Archive for December, 2013

Nutrition Screening and Mental Health

Friday, December 27th, 2013

Nutrition Screening and Mental Health

An internet search for material on nutrition screening reveals many defined groups are discussed, surveyed, and screened: the elderly, cancer patients, renal/kidney patients, hospitalized and patients admitted for long term care, those with autism and individuals with developmental disability.  But information on patients admitted for mental health care seems unavailable.

A notable exception was the 2011 survey by the British Association for Parenteral and Enteral Nutrition (BAPEN) in England, Scotland and Ireland included a category of Mental Health Units. Up to1 in 5 (19%) adults on admission to Mental Health Units in the UK were at risk for malnutrition. Most of those affected were in the high risk category.

Malnutrition is most often defined by BMI, Calorie and/or Protein intake and loss of fat or muscle tissue. See:

White JV, Guenter P, Jensen G, Malone A, Schofield M. Consensus statement: Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition: characteristics recommended for the identification and documentation of adult malnutrition (undernutrition). JPEN J Parenter Enteral Nutr. 2012;36:275-283.
Tappenden, Kelly A., Beth Quatrara, Melissa L. Parkhurst, Ainsley M. Malone, Gary Fanjiang and Thomas R. Ziegler. Critical Role of Nutrition in Improving Quality of Care: An Interdisciplinary Call to Action to Address Adult Hospital Malnutrition. JPEN J Parenter Enteral Nutr 2013 37: 482 originally published online 4 June 2013

Scientific research is indicating that vitamins and minerals are involved in mental status, mood, and function of the brain and central nervous system. Individuals with diagnoses of mental concerns are frequently found to have different biochemistries, genetics, and needs when it comes to nutrition.

Malnutrition relevant to mental health and mental illness likely needs to be defined as much by vitamin and mineral status as by calories, weight and protein intake.

The Alliance for Natural Health reported in September 2010 Medicare reduced support for nutritional screening to one lab test per year to screen for all nutrient deficiencies or imbalances.  http://www.anh-usa.org/medicare-cuts-back-on-nutritional-screening/. A Medicare web site lists 18 preventive services covered by Medicare: depression and alcohol use are the two included in Mental/Behavioral health area. http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/PreventiveServices.html

As much as we now know, is it ethical to NOT screen for nutritional status when people are admitted for mental  health care?