Unintentional and rapid weight loss can result in nutritional deficiencies developing within weeks and occasionally days. Some deficiencies may influence the person’s appetite, energy level and resistance to infection and as a result may further delay the person’s recovery.
Those with this problem should already have received medical assessment and ideally input from an experienced dietitian or nutritional therapist.
Assessment of Those with Rapid Unintentional Weight Loss
Assessment should include determining the possible cause(s) and:
|Early Features of Deficiency
|Vitamin B1 – Thiamine
|Fatigue, nausea, loss of appetite, muscle pain on exercise, confusion, unsteadiness and difficulties with eye movements
|Fatigue, weakness and palpitations
|Fatigue, weakness and muscle cramps
|Fatigue, weakness, shortness of breath, cold intolerance and palpitations
|Fatigue, poor or distorted appetite, sore tongue, cracking at the corners of the mouth, mouth ulcers
|Poor appetite, poor vision in the dark, delayed wound healing and poor immune function
|Fatigue, easy bruising, poor wound healing, poor resistance to infection and anaemia
The most pressing need is for energy, then protein, especially if there is a significant loss of muscle, and then many essential nutrients particularly vitamin B.
Foods need to be chosen because they are nutritious, widely available, easy to prepare and some may need to be suitable for those with swallowing difficulties.
|Main Nutrients Provided
|Fruit juices – diluted if necessary
|Energy, potassium and vitamin C
|Stewed Bramley cooking apples and sugar
|Energy, vitamin C, potassium
|Home made vegetable soup
|Energy, potassium, magnesium and vitamin B
|As above and sodium salt
|Energy, protein, iron, vitamins B1 and B3
|Energy, potassium and magnesium
|Tea with milk and sugar
|Energy and a few nutrients
|Energy, protein, vitamin B and iron
|Spinach with egg and cheese
|Energy, protein, vitamins B12, folate, B2, B3, iron, magnesium and calcium
|Energy, vitamin A and B2, calcium and protein
|Energy, calcium, vitamin B and zinc
|Energy, protein, vitamin B12
|Energy, protein, vitamin B12, zinc calcium and n-3 EFAs
|Mashed or jacket potatoes
|Energy, potassium, magnesium, vitamin C and B
|Energy, potassium, magnesium and iron
|Shepherd’s pie or other minced meat dishes
|Energy, protein, iron, zinc, vitamins B and C
|Fish pie (fish, milk, egg, cheese and potato)
|Energy, protein, calcium, vitamins A, B and C
If necessary the person may require a fortified drink such as Build-up or Complan which are available from a local chemist.
Often the most pressing need is for vitamins B and C. Just such a recommendation was made for the ill and convalescing elderly in 1974 by an editorial in the British Medical Journal Old People’s Nutrition (BMJ 1974 February 9; 1(5901): 212-213) which stated:
“Many would agree that iron, vitamin C, vitamin D and the B-complex vitamins should be given for three to four weeks to elderly patients recovering from a severe illness of any type and the administration of vitamin C before an elective surgical procedure might also be considered”.
For those with significant weight loss >10% of body weight it is better to give small amounts of a nutritional supplement three to four times per day during the convalescent period than giving a large supplement once per day.
It is prudent to check with the patient’s medical advisor that any nutritional supplements are suitable and are not contraindicated.