Frequently Asked Questions

Malnutrition in adults on admission to hospitals and care homes affects almost 1 in 3 patients, with much of the malnutrition originating in the community (BAPEN 2008). 

Previous reports also showed that nutritional status of patients may also deteriorate during a hospital stay.

In a recent BAPEN (British Association for Parenteral and Enteral Nutrition) study (2008), most hospitals reported that they had a nutritional screening policy (89%) however weighing of patients was carried out in less than 50%.  Malnutrition screening tools can be useful in the diagnosis and treatment of malnutrition.

BAPEN have developed the Malnutrition Universal Screening Tool, 'MUST', which is a validated screening tool for use in hospitals, care homes and the community.  'MUST' is a valid, reliable and easy to use tool which can be used for all adults.

More information on the MUST tool can be accessed here: The 'MUST' Tool.

The clinical consequences of malnutrition include: 

• delayed healing of wounds
• increased risk of pressure sores 
• loss of muscle strength 
• increased complications after surgery (e.g. sepsis, wound infection, pneumonia) 
• impaired immune response
• increased mortality

A patient's nutritional status may also become gradually worse during prolonged illness. This is the downward spiral of malnutrition.

Clinical trials have shown that nutritional support can help correct malnutrition, and can have positive effects on clinical outcome and the patient's physical condition. 

Examples of this are a reduction in the rate of post-operative complications and deaths, improved immuno-competence, reduced risk of pressure sores and better healing of existing pressure sores, and improvements in muscle strength. The use of nutritional support has also been shown to reduce length of hospital stay. 

Studies have also demonstrated that oral supplements can increase the intake of protein and energy and maintain or improve parameters of nutritional status in a variety of patients in hospitals and in the community.

Very little published work is available but it is reasonable to assume that improvements in clinical status and reduced complications must lead to cost savings for the Health Service. 

In a study over 11,000 adult patients with chronic respiratory, gastrointestinal and neurological disease it was found that there were higher rates of mortality, hospital admissions, GP consultations and prescriptions in patients underweight patients compared with those with ideal weight (BMI 20-25 kg per metre squared). Further analysis indicated that the rate of GP consultations and prescriptions fell with improved nutritional status, and rose with worsening nutritional status. 

This suggests that even fairly minor degrees of malnutrition are indicators of increased demand on health service resources in patients with chronic disease.

This is because products are designed to meet the nutritional needs of specific groups of patients with specific medical conditions. For example, the same feed would not be suitable for patients with severe burns (who may have very high nutrient requirements) and an elderly stroke patient (who may require a moderate energy intake, but still with adequate levels of vitamins and minerals). 

Specific products are also designed for patients with inborn errors of metabolism, renal disease, respiratory disease, patients who are critically ill, patients with malabsorption, patients who require high fibre diets, patients who require low residue diets etc.

No. Many medical foods are also used in the home under medical supervsion. 

The number of patients being fed medical foods at home as the sole source of nutrition has increased dramatically over the past few years. Most companies who provide medical foods offer some type of delivery service to patients requiring home tube-feeding.

Very often, new medical foods are developed because healthcare professionals identify a need for a product to the manufacturer. 

Manufacturers will also develop new products or reformulate an existing product, to take account of new scientific developments and recommendations for particular patient groups. The manufacturer will work with healthcare professionals to establish the nutrient profile of the product. The new product will then usually be tested in clinical trials.

Medical foods are used as a nutritional therapy to support other medical treatment they are receiving. 

The benefits of nutritional support to treat or prevent malnutrition include offering a patient a better quality of life and can also reduce the burden on healthcare resources (e.g. by reducing length of hospital stay, by reducing complications associated with their condition and associated treatments). So although there are cost implications for feeding medical foods, the cost benefit to both the patient and the NHS means that they are cost effective when correctly used.