Which Group Has the Highest Risk for Malnutrition? A Nutrition Diet Guide for Vulnerable Populations

October 23, 2025 •

3 min read

According to the World Health Organization, millions of people worldwide suffer from various forms of malnutrition, including undernutrition and micronutrient deficiencies. Addressing the crucial question, Which group has the highest risk for malnutrition?, requires a closer look at populations with heightened vulnerabilities and the specific factors influencing their nutritional status.

Quick Summary

This article explores different populations at risk of malnutrition, including the elderly, children, and chronically ill individuals. It details the physiological, social, and economic factors contributing to their vulnerability, offering insights into why older adults, particularly those in institutional care, face the most significant threat.

Key Points

The elderly are the highest risk group: Due to age-related physiological changes, chronic diseases, and social isolation, older adults face the most significant risk of malnutrition, especially in institutional settings.
Children are highly vulnerable: Rapid growth rates and susceptibility to infections make infants and young children, particularly those in low-income areas, a priority group for nutritional intervention.
Chronic illness is a major risk factor: Diseases such as cancer, dementia, and gastrointestinal disorders can severely disrupt a person's appetite, metabolism, and ability to absorb nutrients.
Institutionalization exacerbates risk: Patients in hospitals or nursing homes face a higher risk of malnutrition due to factors like limited food choices, mealtime interruptions, and underlying health issues.
Malnutrition is preventable: Early detection through routine screening, improving access to nutritious food, and providing targeted support for at-risk populations are crucial for prevention.
Both overnutrition and undernutrition are forms of malnutrition: Malnutrition includes deficiencies, excesses, or imbalances in nutrient intake. Obesity is also considered a form of malnutrition and carries its own health risks.

The Elderly: The Highest Risk Group for Malnutrition

Older adults consistently face the highest risk of malnutrition, with this risk significantly increasing in hospital or long-term institutional care settings. Malnutrition in older adults is influenced by a combination of physiological, social, and psychological factors.

Physiological Causes of Malnutrition in the Elderly

Aging can lead to several changes that impact nutritional intake:

Reduced Appetite: Declining senses of taste and smell, along with hormonal changes, can decrease appetite.
Dental and Oral Health: Problems with teeth, dentures, or swallowing can make eating difficult and painful.
Changes in Metabolism: While energy needs decrease, the need for essential nutrients often remains the same or increases, requiring a higher density of nutrients in consumed food.
Chronic Diseases: Illnesses like heart failure, COPD, and cancer can negatively affect appetite and metabolism.
Medications: Multiple medications can have side effects that interfere with appetite, nutrient absorption, and digestion.

Social and Psychological Factors

Social and mental well-being also contribute to malnutrition risk:

Social Isolation: Living alone and lacking the social aspect of meals can reduce interest in eating and cooking. Loneliness and loss of a spouse are significant factors.
Depression and Dementia: These conditions can lead to loss of appetite, lack of motivation to eat, or difficulty with meal preparation.
Limited Income: Financial difficulties can make purchasing nutritious food challenging.

Children and Infants: Another Highly Vulnerable Group

Young children, particularly those under five in low-income countries, are at a high risk of undernutrition due to their rapid growth and development needs.

Factors Affecting Child Malnutrition

High Nutritional Needs: The crucial developmental stages in early childhood require significant nutrient intake. Deficiencies can cause stunting, wasting, and delayed cognitive development.
Socioeconomic Factors: Poverty limits access to diverse and nutritious foods.
Inadequate Care and Infections: Poor hygiene, limited healthcare, and frequent infections impair nutrient absorption. Insufficient breastfeeding also plays a role.

Chronically Ill Individuals

Individuals with serious, chronic illnesses are at increased risk of malnutrition due to the disease's impact on eating, metabolism, or nutrient absorption.

Common Chronic Conditions Linked to Malnutrition:

Cancer: Can lead to appetite loss and increased metabolic demands.
Gastrointestinal Disorders: Conditions like Crohn's can impair nutrient absorption.
Kidney or Liver Disease: Can cause poor appetite and altered nutrient processing.
HIV/AIDS: Increases susceptibility to infections and nutrient malabsorption.

Comparison of Vulnerable Groups to Malnutrition


Group	Primary Risk Factors	Key Outcomes of Malnutrition	Treatment Considerations
Elderly Adults	Physiological changes (appetite, taste), chronic disease, polypharmacy, social isolation, institutionalization	Frailty, increased falls, slower recovery, impaired immune function, decreased quality of life	Individualized nutritional support, oral supplements, management of underlying diseases and psychosocial issues
Infants and Children	High nutritional needs for growth, poverty, poor sanitation, infectious diseases, food insecurity	Stunting, wasting, developmental delays, higher mortality, poor cognitive function	Therapeutic feeding, micronutrient supplementation, addressing root causes like poverty and sanitation
Chronically Ill	Disease-related anorexia, malabsorption, increased metabolic demands, medication side effects	Compromised immunity, delayed healing, worsened disease prognosis	Targeted nutritional therapy, dietary modifications, managing underlying disease states
Institutionalized Individuals	Limited food choice, poor feeding assistance, unfamiliar environments, staff shortages	Weight loss, reduced autonomy, higher morbidity and mortality	Routine screening, enhanced mealtime experience, proper staffing, tailored care plans

Preventing Malnutrition

Preventing malnutrition involves improving access to food, educating populations, and implementing targeted healthcare interventions. This includes ensuring vulnerable groups have access to affordable, nutritious food, providing nutritional education, conducting regular nutritional screening for at-risk individuals, offering support through community programs, and addressing both undernutrition and overnutrition as forms of malnutrition.

Conclusion

While malnutrition affects various groups, older adults are at the highest risk due to a combination of age-related physiological changes, chronic illnesses, and potential social and psychological factors. This risk is further elevated for those in institutional care. By understanding the specific vulnerabilities of the elderly, children, and the chronically ill, we can develop more effective strategies for screening, education, and nutritional interventions to improve health outcomes.

For more information on malnutrition in older adults, refer to this review from the National Institutes of Health.

Frequently Asked Questions

Early signs can include unintentional weight loss (over 5% in 3-6 months), reduced appetite, fatigue, poor wound healing, and a feeling of being cold all the time.

Chronic illnesses can affect appetite, alter how the body absorbs and uses nutrients, increase energy needs, and cause complications like nausea or difficulty swallowing, all of which contribute to malnutrition.

Yes, it is possible for an individual to be overweight or obese while still being malnourished. This can occur when their diet is high in calories but lacks essential vitamins and minerals.

Wasting is low weight-for-height, indicating recent and severe weight loss, while stunting is low height-for-age, reflecting chronic or recurrent undernutrition.

Caregivers can help by offering nutrient-dense foods, serving smaller, more frequent meals, addressing any eating difficulties like chewing or swallowing, and providing companionship during meals.

Yes, many medications can have side effects that reduce appetite, cause nausea, or interfere with nutrient absorption. This is particularly a risk for older adults taking multiple prescriptions.

Poverty is a significant driver of malnutrition as it limits access to nutritious and varied foods. It can lead to reliance on cheaper, energy-dense but nutrient-poor food options, contributing to both undernutrition and overnutrition.