BRASPEN's Fight Against Disease Related Malnutrition (DRM)

Disease-Related Malnutrition (DRM) is a complex condition resulting from inadequate

intake or absorption of energy and nutrients which compromises the fulfilment of the

patient’s physiological requirement. A few decades ago, DRM was present in 48.1% of hospitalized Brazilians adults, with greater prevalence in the North and Northeast

regions of the country. The scenario remains unchanged to this day, thus the high

prevalence of malnutrition in the hospitals is still a reality and the most prevalent

syndrome in this setting.

Evidence demonstrating the association between DRM and poor outcomes, including

increased health care cost, hospital readmissions, mortality, functional decline and

complications has been accumulating in Brazil and around the world over the last four

decades. The burden of malnutrition also extends to the community, where it is

estimated to affect 3-8.5% of the population and has a disproportionate effect on older adults and those in care homes. Further, pandemic measures have resulted in

increased frailty and food insecurity.

There are nutrition care solutions that can address these problems. In 2018,

BRASPEN launched a campaign "Say no to malnutrition: 11 important steps to fight

hospital malnutrition” . This campaign was implemented in several hospitals across

Brazil with the aim of tackling strategies to combat malnutrition and reduce malnutrition rates

through a series of actions that include screening, diagnosis, the management and treatment of

malnutrition. Recentely, BRASPEN has adopted a new initiative, "Care that nourishes, rights that

save", a more inclusive and purposeful campaign for at risk of malnutrition or malnourished patients

focused on well-being and better health of the individuals through effective nutritional care.

A significant challenge that we face relates to the lack of powerful and adopted policy

frameworks in Brazil to addresses DRM and to allow integration into regulations and

standards. This inhibits opportunities to support Brazilians dealing with DRM through

policy-level action. Current health policy is driven largely by conditions related to overnutrition, such as diabetes, obesity and coronary artery disease, and there is a

dearth of health policy related to undernutrition and malnutrition in Brazil. In addition,

there is potential for overlap with Brazil’s Food Policy's vision of improved food-related health outcomes. DRM is relevant given its impact on health equity, health systems, food environments.

Furthermore, the right of the patients to food and nutrition has been supported by the Vienna Declaration and papers on the topic.