'Half admitted internal med. patients malnourished'

Half the patients in the internal medicine departments at Holon’s Wolfson Medical Center – most of them elderly – were found to have been admitted while suffering from malnutrition or close to it, according to a study conducted at the government- owned hospital and published in the Israel Medical Association Journal.

There is no evidence that the condition of elderly patients admitted to other hospitals around the country is much different.

The patients at highest risk are those aged 79 or above, who are 10 times likelier than well-fed patients from the overall population to die during hospitalization, according to Wolfson director-general Dr. Yitzhak Berlovich.

Berlovich promised that as a result of the study a nutritional assessment would be carried out on all relevant high-risk patients and they would be given suitable treatment.

Malnutrition, however, cannot be solved over the long term in hospitals, as inadequate and improper diets lacking necessary nutrition occur at home among people who cannot afford to buy nutritious food or prepare it, and in institutions that do not serve it. People might also lose weight or receive poor nutrition during a period of illness that preceded their hospitalization, or not eat while in the hospital because they are not used to the food they receive.

The Health Ministry – which owns Wolfson – had no comment on the study, which was named “MENU: A Hospital-Based Prevalence Survey MEasuring NUtrition Risk in Hospitalized Patients.”

“Identifying patients with malnutrition is the first vital step in dealing with this serious phenomenon,” said Dr. Mona Boaz, head of Wolfson’s epidemiology and research unit, which took part in the study.

“The time needed to treat malnutrition is long, and it can’t be solved during the relatively short time they are hospitalized,” Boaz said. “But research has shown that food additives, even if given in a hospital setting, can improve patients’ conditions and reduce the time they need to be hospitalized, as well as complications from surgery.”

Wolfson has gone a step farther by setting up a team of ‘volunteer feeders” who have been specially trained to get patients to eat their supplements in the various hospital departments.

Dr. Eyal Leibovitz, a senior Wolfson internal medicine specialist and specialist in treating obesity, said long hospital stays can cause patients to lose weight because they are not used to the food or do not feel well.

Dr. Dov Gavish, head of one of Wolfson’s internal medicine departments, said that previous studies of inadequate nutrition among patients had been conducted, but new research used advanced diagnostics, including measurements and questionnaires that helped find those suffering from functional malnutrition.

The European Society for Enteral and Parenteral Nutrition has recommended several nutrition screening tools to assess malnutrition risks in populations. They include the Malnutrition Universal Screening Tool for use among adults in the community, and the Mini-Nutritional Assessment for use with elderly who are residing at home or hospitalized.

Meanwhile, it was announced by the Welfare and Social Services Ministry that Minister Moshe Kahlon had appointed a “Council for Nutritional Security” to be headed by Ben-Gurion University health economist Prof. Dov Chernichovsky.

Kahlon said the council would be a formal national and interministerial body, making it capable of studying and addressing issues related to nutritional security in the population. It will bring its recommendations to the minister and the cabinet.

The council includes experts from various fields, including welfare and education.

It was established by government-supported legislation and set up after Kahlon announced when entering office that he favored a professional body that would find solutions to nutrition and look into other options beyond voluntary organizations and soup kitchens.