10 Vital Signs You’re Not Getting Enough Nutrients

Malaysia is expected to join the ranks of ageing nations by 2035.

In 2020, the World Bank study predicted that Malaysia would be a ‘super-aged’ nation, with at least 20% of the Malaysian population to be in this age group by 2056.

Ageing comes with its own sets of challenges and is often something that people don’t look forward to or fear.

Sadly, 3 out of 10 elderly Malaysians are either suffering from malnutrition or at risk of becoming malnourished.

What is Malnutrition?

It is a condition whereby one does not get enough energy intake.

One experiences weight loss, in the process, causes loss in muscle mass and subcutaneous fat.

Types of Nutrients

Our body requires nutrients to function.

Nutrients can be broken down into 2 main categories

Macronutrients

This consists of carbohydrates, protein and fats

Carbohydrates are broken down in our body into glucose, which is used as energy and fuel for our cells and organs. Excess glucose is stored in our liver cells and muscles for future use.

We can obtain healthy sources of carbohydrates from

Whole grains such as bread, pasta, rice, noodles
Legumes such as beans and peas
Starchy vegetables such as corn and potatoes
Fruits such as bananas, apples, oranges and melons

It is important to avoid carbohydrates that are highly processed or high in sugar, as they can raise blood sugar levels.

An average person is encouraged to obtain 45-65% of calories from carbohydrates daily.

Protein is required to grow, regenerate and repair cells and tissues in our body. They are made up of amino acids. There are a total of 11 non-essential amino acids. There are 9 amino acids that our bodies cannot make, and thus can only be obtained from dietary intake.

Protein sources include

Animal products – fish, eggs, poultry, beef or dairy products
Plant protein – whole grains, nuts and lentils
Soy products

Avoid red meat as it can cause gout – a painful condition that causes your joints (mainly your big toe) to become inflamed.

It is recommended that an elderly person gets 1 to 1.2 grams of protein per kilogram of body weight per day.

Eating too little protein can cause muscle shrinkage and wasting, edema (an accumulation of fluids, particularly in your feet and ankles) and anaemia.

Fats

Healthy fats are important in regulating hormonal function, absorbing specific nutrients and preventing memory loss.

Healthy fat sources include

Fatty fish (salmon, mackerel, tuna)
Chia Seeds which is rich in omega-3 fatty acids
Eggs
Dark chocolate, which also contains magnesium, potassium and calcium
Nuts
Avocado
Olive Oil

Avoid foods that are high in trans fats (fried foods like keropok, murukku, lekor, curry puffs) as they can cause inflammation of our body. They increase the risk of stroke, diabetes, and heart disease.

Micronutrients

Our bodies require these nutrients in small quantities, hence the term ‘micro’.

These include zinc, iron, magnesium, potassium, manganese and more.

Vitamins include Vitamin A, B, C, D, E and K.

Not getting sufficient micronutrients in our diet can negatively impact one’s development and growth.

One may be at risk of developing complications like anaemia, blindness, fatigue, osteoporosis, goitre and muscle cramps.

Overall, they play an important part in maintaining functions in our body – helping our organs function, strengthening our immune system, regulating our digestive system, metabolism, building healthy bones and more.

Why is Malnutrition so common in the elderly?

Living Alone

Approximately one-third of persons over the age of 65 and one-half over the age of 85 live alone, which typically decreases food enjoyment and calorie intake.

The elderly who dine in the company of others generally experience increased enjoyment of their meals and tend to consume more calories.

Financial factors

In order to save money, the elderly may opt to skip meals or eat less, as they do not want to be a financial burden to family members.

Medical conditions

As we age, it is common to have an increase in chronic diseases.

Some have difficulty in swallowing, especially patients after stroke, people with Parkinson’s disease and gastroesophageal reflux disease (GERD).

Chewing difficulties and oral pain can also make it present as a challenge for elderly patients to consume adequate food and meet their daily requirements.

Mental Health

Mental health is often a taboo topic that is prevalent among the elderly. Depression and dementia, for example, are very common in the elderly which are often undiagnosed and untreated.

A study found that depression was a cause of weight loss in 30% of elderly, compared to just 15% in young adults.

The normal process of ageing

As we age, our taste buds change. We are naturally less hungry and get full faster. This is because it takes a longer time for our bodies to digest food.

This makes it harder for the elderly to have adequate protein intake or sufficient amounts of nutrients.

Sarcopenia

This is a condition where one loses muscle mass, and as a result, strength and performance. It is prevalent in more than half of the adults over the age of 80 years old. There could also be an underlying medical condition causing this.

10 Warning Signs of Malnutrition

Here are some questions to ask :

Do you feel like your appetite has reduced?

Are you experiencing a loss of interest in food?

Signs include playing with food on the plate or in the mouth.

It takes a long time to finish eating or chewing.

You find that you are unable to finish the food on the plate. Sometimes, you may even skip meals especially if you are staying alone.

Have you lost a significant amount of weight?

A weight loss of 5 to 10 percent in 3 to 6 months is significant. A BMI of <18.5 kg/m2 is considered underweight, which is an obvious sign of malnutrition. However, people with a normal BMI can also suffer from malnutrition, so it is important to look at other signs. Loose clothes and jewellery, needing to tighten your belt are some other signs of weight loss.

Have people told you that you look physically frail?

Physical signs include sunken eyes and hollow cheeks. You look thinner and gaunt.

You may even have papery, cold and thin skin.

Other signs include flaky nails and wounds that take a longer time to heal.

Do you have significant hair loss?

You may complain of hair falling out easily, and brittle nails.

This is because there is a lack of vitamin C, folic acid and calcium, which are the building blocks for developing healthy skin, teeth and nails.

Lack of Vitamin B12 can also cause your hair to thin out and disrupt healthy hair follicle growth and development.

Do you feel your heart beating out of your chest?

Chest palpitations, breathlessness, dizziness, and lightheadedness could be due to electrolyte imbalances, a result of insufficient nutrition intake.

Constipation is also a sign of not getting enough nutrients.

Are you constantly tired and lethargic?

Lack of nutrients can increase sleepiness.

You may feel weak and have a lack of energy daily. You may also struggle to perform daily activities and take a longer time to complete tasks.

Do you take a longer time to recover after a sickness?

Insufficient nutrients can cause a weaker immune system.

You may find yourself falling sick often with a cough, runny nose or even the flu. Sometimes, these symptoms may be more severe than an average healthy person – even requiring hospitalisation.

Do you feel more angry, depressed or irritable?

Depression- you are quieter, have a low mood and struggle to smile.

You find a lack of joy and excitement in hobbies.

You may even be more teary and sad.

You find yourself sleeping longer or having disturbed sleep.

You prefer to be alone and keep to yourself.

Do you feel cold often, in places where others don’t?

Inadequate nutritional intake may cause a drop in body thermal temperature. This is a way for our body to adapt to conserve calories.

Do you have difficulty concentrating?

Lack of nutrients can lead to brain fog, affecting our ability to process information. A study found that insufficient nutrient intake can even result in memory loss. Simultaneously, there could be a more sinister cause behind such issues. Cognitive conditions like dementia and Alzheimer’s disease can contribute to difficulties in concentration and memory, ranging from trouble recalling events and faces to everyday tasks such as forgetting to turn off the stove or misplacing keys easily.

Individuals may also experience challenges in finding the right words to express themselves and may undergo changes in their personality.

Symptoms are often subtle and should be identified early for proper treatment to prevent the progression of the disease.

Seek Help Today!

Malnutrition is an increasingly common issue among the elderly.

There are many causes of malnutrition, and the ramifications of malnutrition can be detrimental to one’s health.

There is no one-size-fits-all approach when it comes to treating this.

Your physician and dietitian will discuss and come up with a detailed plan and approach, and walk with you or your loved one every step of the way.

References

https://www.thestar.com.my/news/nation/2023/01/28/malaysia-expected-to-become-a-super-aged-nation-by-2056