Tackling hospital malnutrition head-on

When patients are admitted to the hospital, their nutritional needs are often secondary to diagnosing and treating their core medical condition. While some patients struggle with adequate food intake and weight loss prior to admission, 10-65% of patients experience a nutritional decline during their hospital stay.¹ Additionally, malnutrition prevalence in certain patient populations, such as those with heart failure, may be as high as 90%.² If left untreated, malnourished patients have an increased risk of pressure injuries, immune suppression, and muscle wasting. Malnutrition also contributes to impaired wound healing, higher infection rates, and increased mortality.³ These conditions can result in longer hospital stays and elevated costs of care.

Poor appetite, fatigue, nausea, vomiting, and medication effects are among the clinical factors related to inadequate nutrition. Mealtime interruptions, food dissatisfaction, procedure-related fasting, chewing and swallowing challenges, struggles with self-feeding, and emotional distress can all compound the issue.¹ 

Registered Dietitian Nutritionists (RDNs) are healthcare professionals specifically trained to identify issues related to malnutrition vulnerability. They develop a comprehensive nutrition care plan that includes physical, biochemical, and lifestyle factors. Research has shown a 24% lower risk of 30-day readmission when malnourished patients have a documented nutrition care plan.⁶ By combining their knowledge of clinical nutrition with an understanding of how to maximize a patient’s nutrient and energy intake for adequate healing, RDNs holistically pinpoint and address food intake problems from physical, emotional, social, and cultural perspectives. The involvement of RDNs is essential to achieving a successful MCS.

Here are examples of how RDNs help reduce risk of patient malnutrition:

• Identifying patients’ food preferences and tolerances early in admission.
• Liberalizing diet orders to eliminate unnecessary food restrictions.
• Planning meal delivery around test and procedure schedules.
• Incorporating cultural and religious food preferences in meal choices.
• Highlighting nutrient-rich foods and snacks when the patient is hungriest.
• Providing fortified foods and nutritional supplements to ensure the patient has adequate protein and calories.
• Identifying appropriate food and beverage consistencies.
• Arranging feeding assistance for weak or immobile patients.
• Coordinating specialized oral, tube, and intravenous feedings to meet the needs of patients requiring enhanced nutrition support.
• Specifying community resources for food assistance after discharge.

With Sodexo's Healthcare services Comprehensive Malnutrition Platform (CMP), RDNs are trained to identify, document, and treat patients early on in their hospital stay. This improves hospital performance and overall patient outcomes and plays a key role in decreasing readmissions.

Malnutrition Awareness Week is a time to acknowledge the burden of malnutrition on patients, caretakers, families, healthcare facilities, and society. It is also an occasion to recognize the important contributions of the RDN in addressing this serious health issue.

1. Cass AR, Charlton KE. Prevalence of hospital-acquired malnutrition and modifiable determinants of nutritional deterioration during inpatient admissions: A systematic review of the evidence. J Hum Nutr Diet. 2022;35(6):1043-1058. doi:10.1111/jhn.13009
2. Vest AR, DiDomenico RJ, Lichtenstein L, et al. Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association. Circulation. 2026;153(13):e1078-e1105. doi:10.1161/CIR.0000000000001405
3. Ojeda T, Ashafa M, Pertel D, McCauley S, Coltman A. The Updated Global Malnutrition Composite Score Clinical Quality Measure: Its Relevance to Improving Inpatient Clinical Outcomes and Health Equity. J Acad Nutr Diet. 2024;124(2):249-256. doi:10.1016/j.jand.2023.11.007
4. FY 2027 Hospital Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System Final Rule (CMS-1849-F). Centers for Medicare and Medicaid Services (CMS). Published July 31, 2026. Accessed August 13, 2026. https://www.cms.gov/newsroom/fact-sheets/fy-2027-hospital-inpatient-prospective-payment-system-long-term-care-hospital-prospective-payment
5. Malnutrition Care Score. eCQI Resource Center. Updated May 13, 2026. Accessed August 13, 2026. https://ecqi.healthit.gov/ecqm/hosp-inpt/2026/cms0986v5?qt-tabs_measure=measure-information
6. Valladares AF, Kilgore KM, Partridge J, Sulo S, Kerr KW, McCauley S. How a Malnutrition Quality Improvement Initiative Furthers Malnutrition Measurement and Care: Results From a Hospital Learning Collaborative. JPEN J Parenter Enteral Nutr. 2021;45(2):366-371. doi:10.1002/jpen.1833