You know that what they eat they are...

Association of Directors of Adult Social Services
Date: Friday 28th June 2013
Embargo: Immediate

Anya Harris talks us through the measures local authorities can take in relating older peoples daily diets,  their independence and wellbeing, and the wider local government spectrum.

Its shocking to think that within the UK up to three million people are malnourished or at risk of malnourishment. 

There has been a frenzied media coverage of this issue occurring in hospitals, with staff not helping patients to eat and drink properly. However, research produced by Bapen The British Association for Parenteral and Enteral Nutrition ( has identified that at least one million affected are aged over 65 with at least 93 per cent of those living in the community; only two per cent in hospitals and five per cent in residential care homes.

The low awareness of malnutrition and dehydration among service users, carers and social and health care professionals is still widespread and the need to reduce the number of people who suffer - or are at risk of suffering under-nutrition is vitally important.

Public sector expenditure related to treating malnutrition is estimated to be billions of pounds a year. Yet policy makers do not take this matter seriously by developing strategies to improve the current situation. Malnutrition occurs in a number of complex interrelated factors which can include social isolation, poor access to shopping facilities, poverty, and physical and learning disabilities.

Another common misconception is that as we age it is natural to lose weight which in turn prevents people from looking at other social and environmental factors of why the weight loss has occurred.

The obesity epidemic also may impact on the types of food older people are eating. The healthy eating message focuses on eating `five a day while consuming less sugar and less fat. But this does not apply to this group of people. There is a need for them to eat small amounts with a high calorific content.

The Malnutrition Task Force - an independent group of experts from health, social care and dietary advice - came together in 2012 to prevent and address malnutrition among the over 65s wherever it occurs. The group has developed a number of guides that includes a range of best practice and also a framework to help those in a wide range of health and social care environments make the changes that are required to counter malnutrition. 

Local authorities are best placed to prevent malnutrition and realise the potential for saving costs when identifying nutrition within the strategic needs assessment. Excellent current examples of this  can be found in

Derbyshire who are driving forward plans to promote awareness of malnutrition in older people. And

Leicestershire where community meals services have been developed which include collaborating with other services such as lunch clubs in  libraries, supermarket cafes, travelling lunch clubs and a school. The majority of lunch clubs are delivered by volunteers and they currently have commissioned 52 throughout the county. They have recently evaluated this scheme using the Social Return on Investment  (SROI) method. The estimated return on every £1 spent was £2.90 in social value. This was evident  through the outcomes for family members, lunch club users and those receiving meals in their own homes.

The campaigns ultimate aim is to reach the widest audience and increase awareness through a number of avenues including posters, booklets, leaflets, information on the website and also sending out simple tape measures for the upper arm measurement to help check own or others nutritional risk. (For an explanation of the upper arm measurement method of calculating BMI, go to

So, Indentifying and treating malnutrition in the community can be seen as being crucial to improving the health and wellbeing of older people in our communities. Local authorities must take this issue seriously in raising awareness to all people that work and support older people in the community and also develop strategies and pathways as seen above to reduce the negative impact of malnutrition.  

We must also ensure that access to nutritional food is incorporated into all local and community planning. Ultimately preventing and treating malnutrition and dehydration should be the main focus of everything we do to ensure older people can live independent and fulfilling lives. The fact that public health is now centred on local government rather than the health service will  make this all the more possible.


Anya Harris is a graduate management trainee with the national Skills Academy. She is based with the LB Lambeth, and recently spent a short spell with the ADASS Business Unit to widen her perspectives