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Managing malnutrition

Practical strategies for effective management

How can malnutrition be managed effectively?

Effective management of malnutrition requires a person-centred and multidisciplinary approach, with early interventions improving patient outcomes and reducing health and social care costs.1-5

What is ‘Food First’?

For many patients a ‘Food First’ approach, using dietary advice and treatment goals to optimise dietary intake, is an appropriate first step.3

Dietary advice from BAPEN to optimise food includes:6

  • Eating little and often
  • Choosing full fat and sugar products rather than low fat/low sugar/sugar free
  • Prioritising nourishing drinks.
  • Food Enrichment
  • Consider a multivitamin & mineral supplement

For more details on this, visit the BAPEN website here.

When to consider oral nutritional supplements (ONS)

ONS are sterile liquids, semi-solids or powders, which provide macronutrients and micronutrients and can be used when optimised food intake has been insufficient, or when it is anticipated that food alone will not meet nutritional requirements.3,7

For appropriate patients where malnutrition or the risk of malnutrition is a concern, healthcare professionals should consider initiating oral enteral or parenteral nutrition support, alone or in combination as per individual requirements, with any swallowing issues taken into account.8

When to consider a multivitamin

Learn more about when to consider supplementation for your patients.

Find out more >
  1. Serón-Arbeloa, C. Malnutrition Screening and Assessment. Nutrients 2022, 14, 2392. https://doi.org/10.3390/nu14122392
  2. Nutrition support in adults. NICE Quality Standard 24. Published 30 November 2012.
  3. Managing Adult Malnutrition in the Community. BAPEN. 3rd Edition 2021. Available at: https://www.malnutritionpathway.co.uk​/library/managing_malnutrition.pdf
  4. Launholt T, et al. Barriers and facilitators in the implementation of nutrition interventions to prevent or treat malnutrition in older adults: A scoping review. Nutr. Clin. Pract. 2025; 1-46.
  5. Murphy JL (2022) Prevention, identification and management of malnutrition in older people in the community. Nursing Standard. doi: 10.7748/ns.2022.e11891
  6. BAPEN Food First/Food Enrichment. Available at www.bapen.org.uk/nutrition-support/nutrition-by-mouth/food-first-food-enrichment
  7. British Association for Parenteral and Enteral Nutrition (BAPEN). Oral Nutritional Supplements (ONS). Available at: bapen.org.uk/education/nutrition-support/nutrition-by-mouth/oral-nutritional-supplements-ons
  8. Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition. NICE guideline CG32. 2006. Available at: www.nice.org.uk/Guidance/CG32

References accessed February 2026.

Adverse events should be reported. Reporting forms and information can be found at yellowcard.mhra.gov.uk or by searching for MHRA Yellow Card in the Google Play or Apple App Store. Adverse events should also be reported to Pharmacovigilance at Alliance Pharmaceuticals Ltd, Tel: 01249 466966, email: pharmacovigilance@alliancepharma.co.uk.