Looking Forward to Progress on Malnutrition in 2023!

Healthy aging is very difficult to achieve without proper nutrition—malnutrition can lead to a higher risk of falls and loss of muscle mass (also known as sarcopenia), which are common concerns for older adults and those who care for them. We need to do more at the national level to combat malnutrition, and as the historic White House Conference on Hunger, Nutrition, and Health made clear, we need to execute a comprehensive federal policy agenda on older adult nutrition.

Prior to the COVID-19 pandemic, poor nutrition status and food insecurity were growing crises among older Americans. Up to one out of every two older adults was already at risk for malnutrition. The isolation and other challenges of the pandemic further amplified this risk. Federal nutrition programs have become increasingly important in tackling malnutrition. Congress took positive steps during the pandemic to provide increased funding and flexibility for older adult nutrition programs and the Supplemental Nutrition Assistance Program (SNAP). Yet funding shortfalls for these programs continue and further action is urgently needed.

Progress Was Made in 2022 on Older Adult Malnutrition

Last year, several accomplishments helped advance solutions to older adult malnutrition. First, after nearly ten years of data collection and advocacy, The Centers for Medicare & Medicaid Services (CMS) adopted the Global Malnutrition Composite Score Measure (GMCS) for reporting through its Hospital Inpatient Quality Reporting Program. This measure is a tool for assessing quality hospital care for older patients who are at risk of malnutrition and can help better quantify and improve nutrition care. CMS adopted the GMCS as a health equity–focused quality measure. Reporting on the GMCS measure is one way to help reduce drivers of inequitable access to malnutrition care and nutritious food and thus help address social determinants of health, like food insecurity.

Beyond advocating for federal policy priorities, there are specific steps to take in your community to help increase older adults’ nutrition security.

The Older Americans Act (OAA) Nutrition Program celebrated its 50th anniversary. The purposes of this program (which offers congregate and home-delivered meals) are to provide a meal, nutrition education, an opportunity for socialization, and to reduce hunger and malnutrition among older adults.

For more than 50 years, tens of millions of older adults have benefited from these life-sustaining services. However, even with longstanding programs there often is pressure to “show me the data.” Last year’s addition of malnutrition and food insecurity questions to the annual survey of OAA participants means there will be data in the future to help document these programs’ impact.

The first White House Conference on Hunger, Nutrition and Health since 1969 was held, and recognized that combating hunger and improving nutrition and health requires strong partnerships, especially public-private partnerships. It put forth a national strategy that, when carried out, will benefit not only older adults but also will have positive impact across generations. The year 2023 will be the one to watch for successful enactment of this strategy.

Malnutrition Priorities for 2023

The year 2023 is the first in which the Global Malnutrition Composite Score Measure will be implemented, and with that comes a lengthy to-do list. Hospital systems need to learn about and take up the quality measure components. Connecting participating hospitals with community-based nutrition programs and services will be crucial for successful patient referrals and continuity of care. Additionally, there is a need to advocate for developing malnutrition quality measures in other sites of care.

The Farm Bill is renewed on a five-year cycle, which is up in 2023. Its name is deceptive; nearly 80% of the funding in this piece of legislation is dedicated to domestic nutrition programs such as SNAP. The Farm Bill could expand the reach of SNAP benefits and increase pilot programs like produce prescriptions and others aimed at increasing access to nutritious food, continuing to meet the critical needs for older adults.

Next month marks the first meeting of the Dietary Guidelines Advisory (2025–2030) Committee. The Dietary Guidelines have yielded MyPlate and other specific recommendations on what to eat and drink to meet nutrient needs, promote health, and prevent disease. The Dietary Guidelines also provide the framework for federal nutrition programs like the sOAA nutrition programs. The Government Accountability Office has recommended this next iteration of the Dietary Guidelines include a focus on the unique nutrition needs of older adults. Continued advocacy is important though, as the proposed scientific questions that will inform the next Dietary Guidelines appear to have a limited focus on older adults.

Beyond advocating for these federal policy priorities, there are specific steps you can take in your community to help increase older adults’ nutrition security. You can assist older adults in applying for SNAP benefits—use our interactive map to find your state agency or use the Eldercare Locator to find local counselors who can assist. You also can point older adults to their local OAA nutrition programs using our map or the Meals on Wheels America program locator.

In short, there are many opportunities to increase nutrition security and decrease malnutrition risk for older Americans. It starts with a comprehensive federal policy agenda, and the next step is getting leaders to pay attention. National Nutrition Month in March, Older Americans Month in May and Malnutrition Awareness Week (September 18–22) are all great times to plan events and advocate for these changes!

For more information and tools, check out Defeat Malnutrition Today’s state and federal legislative and advocacy toolkits.

Meredith Whitmire is vice president of Matz Blancato and Associates and policy director of Defeat Malnutrition Today, and Laura Borth is a policy analyst for both Matz Blancato and Associates and Defeat Malnutrition Today, in Washington, DC.