‘Malnutrition’ refers to a physical condition in which the body has a shortage of nutrients, leading to disruption of the body’s biological function. Malnutrition is also described as: ‘a deficiency or imbalance of energy (carbohydrates and fats), protein and other nutrients that causes measurable adverse effects on the body (body shape, size and composition), bodily function and clinical outcome.’(Elia, 2000).
Malnutrition resulting from illness, also known as clinical depletion, can be subdivided into a chronic form (marasmus form), occurring chiefly in patients in long-term care (nursing homes and home care), and an acute form (kwashiorkor form) which occurs chiefly in hospitals. Marasmus involves a physical condition initially characterized by clearly reduced fat mass while retaining the body proteins; however, this is later followed by a reduction of muscle mass. Marasmus may be the consequence both of an insufficient food intake or of a (chronic) disease. The acute form of malnutrition (kwashiorkor = protein malnutrition) is caused by a rapidly occurring lack of protein while sufficient carbohydrates and fats are still available as energy source (Stratton et al. 2003). This form of malnutrition occurs during an acute illness or a major operation. It involves strong and rapid tissue decomposition with the breakdown of many body proteins even if sufficient food is ingested.
Malnutrition is chiefly associated with developing countries and is then mostly a result of poverty or famine. One would not tend to assume that malnutrition also often occurs in Western healthcare institutions. But ever since 2004 the results of the LPZ have shown that malnutrition is and remains a relevant and important problem, in home care, hospitals and long-term care institutions (including nursing homes). In recent years, thanks in part to the LPZ measurements in all types of Dutch care institutions, greater attention has been given to timely flagging and treatment of illness-related malnutrition.