Can you be malnourished and not know it? 5 common causes of malnutrition

Many people tend to think of malnutrition as something that happens outside the U.S. But in Tennessee, 12% of households are food insecure — with more than 800,000 Tennesseans having limited or uncertain access to food.

Those situations lead to malnutrition more often than people think, says Erica Fleming, registered dietitian-nutritionist at BlueCross BlueShield of Tennessee.

“The reality is that anyone can be malnourished if they consume a diet that doesn’t contain enough nutrients or doesn’t contain the right nutrients,” says Fleming.

What are the signs of malnutrition?

Fleming: Malnutrition can be difficult to diagnose. To know for sure, you need a physician to draw labs and look at nutrient levels.

Common signs of malnutrition include:

Lack of energy
Extended illness or injury that won’t heal
Fleming: This happens because the body no longer has the extra resources to put toward healing.

Poor appetite
Fleming: It seems counterintuitive that malnutrition would decrease a person’s appetite, but there does come a point where your body doesn’t have enough energy to even want to consume the calories you need.
Inability to focus
Fleming: You’ve probably heard of this in terms of kids being unable to pay attention in school because they didn’t have breakfast or dinner the night before.

What are the main causes of malnutrition?

Fleming: Malnutrition is typically caused by a lack of something — information, access, money. But it can also be the result of unhealthy habits or other health conditions.

5 causes of malnutrition

1. Access

Fleming: In rural areas, the nearest grocery store may be many miles away. In urban areas, there may not be any grocery stores, instead, just convenience stores that don’t carry fresh fruits or vegetables. If you have limited access to transportation, it’s easy to see how fast-food or convenience stores quickly become your only options.

2. Income

Fleming: Many people can’t afford fresh food, or they can’t risk buying fresh food they may not have time to prepare before it goes bad. People may also choose foods that are high in added sugar, trans fats, refined grains or preservatives because they’re less expensive and shelf-stable. Pre-prepared or canned foods may also be higher in sodium than their fresh counterparts.

But often there are low-sodium alternatives or ways to use these products to get the nutritional benefits. With canned vegetables, for example, you can replace the liquid they’re packed in with plain water and soak them to remove some of the sodium. But, to make your food options work for your income, you need that knowledge.

3. Knowledge

Fleming: Education plays a huge part. If no one teaches you which foods contain the nutrients, vitamins, and minerals you need, you don’t know what to eat to avoid malnutrition.

4. Habits

Fleming: Our environments inform our behavior. If it’s normal to have candy, soda or other foods that are high in unhealthy fats, sugars, or sodium around your house, or at school or work, you’re going to get in the habit of eating those foods.

5. Health conditions

Fleming: There are certain health conditions that put people at higher risk of malnutrition because they make it harder for the body to absorb nutrients. These include:

Digestive disorders such as IBS, Crohn’s disease, celiac disease or colitis
Eating disorders
Diseases such as cancer where the treatment process itself can affect food intake or absorption

What’s the best way to address malnutrition?

Fleming: One of the biggest things we can do is recognize that we can be significantly overweight and malnourished. In the U.S., 50-75% of adults are overweight or obese, and often those are the people who aren’t getting the right vitamins and minerals, which can cause even more health problems.

Start with baby steps. Take a look at your grocery list, your dinner plans or what you’re taking for lunch tomorrow and see if you can identify one small, reasonable change you can make to move toward a healthier diet. You don’t have to make big, sweeping changes, since, in fact, those usually don’t work. Set one reasonable goal and work toward that.

Not sure where to start?

Check out these WellTuned resources for easy, specific tips:

Ashley Brantley

Ashley Brantley has been writing about food, culture and health for more than a decade, and has lived in three of Tennessee’s four major cities (Memphis, Nashville and Knoxville).