Soaring malnutrition is a stain on British society | Letters
While malnutrition is rightly discussed in the context of poverty in your article (Surge in number of people in hospital with nutrient deficiencies, NHS figures show, 21 December), it’s important that this isn’t at the expense of conversations around disease-related malnutrition – a significant health issue that has been worsening for decades.
A 2022 survey of 1,543 adults across the UK found that 45% of those screened in health and care settings were at risk of malnutrition, including 55% of residents in care homes. Malnutrition prevalence was highest in individuals with cancer, and gastrointestinal and respiratory conditions. The data was collected using the malnutrition universal screening tool, a comprehensive measure of malnutrition risk that can and should be used in all health and social care settings.
People at risk of disease-related malnutrition require specific, personalised care plans in which oral nutritional supplements can have a powerful role. These are able to provide micronutrients as well as calories and protein in low volumes, which can be very helpful when illness impacts on appetite. With an ageing population and a growing number of patients with multiple morbidities, nutrition supplements are an important tool to help manage malnutrition and so help reduce hospital stay, complications and to save lives.
Hospital data significantly underrecords the frequency of protein energy malnutrition, while data on iron deficiency might reflect issues of iron loss through bleeding as well as insufficient dietary intake. In 2015, a National Institute for Health Research report estimated malnutrition to cost £19.6bn a year, costs that will only have increased.
Dr Nick Thompson
Consultant gastroenterologist, Newcastle upon Tyne
I read your report with anger and indignation. It is not right that in 21st-century Britain rickets is on the rise. It is deeply shaming that children are going to school hungry, and just plain wrong that parents are having to choose who in the family to feed. In Newport, virtually every school runs an inhouse food initiative supported by faith and civic groups. People of goodwill are pulling together, but against a background of apathy and hostility from those who should know better.
As a country we need to decide where our priorities lie. I hope that those in positions of power and influence reflect on his story, and allow it to shape their priorities.
Canon Andrew Lightbown
Newport Cathedral
Re your article (‘Children have bowed legs’: hunger worse than ever, says Norwich school, 21 December), in 1924 more than 10,000 people in Norwich were employed in the shoe trade. Yet some children went to school without shoes. Today in Norfolk, the breadbasket of England, children arrive at school hungry because there is no food at home. In 2023, there are bow-legged children with rickets caused by vitamin D deficiency. What have we achieved in 100 years?
Cllr Peter Prinsley
Bowthorpe Ward, Norwich
The Royal College of General Practitioners is wrong. We do not need more free school meals or improved affordability of healthy food. We need a fairer, more equitable society in which everybody can afford a decent life. Doctors should know that we need to treat the disease, not the symptoms.
Tony Parsons
Buxton, Derbyshire