{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T08:48:04Z","timestamp":1762505284798},"reference-count":55,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2007,10,25]],"date-time":"2007-10-25T00:00:00Z","timestamp":1193270400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Proc. Nutr. Soc."],"published-print":{"date-parts":[[2007,11]]},"abstract":"<jats:p>Malnutrition (undernutrition) is one of the many health inequalities facing governments in the 21st century. Malnutrition is a common condition affecting millions of individuals in the UK, particularly older adults, the sick and those cared for within the healthcare system. It costs the National Health Service &gt;\u00a37\u00b73\u00d710<jats:sup>9<\/jats:sup> annually. New data highlight marked geographical differences in the prevalence of malnutrition across England and an inter-relationship between deprivation, malnutrition and poor outcome. As malnutrition is a largely treatable condition, prompt identification and effective prevention and treatment of this costly condition is imperative. Routine screening for malnutrition in high-risk groups (e.g. the elderly and those in areas with high deprivation) and within the healthcare system should be a priority, with screening linked to appropriate plans for the management of malnutrition. Use should be made of specialised interventions, including oral nutritional supplements and artificial nutrition, to aid recovery and improve outcome, with skilled health professionals, including dietitians, involved where possible. Equity of access to nutritional services and treatments for malnutrition needs to occur across the UK and, although complex and multi-factorial, the effects of deprivation and other relevant socio-economic and geographical factors should be addressed. Ultimately, as malnutrition is a public health problem, its identification and treatment must become a priority for governments, healthcare planners and professionals.<\/jats:p>","DOI":"10.1017\/s0029665107005848","type":"journal-article","created":{"date-parts":[[2007,10,25]],"date-time":"2007-10-25T12:03:56Z","timestamp":1193313836000},"page":"522-529","source":"Crossref","is-referenced-by-count":21,"title":["Malnutrition: another health inequality?"],"prefix":"10.1017","volume":"66","author":[{"given":"Rebecca J.","family":"Stratton","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2007,10,25]]},"reference":[{"key":"S0029665107005848_ref013","unstructured":"13. Department of Health (1991) Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. Report on Health and Social Subjects no. 41. London: H. M. Stationery Office."},{"key":"S0029665107005848_ref044","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.323.7316.773"},{"key":"S0029665107005848_ref001","volume-title":"Guidelines for Detection and Management of Malnutrition","author":"Elia","year":"2000"},{"key":"S0029665107005848_ref050","volume-title":"Postoperative Management in Adults. A Practical Guide to Postoperative Care for Clinical Staff. SIGN Publication"},{"key":"S0029665107005848_ref031","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0b013e32801055c0"},{"key":"S0029665107005848_ref041","volume-title":"Nutritional Supplementation for Stable Chronic Obstructive Pulmonary Disease. 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Eurostat (2007) Population projections. http:\/\/epp.eurostat.ec.europa.eu\/portal\/page?_pageid=1996,39140985&_dad=portal&_schema=PORTAL&screen=detailref&language=en&product=Yearlies_new_population&root=Yearlies_new_population\/C\/C1\/.C11\/caa11024"},{"key":"S0029665107005848_ref022","volume-title":"Indices of Deprivation 2000","year":"2000"},{"key":"S0029665107005848_ref023","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-200410000-00002"},{"key":"S0029665107005848_ref016","volume-title":"Tackling Health Inequalities. A Programme for Action","year":"2001"},{"key":"S0029665107005848_ref043","volume-title":"Protein and Energy Supplementation in Elderly People at Risk Form Malnutrition","author":"Milne","year":"2002"},{"key":"S0029665107005848_ref007","doi-asserted-by":"publisher","DOI":"10.1079\/BJN20041258"},{"key":"S0029665107005848_ref049","volume-title":"The Management of Pressure Ulcers in Primary and Secondary Care. A Clinical Practice Guideline","year":"2005"},{"key":"S0029665107005848_ref009","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2005.03.005"},{"key":"S0029665107005848_ref019","doi-asserted-by":"publisher","DOI":"10.1136\/adc.88.8.671"},{"key":"S0029665107005848_ref020","volume-title":"Independent Enquiry into Inequalities in Health","author":"Acheson","year":"1998"},{"key":"S0029665107005848_ref034","volume-title":"Dietary Advice for Illness-related Malnutrition in Adults. The Cochrane Database of Systematic Reviews 2007","author":"Baldwin","year":"2007"},{"key":"S0029665107005848_ref045","volume-title":"Chronic Obstructive Pulmonary Disease. Management of Chronic Obstructive Pulmonary Disease in Adults in Primary and Secondary Care. 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Finch S , Doyle W , Lowe C , Bates CJ , Prentice A , Smithers G & Clarke PC (1998) National Diet and Nutrition Survey: People Aged 65 Years and Over. vol. 1: Report of the Diet and Nutrition Survey. London: The Stationery Office."},{"key":"S0029665107005848_ref018","volume-title":"Inequalities in Health: Report of a Research Working Group (Black Report","year":"1980"},{"key":"S0029665107005848_ref025","volume-title":"Nutrition and Patients. A Doctor's Responsibility. Report of a Working Party of the Royal College of Physicians","year":"2002"},{"key":"S0029665107005848_ref005","volume-title":"Obesity","volume":"1","year":"2004"},{"key":"S0029665107005848_ref046","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2006.01.017"},{"key":"S0029665107005848_ref030","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2005.03.005"},{"key":"S0029665107005848_ref053","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2005.04.036"},{"key":"S0029665107005848_ref006","doi-asserted-by":"publisher","DOI":"10.1017\/BJN20061852"},{"key":"S0029665107005848_ref002","doi-asserted-by":"publisher","DOI":"10.1079\/9780851996486.0000"},{"key":"S0029665107005848_ref047","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2006.01.012"},{"key":"S0029665107005848_ref012","unstructured":"12. Eurostat (2004) Chapter 2. Eurostat yearbook 2004: the statistical guide to Europe \u2013 people in Europe. http:\/\/epp.eurostat.ec.europa.eu\/cache\/ITY_OFFPUB\/KS-CD-04\u2013001\u20132\/.EN\/KS-CD-04\u2013001\u20132-EN.PDF"},{"key":"S0029665107005848_ref048","volume-title":"Prevention and Management of Hip Fractures in Older People. SIGN Publication","year":"2002"},{"key":"S0029665107005848_ref039","article-title":"Fewer complications with liquid supplements than food snacks in fracture patients at risk of malnutrition","author":"Stratton","year":"2007","journal-title":"Clin Nutr"},{"key":"S0029665107005848_ref038","first-page":"4A","article-title":"Food snacks or liquid oral nutritional supplements as a first line treatment for malnutrition in post-operative patients?","volume":"65","author":"Stratton","year":"2006","journal-title":"Proc Nutr Soc"},{"key":"S0029665107005848_ref037","unstructured":"37. 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