Malnutrition is far from the leading cause of death in the United States, but the death rate has increased significantly enough in recent years to affect life expectancy.
More than 21,000 people will die of malnutrition in 2022, more than doubling in the past five years, according to data from the US Centers for Disease Control and Prevention. And a 20 percent spike in mortality between 2021 and 2022 put nutritional deficiency among the top five factors negatively impacting 2022 life expectancy estimates.
Poor nutrition is the deadliest for the oldest Americans; More than half of deaths from malnutrition in 2022 were among people 85 and older, CDC data show. But the death rate has increased in almost all age groups.
Typically, changes in life expectancy estimates are most affected by causes of death that affect younger people. Birth defects were also a key factor in 2022, or those that affect a large number of people. The reduction in Covid-19 mortality was a key factor that increased life expectancy by more than a year in 2022.
Although the effect of nutritional deficiency on life expectancy estimates was relatively small, experts say the finding should not be underestimated and that the negative impact of malnutrition is likely to be underestimated.
Good nutrition contains a healthy balance of macronutrients, such as carbohydrates and proteins, which are needed in large amounts for the body’s systems to function, and important micronutrients, or vitamins and minerals.
A lack of protein can cause many of your body’s systems to potentially shut down. On the other hand, many of the systems that our micronutrients feed are things that lead to resilience. So when we are low in different micronutrients, all these systems start to be compromised. That can eventually lead to death or dysfunction, said Emily Ho, director of the Linus Pauling Institute, a research center at Oregon State University focused on the role of vitamins and essential minerals in health.
When we look at the leading causes of death, especially in the United States, infections, cancer, cardiovascular disease, nutrient deficiencies can all accelerate these disease processes as well. So I strongly believe that malnutrition is probably an even bigger factor than we think, he said.
For example, it is more difficult for a malnourished person to fight against the Covid-19 infection. When the body’s systems don’t have the fuel they need to function properly, the risk of submission increases. Nutritional deficiencies are most common among older adults, which may have contributed to higher mortality from Covid-19.
As we age, our immunity begins to decline, not only because of age, but also because of a lack of nutrients that can actually promote the process, Ho said.
Experts say older adults are more susceptible to nutritional deficiencies for a number of reasons.
Many older adults have chronic illnesses that affect their appetites, such as heart failure, cancer, Alzheimer’s disease. Gastrointestinal diseases, which are common in older adults, can also affect how their bodies absorb nutrients, said 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 they may not be able to get to the grocery store to buy nutritious foods.
These concerns about the health of aging adults in the United States are 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 with a million aging adults walking through the doors 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 shared meals are only 50% back in terms of attendance because people are still cautious, especially in this respiratory season, about going out and being in those group settings. So I think they still unpacked some of it.
According to the National Council on Aging, more than half of older adults who qualify for SNAP, the federal nutrition assistance program, are not enrolled.
The US Department of Health and Human Services and the US Department of Agriculture work together to update and publish the Dietary Guidelines every five years. Recent discussions include discussions of special needs and the healthiest balances for the elderly.
A person suffering from malnutrition is not always stereotypically frail and thin.
In the US, we often have overnutrition and undernutrition in the same person, which is somewhat unique to us. Overfeeding on empty calories can lead to obesity, but the quality of their diet is low, so they are malnourished when looking at micronutrient content, Ho said. So the body’s systems are compromised even though you are not losing weight.
A simple nutritional screening assessment that primary care physicians can use during annual wellness visits can help, an expert says.
Taking a daily multivitamin is also good insurance, Ho said. Even people who try to eat healthy sometimes still have some of these deficiencies.
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