March 21, 2018

Malnutrition is usually associated with simply not having enough to eat, but it’s not that simple. It can refer to any nutritional problem, from a diet that’s excessive to one that is inadequate or simply poorly balanced.

Older adults are especially vulnerable to malnutrition; in fact, it’s a leading cause of morbidity and mortality, especially in this population.

Malnutrition can be caused by a combination of physical, social and psychological issues.

How can you tell if you or a loved one may be malnourished? Signs and symptoms of undernutrition include:

  • Lack of appetite or interest in food or drink
  • Tiredness and irritability
  • Inability to concentrate
  • Always feeling cold
  • Loss of fat, muscle mass and body tissue
  • Taking longer to heal
  • Longer healing time for wounds
  • Depressed
  • Reduced sex drive and problems with fertility

The good news? Adults with severe undernourishment that started during adulthood usually make a full recovery with treatment.

Debbie King, director of Waco’s Meals on Wheels’ Nutrition Services, said that people who think a loved one is malnourished should discuss the subject in a friendly and loving manner, but at the same time be frank and open about their concerns.

“Talk to them in a supportive way, and ask them what they would like to eat,” she said. “And always follow up on that by making sure they have food or supplements.”

If the person is not housebound, getting them to a congregate meal site where they can eat with others can make dining more enjoyable. For those who have limited or no mobility, offer to take them grocery shopping or arrange for a service like Meals on Wheels to deliver food to their homes.

Another route to better nutrition is oral supplements, which she said are a concentrated form of nutrients and are an easy way for seniors to get the good nutrition they need. They are easy to swallow and can be used in a number of ways to boost a senior’s caloric intake.

“They can be used as coffee creamers, or mixed with orange juice to make an Orange Julius, or used in smoothies,” she said. Powdered supplements can also be added to other foods such as soup to boost their nutritional value.

King said getting a physician or nutritionist to evaluate them may be a good idea.

“The big thing is figuring out how to get them to eat.”

“Texas has resources to help seniors address malnutrition,” said Chelsea Couch, Texas Health and Human Services Aging Service Coordination unit. SNAP-Ed, the educational component of Supplemental Nutrition Assistance Program, helps people lead healthier lives, teaches people about good nutrition and how to make their food dollars stretch further.”

Area agencies on aging also provide nutrition services, as do meal-delivery services such as Meals on Wheels. “When older adults go to a community center and have a meal that can provide them with social support and companionship. Sometimes simply eating with others can promote better eating, and it also provides social connection. Seniors can call 855-252-9240, and their call will be routed to the nearest AAA,” Couch said.

“They can also call Aging and Disability Resource Center at 855-937-2372. Counselors there can help them determine what resources they need and what services they may qualify for” Couch said.

The Texas Department of Agriculture’s Square Meals program (, a supplemental food program, can help seniors get fresh, nutritious food while also making the food dollar go further. In addition, Texas A&M’s AgriLife Extension Service offers ideas for healthy low-cost meals at

What Can I Do?

To improve your loved one’s nutrition, try some of the following:

  • Encourage healthier food choices. The best foods are those that are full of nutrients, such as fruits, vegetables, whole grains, and lean meats. Help your loved one limit his or her intake of solid fats, sugars, alcoholic beverages, and salt. Suggest ways to replace less healthy foods with healthier choices.
  • on healthy foods is a good way to get extra nutrients and calories between meals. It may be especially helpful for older adults who quickly get full at mealtimes.
  • Make food taste good again. If your loved one is on a restricted diet, herbs and spices can help restore flavor to bland foods. Just remember to avoid herb or spice blends that are heavy in salt.
  • Consider adding supplements to your loved one’s diet. He or she may benefit from a supplement shake or other nutritional supplements. Talk to their doctor about these options.
  • Encourage exercise. Even a little bit of exercise can help improve your loved one’s appetite and keep his or her bones and muscles strong.
  • Plan social activities. Make mealtimes and exercise a social activity. Take your loved one on a walk around the block. Encourage him or her to meet a neighbor or friend for lunch. Many restaurants offer discounts for seniors.


  • National Council on Aging
  • Meals on Wheels America
  • The National Resource Center on Nutrition and Aging