Nutrition Resources

In 2006, the National Institute for Health and Care Excellence (NICE) released the landmark guidance on nutrition, ‘Nutrition support in adults: oral nutrition support, enteral tube feeding and parenteral nutrition’ (NICE, 2006). At the heart of NICE guidance and quality standards is the aim to integrate research into practice and reduce gaps between recommended and actual practice. However, successful implementation is dependent on national and local action. To facilitate the implementation of the NICE clinical guidance (CG32), a national multidisciplinary expert panel was convened to explore and develop strategies that would overcome barriers to implementation of the NICE guidance, facilitate access to practical tools, and enhance knowledge to improve the management of disease-related malnutrition in the community. The collaborative work undertaken by the panel, in conjunction with major stakeholders, led to the development of the ‘Managing Adult Malnutrition in the Community’ materials. This article reviews the work of both the initial panel in 2012 and subsequent expert panels, that have delivered and continue to develop resources for nurses and the wider multidisciplinary team to assist in tackling malnutrition, which affects up to three million people in the UK at any time (Elia and Russell, 2009), especially that which arises as a consequence of illness and long-term medical conditions having an impact on appetite and the ability to eat and drink.

Nutrition and Hydration Week has historically taken place every March since 2012. It was even held in March 2020 at the very beginning of the Covid-19 pandemic. The challenges of the pandemic on all of us has meant that Nutrition and Hydration Week this year will be held from 14–20 June 2021 — so there is time to get involved.

Nutrition and hydration are vital components of successful wound management. Malnutrition is associated with a delay or failure of the wound healing process and this article discusses the macro and micronutrient requirement of each stage of the wound healing process. Holistic wound assessment, including assessment of nutrition and hydration, plays a significant part in successful wound management, in partnership with controlling exudate with appropriate wound care products.

This article discusses the assessment and management of vitamin B12 deficiency. The author examines the causes of this condition, such as pernicious anaemia, and the different methods that can be used to manage it, for example vitamin B12 supplements, diet and medication review. Primary care nurses are frequently responsible for ordering blood tests and managing B12 deficiency. However, there is a lack of consistency in the management of the condition, partly because there are a number of different blood tests that can be performed, not all of which are available in every hospital laboratory.

Nutrition is an important modifiable factor for patients with chronic obstructive pulmonary disease (COPD). Being overweight brings breathing difficulties and being malnourished leads to poorer outcomes. Maintaining a healthy weight and a nutritious diet is a central part of COPD management. This article equips general practice nurses (GPNs) and patients with the tools needed to assess and promote a healthy weight and diet while living with COPD. It explains the reasons for malnutrition and how these can be avoided. Helping people improve their diet as well as the role of oral nutritional supplements (ONS) are explored, and specific issues, such as vitamin D deficiency, are discussed.

A woman’s average age for her periods to end, marking the menopause, is 51. Roughly, 80% of women suffer from some menopausal symptoms which last for two years on average. Lowered oestrogen levels are responsible for most menopausal symptoms; the most common in western culture being hot flushes, night sweats, vaginal dryness and sleep disturbance. Weight gain that is often associated with the menopause can further add to the development of health conditions, such as heart disease, and make certain symptoms, such as hot flushes, worse. The combination of a healthy diet, in particular with a low glycaemic load, keeping active, and avoiding weight gain can help alleviate or reduce severity of menopause symptoms. Some foods such as soya products, oily fish, oats, possibly probiotics, and milk products or their alternatives, can help with a number of symptoms. More evidence is gathering for how a Mediterranean diet can help with symptoms.

Malnutrition (undernutrition) affects three million people in the UK (Brotherton et al, 2010) and is responsible for health and social care costs exceeding £19 billion annually in England alone, half of which is due to people over 65 (Elia, 2015). While it is accepted that good nutrition is important to maintain health, there is a general lack of responsibility and ownership around the problem of undernutrition in primary care. Lack of understanding, including how to identify and treat it is also widespread. Despite National Institute for Health and Care Excellence (NICE) guidelines stating that all healthcare professionals should be involved in nutritional screening and treatment (NICE, 2006), there are barriers stopping primary care nurses from screening, i.e. challenges of organisational culture and competing priorities (Green and James, 2013; Green et al, 2014).

A review of a patient with chronic obstructive pulmonary disease (COPD) by the general practice nurse (GPN) will usually include measures such as spirometry, smoking cessation advice, and a check of inhaler technique to name just a few. However, it also provides an ideal opportunity to assess the patient’s nutritional status and determine the level of risk this may pose. This article explores the need for nutritional assessment, how to stratify risk, how to plan interventions and, importantly, how to incorporate this vital element of care into everyday interactions with this group of patients.

Statistics suggest that one in four adults are obese, and up to 33% of school-aged children are overweight or obese (National Obesity Forum, 2015). Thus, on a daily basis, it is likely that general practice nurses (GPNs) will engage in consultations with patients who are overweight or obese, quite often while presenting for advice for another condition. This article explores how to broach this sensitive issue and the GPN’s role to reduce weight stigma in line with the new Nursing and Midwifery Council Code (NMC, 2015). Practical advice for GPNs to support patients in managing their weight, and identifying appropriate onward referrals, including for bariatric surgery and eating disorders, will also be discussed.