Tool (MUST) is the recommended approach for nutritional screening. Provision of a balanced diet, which is both energy and nutrient dense, is an obvious treatment approach for malnourished individuals. However, it is not always a feasible solution as their dietary requirements can be significantly altered in illness and chronic loss of appetite is common. Appetite stimulation therefore poses an attractive opportunity for overcoming this challenge. Novel research by Food for Health Ireland (FHI) is exploring the possibility of using milk-derived bioactive peptides to mimic the action of ghrelin, the body’s appetite stimulating hormone. These peptides therefore have promising potential as functional ingredients in food or oral nutrition supplements to treat malnutrition.

This FHI research is aimed at tackling appetite loss, which is one of the key factors driving malnutrition in the elderly and hospitalised. The work explores the potential role of dairy peptides, which could be used to mimic the appetite stimulating effects of ghrelin, better known as the body’s ‘hunger’ hormone. Improving appetite in those at risk of malnutrition from ill health or ageing could help to alleviate the problem. We hope you enjoy this edition of DN Forum and look forward to any feedback or comments you wish to share: nutrition@ndc.ie

Dr Marianne Walsh Nutrition Manager The National Dairy Council (NDC)