Governors should reject unscientific and discriminatory approaches to drug pricing
Malnutrition Awareness Week spotlights the importance of national nutrition programs
What is malnutrition, and why should you care? If you knew that one in two older adults is at risk, and that the cost of this health condition for older adults exceeds $50 billion per year, would it make you more interested in solutions?
This week America observes Malnutrition Awareness Week a time to raise awareness about and identify solutions to this growing national problem. Malnutrition happens when people do not receive the necessary nutrients in their diet, often leading to loss of muscle mass and significant health problems. Older adults are particularly susceptible to this condition.
One step to prevent malnutrition is to strengthen our nation's nutrition programs. I strongly urge Congress to complete action on the farm bill reauthorization, and I advocate for adoption of the bipartisan Senate bill because it actively supports nutrition programs.
If the farm bill is reauthorized, Congress will have reaffirmed support for the Supplemental Nutrition Assistance Program (SNAP), the Commodity Supplemental Food Program (CSFP), the Senior Farmers Market Nutrition Program, and a host of other valuable nutrition programs keeping our nation healthy.
To complement this achievement, we need a new national strategy to address the growing problem of malnutrition in America. This problem is startling; for example, it's estimated that as many as one in three patients is malnourished upon admission to the hospital. And in many cases, this malnutrition goes undiagnosed; according to the American Society for Parenteral and Enteral Nutrition (ASPEN), every minute, 10 hospitalized patients with malnutrition go undiagnosed.
One part of the national strategy should be the adoption of malnutrition electronic clinical quality measures by the Centers for Medicare and Medicaid Services (CMS), proposed by the Academy of Nutrition and Dietetics. The proposed measures would aid in detecting malnutrition by requiring screening for everyone, further assessment of those determined to be at risk, diagnosing malnutrition if found, and creating a nutrition care plan for those who are diagnosed.
The VA is already doing impressive and important work in malnutrition screening and nutrition care for the veterans they serve, and CMS should encourage this sort of care for all. CMS has indicated that they are giving these measures serious consideration and expect to decide soon.
Another part of the national strategy should be to update our national health surveys and the national health indicators and goals for older Americans that help shape public health programs and guide healthcare professionals.
Currently, these surveys and goals do not include malnutrition. The U.S. Department of Health and Human Services (HHS) should routinely include malnutrition screening measures in national health surveys of older adults and include malnutrition among national key health indicators and the Healthy People 2030 goals for older adults.
Also important is the completion of a Government Accountability Office (GAO) study requested by Sens. Patty Murray (D-Wash.) and Bob Casey (D-Pa.) inquiring into the caloric and nutrient needs of older adults, the requirements of federal nutrition programs to serve these needs and how well the programs are doing, and the challenges facing nutrition programs in meeting these needs now and in the future.
Further, HHS and the U.S. Department of Agriculture (USDA) jointly develop new national dietary guidelines every five years, but the guidelines have never addressed the issue of older adult malnutrition. HHS and USDA should include dietary guidance for the prevention and treatment of older adult malnutrition and the closely aligned problem of age-related sarcopenia (loss of strength and muscle) in the 2020 Dietary Guidelines for Americans, particularly as sarcopenia is among the topics to be examined by the 2020 Dietary Guidelines Advisory Committee.
Finally, the strategy should include the development of stronger nutrition education provisions in the expected 2019 reauthorization of the Older Americans Act. The Older Americans Act nutrition program currently includes the provision of both Meals on Wheels and meals served in congregate settings such as senior centers. Nutrition is the largest component of the Act, and Congress needs to bolster the required nutrition education provided by meals programs. These programs must educate more older adults and their families and caregivers about the risk of malnutrition.
As the name suggests, Malnutrition Awareness Week is a time to raise awareness about malnutrition and its prevention. Ultimately, we can't and shouldn't allow anyone's health to be impacted by a lack of access to nutritious foods or the knowledge of what constitutes good nutrition.
Bob Blancato is the executive director of the National Association of Nutrition and Aging Services Programs (NANASP). He is also the National Coordinator of the Defeat Malnutrition Today coalition.