Malnutrition costing up to €1.5 billion per year

MALNUTRITION IN older people is a significant public health problem which is costing Ireland in excess of €1

MALNUTRITION IN older people is a significant public health problem which is costing Ireland in excess of €1.5 billion annually and needs to be urgently addressed, according to a leading international expert.

Professor of nutrition at the Institute of Human Nutrition in Southampton, Marinos Elia, said that Ireland – in common with other countries – had reached a critical crossroads in its approach to the problem of malnutrition.

He pointed out that the cost of treating malnutrition-related illness was twice that of obesity, with the condition exacerbating a range of age-related conditions including diabetes, vascular diseases, cancer, osteoporosis and Alzheimer’s.

The issue hit the headlines in the UK last week with newspapers reporting that nearly 250 NHS patients were dying of malnutrition every year. In the UK, the cost of treating malnutrition was estimated to be over €16 billion in 2007, or just over 10 per cent of the annual healthcare budget.

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Prof Elia points out that oral nutritional supplements (ONS) are the bedrock of malnutrition treatment across Europe and have consistently been found to deliver huge cost benefits.

However, a threat hangs over funding of these supplements in Ireland after research carried out by Dr Michael Barry and the National Centre for Pharmacoeconomics determined that up to half of the almost €30 million spent on ONS here every year was being wasted due to overprescribing.

Professor of nutrition at the UCD Institute of Food and Health, Michael Gibney, pointed out that there was no comprehensive data on malnutrition in Ireland – and the benefits or otherwise of ONS – but ad-hoc research suggested the problem was every bit as serious in Ireland as the rest of Europe.

“I can’t understand how anyone can make a decision in the absence of data. If you want to reduce the problem of malnutrition, you have to give proper nutrition to older people at home, in nursing homes and hospitals and this can be done easily with oral nutritional supplements. The return from this investment is probably the best value for money in terms of healthcare interventions.”

He explained that the UK and other countries now had mandatory testing for malnutrition in older patients admitted to hospital as well as programmes of nutritional rehabilitation.

“A report from the European Parliament has found that the cost of malnutrition in older people exceeds the cost of obesity and overweight, despite all the attention those conditions attract. There are as many older people in Ireland as there are overweight and obese people and the numbers are growing.

“More elderly people are admitted to hospital which is the expensive end of the health services. If they are malnourished, they will go into hospital more frequently, stay there longer, have more complications and a greater chance of readmission.”

Prof Gibney organised a recent conference at the Institute of Food and Health on malnutrition which was addressed by a number of international experts on the topic.

He expects the recommendations from this conference to culminate in the establishment of a group early next year to formulate a policy on how to tackle the growing problem of malnutrition in Ireland.

Michelle McDonagh

Michelle McDonagh

Michelle McDonagh, a contributor to The Irish Times, writes about health and family