‘Let food be thy medicine and medicine be thy food’Hippocrates
For centuries we have known about the benefits of food in supporting health and well being and it’s no different today.
Diets and nutritional advice is everywhere. There is no escaping it, with a new ‘food revolution’ advertised to cure all festive period blues and weight gain every winter, and one to provide the perfect ‘beach body’ every summer. And what makes it more confusing is that each has a different slant on eating; different cooking methods, volumes, combinations and timings of ingesting foods for us all to achieve the goal of feeling ‘better’.
Yet there is very little focus on food as an aid to recovery in our hospitals, the very place where the majority of people want to feel healthy and well.
Good nutrition and hydration are vital components within the healing and recovery process for most people who have been ill, with poor diet and nutrition leading to malnutrition.
The British Association of Parenteral and Enteral Nutrition (BAPEN) describe Malnutrition as a state of nutrition in which a deficiency or excess (imbalance) of energy, protein and other nutrients causes measurable adverse effects on tissue/body form (body shape, size and composition) and function and clinical outcome.
For those in hospital, the focus of malnutrition is generally in relation to undernutrition.
We already know that approximately 25-34% of hospital admissions and one third (32%) of people aged 65 years or over are at risk of malnutrition on admission to hospital.
The short and long term effects on the body are well documented (BAPEN 2016) and can include:
- Impaired immune function
- Wound healing,
- Reduced function with loss of lean mass impacting on mobility,
- Potentially increasing of falls
- Pressure damage,
- Altered mood with apathy and depression having an knock on effect on ability to perform normal activities of daily living.
These can all lead to longer hospital stays, more complications, poorer outcomes, increased need for additional support on discharge and further hospital admissions.
For patients to be able to get up and keep moving, adequate nutrition is vital part of recovery.
The financial cost of providing health care associated with malnutrition is huge; with new evidence suggesting it amounts to approximately 15% of the total expenditure on health and social care. These costs are likely to continue to rise in line with our ageing population – adults over 65 currently account for 52% of these total costs (BAPEN 2018).
What have we done in NHSGGC to tackle the issue?
Our team has carried out a refresh of guidance in the Malnutrition Universal Screening Tool (MUST), the validated tool routinely used to screen for risk of malnutrition on admission to hospital.
This was supported by a multidisciplinary team from NHS Greater Glasgow and Clyde embarking on an extensive social media campaign to debunk some common misconceptions and get staff and the public to learn more about the importance of food.
The campaign began in May 2018 with the aim of encouraging a ‘food first’ approach to nutritional care. This is highlighting the importance of nutrition, food and fluid, as an integral part of a patient’s care.
We are supporting all activity for the campaign with eye-catching infographics across our social media channels and the dedicated #FoodFirstGGC.
The goal is to empower all staff, within the acute in-patient setting, in contact with patients to be able to support a patient centred nutritional care plan for optimal recovery.
- Physiotherapists – where appropriate do you always offer a drink and snack after gym sessions?
- Dietitians – do you offer a snack and drink at the end of your consultation?
- Occupational Therapists – do you encourage snacks during activities
- Speech Therapists – do you record significant diet trials on food charts?
- Patients and families – do you record food provided when visiting?
Working as a team, we can all support people in their journey to recovery .
We are all in this together – Nutrition is everyone’s business!