Malnutrition is far from a leading cause of death in the United States, but the mortality rate has grown significantly in recent years to affect life expectancy.
More than 21,000 people will die from malnutrition in 2022, according to data from the US Centers for Disease Control and Prevention, more than doubling in the past five years. And a 20% increase in mortality between 2021 and 2022 puts malnutrition in the top five factors with a negative impact on life expectancy estimates for 2022.
Poor nutrition is deadliest for the oldest Americans; More than half of malnutrition-related deaths in 2022 will be among those ages 85 and older, according to CDC data. But deaths increased in almost every age group.
Generally, the causes of death that contribute most to changes in life expectancy estimates are those that affect the younger congenital malformations are also a major factor in 2022, for example or those that affect a large number of people. Declining mortality from Covid-19 is the main factor driving life expectancy up by more than a year in 2022.
Although the impact of malnutrition on life expectancy estimates is relatively small, experts say the finding should not be discounted and the negative impact of malnutrition is likely underestimated.
Good nutrition involves a healthy balance of macronutrients, such as carbohydrates and proteins, which are needed in large quantities to keep the body’s systems running, as well as essential micronutrients, or vitamins and minerals.
A lack of protein can cause many of your body’s systems to start shutting down. On the other hand, many of the systems that our micronutrients activate are things that lead to resilience. So when we’re depleted of various micronutrients, all of those systems start to get compromised. That can lead to death or malfunction, says Emily Ho, director of the Linus Pauling Institute, a research center at Oregon State University that focuses on the role of vitamins and essential minerals in health.
If we look at the main causes of death, especially in the United States, infection, cancer, cardiovascular disease, nutritional deficiencies can also accelerate those disease processes. So I strongly believe that malnutrition is probably a bigger contributor than we think, he said.
For example, it is more difficult for a malnourished person to fight a Covid-19 infection. When the body’s systems don’t have the fuel they need to function properly, the risk of giving up increases. Nutritional deficiencies are most common in the elderly, which may be linked to higher mortality rates from Covid-19.
As we age, our immunity is something that begins to decline not only because of age, but also because of nutrient deficiencies that can actually contribute to the process, says Ho.
The elderly are more susceptible to nutritional deficiencies for a variety of reasons, experts say.
There are many elderly people with chronic diseases that affect their appetite such as congestive heart failure, cancer, Alzheimer’s disease. Digestive disorders, too, that are common in older adults can also affect how their bodies absorb nutrients, says Kathleen Cameron, senior director of the National Council on Aging’s Center for Healthy Aging.
Many are also socially isolated, he said. They don’t want to cook for themselves and may not have access to transportation to go to the grocery store to buy healthy foods.
These concerns about the health of older adults in the US have been long-standing, and mortality from malnutrition had been rising long before the pandemic but the pandemic likely exacerbated many factors.
There are 10,000 senior centers out there that a million older adults go through every day, said Ramsey Alwin, president and CEO of the National Council on Aging. When we visited some of our senior centers, we heard that their congregate meals are only 50% back in terms of attendance because people are still cautious, especially in this respiratory season, about exiting and being in group settings. So I think some of that is still unwinding.
Also, more than half of seniors eligible for SNAP, the federal government’s nutrition assistance program, are not actually enrolled, according to the National Council on Aging.
The US Department of Health and Human Services and the United States Department of Agriculture work together to update and release the dietary guidelines every five years. Recent conversations include discussions about the specific needs and healthiest balance for seniors.
A person suffering from malnutrition is not always weak and thin.
In the US, we tend to have over-nutrition and under-nutrition in the same person, which is something that is quite unique to us. There may be an overnutrition of empty calories that leads to obesity, but the quality of the diet they have is so low that they are malnourished when you look at the micronutrient content, Ho said. So the body’s systems are compromised, even if you don’t show a wasting syndrome.
A simple nutritional screening test that primary care doctors can use during annual wellness visits can help, the expert said.
Taking a daily multivitamin is also good insurance, says Ho. Even people who try to eat healthy sometimes still have some of the shortcomings.
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