I have been doing some research for a book that explores why nutrition advice is mired in so much confusion these days. Along the way, I came upon a disturbing statistic: According to a study published in March by researchers at Johns Hopkins University, 30% to 55% of hospital patients are malnourished. There seems to be a shocking lack of awareness regarding this problem and the role proactive nutrition support plays in speeding healing and recovery and in preventing complications such as infections - not to mention decreasing costs.
It's almost 2012! How can this be? Didn't we identify and address this problem in the early 1980s? With so many advances in disease-specific nutrition therapies, how can we be facing this problem again?
And this time around, it's not only about doing the right thing for patients; it's about money. When provisions of the Affordable Health Care Act take effect in July 2012, hospitals will be penalized for unnecessary readmissions that occur within 30 days of discharge for certain conditions. Patients who are discharged in a malnourished state or without access to the nutrition therapy necessary to support continued recovery are extremely vulnerable to unnecessary readmission.
I spent the majority of my career as a dietitian/nutritionist with Abbott Nutrition (formerly Ross Laboratories) - for more than two decades, the leading the manufacturer of medical nutrition products. In 1989, Abbott created and funded the Nutrition Screening Initiative, a multifaceted campaign to educate hospital professionals about the need to identify patients at nutritional risk and intervene before complications develop. We promoted the seminal work of scientists like George Blackburn, PhD, MD, and B. R. Bistrian, PhD, MD, that demonstrated the seriousness of iatrogenic malnutrition - that is, protein-calorie malnutrition brought on by treatments, medications and hospitalization.
Abbott was committed to providing solutions to prevent and treat patients at high risk for this condition. As we had done many times in the past, we once again showcased the value of the registered dietitian, this time as an architect of effective prevention and treatment of iatrogenic malnutrition.
That was then. Here's where I think we are today: Nutrition's role in health and wellness garners a lot of attention, with much of the focus centering on obesity. With overweight so prevalent in this country, I fear that we just assume that it's okay for a person to not eat for a few days. Not true - especially among the sick and the elderly. What we need to remember is that malnutrition and obesity are not mutually exclusive.
To advance nutrition science and promote best practices, we must build on what we have learned, not abandon it. Hospitals are under tremendous pressure to develop protocols that help avoid costs. Here's an easy (and familiar) one: Assess nutrition status at admission. Provide necessary nutrition support during hospitalization. Prescribe continuing nutrition therapy at discharge. It's not a new idea. But it is an idea whose time has come.