BRASPEN's Fight Against Disease Related Malnutrition (DRM)

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 hospitalised 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 healthcare 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% to 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 the 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 and the management and treatment of malnutrition. Recently, BRASPEN has adopted a new initiative, ‘Care that nourishes, rights that save’, a more inclusive and purposeful campaign for patients who are at risk of malnutrition or being malnourished; it is 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 and food environments. Furthermore, the right of the patients to food and nutrition has been supported by the Vienna Declaration and papers on the topic.