A new report published by the European Nutrition for Health Alliance (ENHA) has drawn attention to the issue of malnutrition in Europe's ageing population - a problem it says is widespread but receives considerably less attention than obesity.
In the report entitled "Malnutrition within an ageing population: a call for action ", the alliance advocates the recognition of malnutrition as a disease in its own right. It says it is a serious social and economic issue that has significant costs for both individuals and society as a whole.
It comes just two weeks after the UK health services released guidelines to try to tackle malnutrition, a problem that affect 60 per cent of over 65s in hospitals.
Although less than five per cent of the whole British population is affected by malnutrition (defined as a deficiency, excess or imbalance of nutrients that causes adverse effects on wellbeing and body function), the figure rockets to 40 per cent for over 65s in care homes, and 60 per cent for the elderly in hospital.
Prevalence increases with age and they may be less well equipped to make a recovery. Moreover, malnutrition is a secondary feature of a number of serious diseases, such as cancer, arthritis, diabetes and emphysema.
In recent years there has been an enormous effort to combat the rising tide of obesity, and the alliance says that malnutrition has been left in the shadows by this, as a result being "under-detected, under-recognised and under-treated". A recent study (Elia et al, 2005), estimated the cost of malnutrition to the UK to be £7.3b (€10.6) per year, double the projected £3.5b (€5.1) cost of obesity.
However some experts maintain that although we usually associate malnutrition with starvation, in fact it is a contributing factor to obesity.
A study released by the UN-backed Food and Agriculture Organization (FAO) in February 2004 concluded that preventing malnutrition and hunger in pregnant women and children could stop the onset of obesity in later life.
There have been some high-profile attempts to promote better nutrition amongst certain communities: UK celebrity chef Jamie Oliver has campaigned successfully to improve the nutritional content of school dinners, and Lloyd Grossman has been active over hospital food.
But the alliance says that "tolerating the wide prevalence of malnutrition among older people is simply unaffordable".
"All stakeholders need to take ownership and action to address the problem. Malnutrition occurs across all settings. Targeted actions are needed to address the root causes of malnutrition and empower individuals to foster 'well-nutrition' for themselves."