21September2014

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BAPEN

You are here: Home Tackling Malnutrition Nutritional Advice and Information Treating Malnutrition

Treating Malnutrition

Encouraging Nutritional Intake by Mouth

“Understanding the nutrition gap and how it affects the person you care for” leaflet produced as part of the Carers UK and Nutricia Care with Nutrition campaign.

“Eating Better, Feeling Better” is a leaflet produced by the British Dietetic Association (BDA) as part of their “Mind the Hunger Gap campaign” for people who need simple advice to add more energy to their diet.

“Eating well for older people and older people with dementia: Practical Guide.” Helen Crawley and Erica Hocking. Caroline Walker Trust. This report includes a report and materials that can be used by those caring for older people to support them to eat well.

“Dementia Gateway: Eating well for people with dementia”. This web resource from the Social Care Institute for Excellence (SCIE) includes practical advice and a video on nutritional care for older people.

“Food First” Project Advice Leaflets These leaflets have been made available by the kind permission of Cathy Forbes, Advanced Specialist Dietitian - Food First Project Lead, SEPT Community Health Services, Bedfordshire.

“Focus on Undernutrition” is a project implementing a service to identify and treat undernutrition in health and social care settings across County Durham and Darlington. Although primarily addressed at healthcare professionals, it does also have resources for the public available on the website including information on “Food as Treatment for Undernutrition” and “Nutritional Supplements.”

The “Nutritional COPD Guideline” was created a working group of the Respiratory Healthcare Professionals and includes information leaflets on nutrition for patients with COPD:

“Eating well for Your Lungs” for patients at low risk of malnutrition

“Improving Your Nutrition” for patients at medium risk of malnutrition

“Nutrition Support in COPD” for patients at high risk of malnutrition

“Solihull Nutrition Support Project” Advice Leaflets These leaflets have been made available by the kind permission of Ruth Stow and the Soihull Nutrition Project Support Team

Oral Nutritional Supplements (ONS)

Oral Nutritional Supplements can be an effective way of increasing total energy and nutrient intakes without suppressing appetite or food intake.
There are several types of oral nutritional supplements that include:

  • Drinks in a variety of flavours that are either like a milkshake or like a juice
  • Powders and liquids that can be added to normal foods to make them more nourishing
  • Pudding style desserts

There is evidence to suggest benefits to those who are malnourished or who are at risk of malnutrition when oral nutritional supplements are used appropriately in treatment plans that include regular monitoring. This should usually be under the supervision of a dietitian.

Examples of advice on the use of oral nutritional supplements have been made available by the kind permission of the “Food First Project” and the “Solihull Nutrition Support Project”.

ONS are classed as ‘border-line substances’ and so can only be prescribed on an NHS prescription if the patient’s condition comes into specific categories –such as disease related malnutrition. There are alternatives available that can be bought over the counter such as Build Up and Complan. However, if there is concern about malnutrition, professional help should be sought from your GP or dietitian.

Enteral Nutrition (EN)

This may be required when a patient is unable to take adequate amounts of food and drink by mouth. Feed is then delivered by a tube either into the stomach or small bowel (jejunum). Further information on enteral feeding can be found on the PINNT website. PINNT is a support group for people receiving artificial nutrition and is one of the Core Groups of BAPEN.

Parenteral Nutrition (PN)

This is only required if a patient is unable to absorb nutrition through their gut. Nutrients are given directly into a vein. In most cases this is given whilst a patient is in hospital, but in rare cases patients need to continue Parenteral Nutrition for longer and learn to manage this themselves (Home Parenteral Nutrition or HPN). Further information on Parenteral Nutrition can be found on the PINNT website.