Guidance to help Fight Adult Malnutrition in the Community Launched

By on June 18th, 2012

A new practical guide has been launched to assist GPs and other community healthcare professionals in identifying and managing the 3 million people in the UK at risk of disease-related malnutrition.

While poverty is often considered a major factor in malnutrition, disease is actually the primary cause1. More than three million people in the UK are at risk of disease-related malnutrition at any one time2, the vast majority (93%) live in the community. At risk groups include those with chronic disease such as cancer, individuals suffering from dementia, patients with an acute illness and  those recently discharged from hospital1.

Public health expenditure on disease-related malnutrition costs in excess of £13 billion per year 3. Malnourished individuals cost the NHS more than twice as much to treat as non-malnourished individuals4. NICE recommend that malnutrition can be identified  using the ‘Malnutrition Universal Screening Tool (‘MUST’), and this new guide also clearly explains its use. Where malnutrition risk is identified, action should be taken to address using oral nutrition support5,6. Nurses working in the community are ideally placed to identify malnutrition in some of the vulnerable patient groups they see e.g. wound healing, chronic conditions and frail elderly.

The guide ‘Managing Adult Malnutrition in the Community’ has been developed by a multi-professional team and is supported by key organisations including the Royal College of Nursing (RCN), Royal College of General Practitioners (RCGP) and the National Nurses Nutrition Group (NNNG) 5.  The document is based on clinical experience and evidence alongside accepted best practice.  It also includes a pathway to assist in the appropriate use of oral nutritional supplements (sip feeds).

Iain McGregor, Former Chair of the RCN Older People’s Forum and nurse member of the consensus panel which developed the document, said:  ‘‘Malnutrition is often overlooked in the community and with an ageing population many of the risks associated with the disease are on the increase.  Nurses will often see patients discharged from hospital on ONS with little information to assist decision making regarding on-going use. This guide aims to assist all community healthcare professionals on the appropriate use of ONS for individuals to enable appropriate monitoring, escalation or cessation of the intervention.”

“This is a well thought out and informative piece of work; it is a timely and much needed document‘ says Liz Evans, Nutrition Nurse Specialist and Chair of the NNNG  ‘I am sure it will prove invaluable to our colleagues in the community who play a key role in the identification and management of malnutrition. The NNNG are delighted to support it”.

‘Managing Adult Malnutrition in the Community’ includes:

  • An overview of malnutrition including its clinical consequences, cost implications, details on the prevalence across healthcare settings and information on key patient groups at risk
  • Information on the identification and management of malnutrition according to risk category
  • Guidance on optimising oral intake including dietary advice and the appropriate use of oral nutritional supplements
  • A practical pathway on the appropriate use of oral nutritional supplements in the management of malnutrition

‘Managing Adult Malnutrition in the Community’ is available as an interactive website or download for free via

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For further information please contact:

Hilary Franklin

Hilary Franklin Healthcare Communications

Email: [email protected]

Tel: 020 8398 8551

Mobile:  07958 607898


  1. Stratton RJ et al. Disease-related malnutrition: an evidence-based approach to treatment. Oxford: CABI publishing; 2003.
  2. Elia M and Russell CA. Combating Malnutrition: Recommendations for Action. Report from the advisory group on malnutrition, led by BAPEN. 2009.
  3.  Elia M and Stratton RJ. Calculating the cost of disease-related malnutrition in the UK in 2007 (public expenditure only) in: Combating Malnutrition: Recommendations for Action. Report from the advisory group on malnutrition, led by BAPEN. 2009.
  4. Guest JF et al. Health economic impact of managing patients following a community-based diagnosis of malnutrition in the UK. Clin Nutr 2011; 30(4):422-429
  5. The document has been supported by ten key professional associations:
  • The British Association For Parenteral And Enteral Nutrition (BAPEN)
  • The British Dietetic Association (BDA)
  • The British Pharmaceutical Nutrition Group (BPNG)
  • The National Nurses Nutrition Group (NNNG)
  • The Pharmaceutical Service Negotiating Committee (PSNC)
  • The Primary Care Pharmacists Association (PCPA)
  • The Primary Care Society For Gastroenterology (PCSG)
  • The Royal College Of General Practitioners (RCGP)
  • The Royal College Of Nursing (RCN)
  • The Royal Pharmaceutical Society (RPS)

Notes to editors

Topics covered by the guidance: disease-related malnutrition; how to identify malnutrition and nutritional screening; management, including initial dietary approaches, according to the degree of malnutrition risk; and evidence-based management pathway for using oral nutritional supplements appropriately.