BAPEN President Issues Warning on Malnutrition

Even amongst those of us who work professionally in the field of caring for older people, there is often a misconception that weight loss is an inevitable part of ageing. Amongst the general public, including the families of those in our care, this belief is even more widespread, often expressed with an attitude of “well, what can you expect at their age?”.

However, as part of the UK’s first ever malnutrition awareness week, Dr Simon Gabe, president of the British Association for Parenteral and Enteral Nutrition (BAPEN) has issued a reminder that weight loss in old age should not simply be accepted as normal but seen as a sign of potential malnutrition. Statistics suggest that 1 in 10 people over the age of 65 is malnourished or at risk or malnourishment but for the people in this group, taking a few simple measures can help to improve their nutritional state and stave off serious complications related to poor dietary intake.

Read on to learn more about the easy steps you can take to prevent malnutrition amongst the people in your care.


Weight loss can be insidious, with an older person’s weight falling so gradually that those closest to them barely notice. Often it is the occasional visitor who notices how much weight a person has lost but by then, a considerable amount of body mass may already have been shed, making it even harder to return to a previously healthy weight.

You will almost certainly check the weight of the people in your care at least monthly but in some cases, even this can fail to detect weight loss quickly enough, particularly if the person has been unwell and the loss has been rapid. In cases like this, you should observe for tell-tale signs, such as clothing or wedding rings appearing to be looser than usual, as a prompt to carry out weight measurement more frequently.

Thankfully, there are a number of simple measures you can take to help support service users at risk of malnutrition and prevent unplanned weight loss. Even without resorting to prescribed nutritional supplements, you can quickly act to prevent weight loss by knowing how to fortify the food and drinks that you serve every day.

4 Tips to Improve Nutritional Status by Fortifying Food and Drink 

  1. Use cream or butter: Simply adding these items to everyday foods can greatly increase their calorific value. For example, adding a knob of butter and a tablespoon of double cream to a scoop of mashed potato will increase its calorific value from 45kcal to 195kcal, an increase of over 300% and adding cream and sugar to porridge can double the amount of calories it contains.
  2. Add grated cheese: Using as little as a matchbox-sized amount of grated cheddar cheese can double the calorific value of a small tin of baked beans or ravioli, making an evening snack much more substantial.
  3. Offer high calorie snacks: Even if a person eats frequently, consuming snacks that have low nutritional value may mean that no weight is gained. Aim for high fat items, such as crumpets with butter, full fat yoghurt, peanuts or chocolate rather than those with fewer calories like sweets or plain biscuits.
  4. Choose drinks with care: Many of the drinks offered in care homes such as tea, coffee and sugar-free squash offer very few nutritional benefits. But by offering drinks made with full fat milk, such as milky coffee, Ovaltine, milkshakes or simply a glass of cold milk, you can improve calorie intake by several hundred kcal per day.

For more practical guidance and advice on ensuring the highest quality of care provision, check out Care Quality Matters. Registered Managers across England rely on its advice every month to make sure they pass their CQC inspections.

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