| Turning Awareness into Action

| Laura Borth and Robert Blancato

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|  Nutrition is fundamental to health. Yet one of the most serious nutrition problems facing older adults can still go unnoticed until it has already taken a toll. That gap between what we know and what we recognize is why Malnutrition Awareness Week exists. Created by the American Society for Parenteral and Enteral Nutrition (ASPEN) in 2012, the week has helped bring malnutrition into the national conversation and connect health professionals, policymakers, caregivers, patients and community organizations. ASPEN deserves tremendous credit for building this movement.

Members of Congress also recognize the importance of addressing malnutrition through congressional resolutions in both chambers. Representative Suzanne Bonamici (D., Ore.) and Senator Chris Murphy (D., Conn.) have helped bring attention to this often-overlooked condition.

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“In a country as wealthy as the United States, no one should struggle to have enough to eat. Since H.R. 1 passed more than a year ago, too many people are experiencing food insecurity and hunger. Republicans in Congress have forced states to absorb hundreds of millions of dollars – that they do not have – to keep critical nutrition assistance programs funded. The cuts from H.R. 1 will harm working families and seniors who desperately need some extra support. This Malnutrition Awareness Week, I’m urging my colleagues to reverse the cuts and fund the nutrition programs that keep our nation healthy and strong”
—Representative Bonamici 

Malnutrition is more than not having enough food. It occurs when the body does not get the nutrients it needs to maintain health and function, whether because someone is eating too little, cannot absorb nutrients properly, or has increased nutritional needs because of illness. Older adults are particularly vulnerable, and malnutrition can be missed when someone is obese or intentionally losing weight. A recent analysis found that malnutrition-related mortality among adults age 85 and older increased sharply between 2013 and 2021, underscoring the need for earlier identification and better care. 

There is reason for optimism. CMS has finalized mandatory reporting of the Malnutrition Care Score (MCS) in more than 3,000 hospitals beginning in 2028. The MCS (originally the Global Malnutrition Care Score) brings together key steps in malnutrition care—from screening and assessment to diagnosis and a nutrition care plan. The measure began as a voluntary measure under President Biden in 2024 for patients 65 years and older and expanded to those 18 years and older in 2026.. It has continued and improved under President Trump. That progress reflects years of work by the Academy of Nutrition and Dietetics, the Malnutrition Quality Improvement Initiative, Defeat Malnutrition Today, participating hospitals and many others.

Registered dietitian nutritionists play a critical role. They bring specialized expertise to identifying malnutrition, determining what is driving it, developing individualized nutrition plans and monitoring whether those plans are working. As the Food Is Medicine movement grows, there is also increasing recognition that nutrition interventions are part of healthcare, not just something discussed at the dinner table. Connecting clinical nutrition expertise with community-based nutrition services can help ensure people have both the care and the food they need to recover and stay well.

Just as important, malnutrition care cannot stop at the hospital door. Hospitals need to connect patients with nutrition resources and community-based programs after discharge. This creates an opportunity to connect clinical nutrition care with the community organizations already helping people access food, nutrition services and other supports. It also aligns with the growing Age-Friendly Health Systems movement from the John A. Hartford Foundation and CMS’s Age-Friendly Hospital quality measure, which encourages hospitals to provide better, evidence-based care for older adults. 

The community-based aging network has an important role to play, too. The 2020 Older Americans Act reauthorization explicitly added malnutrition screening to routine health screening and recognized reducing malnutrition as a purpose of nutrition services. Malnutrition risk in OAA participants is now surveyed annually. Across the country, OAA-funded programs address malnutrition through nutritious meals, nutrition education and counseling, and referrals to needed services. 

At Defeat Malnutrition Today, we are working with partners to make sure community systems are connected to hospitals and ready for this next phase of malnutrition care. Our updated 2026 National Blueprint: Achieving Quality Malnutrition Care for Older Adults provides a roadmap, identifying both progress made since 2020 and the actions still needed across health care, community services and federal policy.

Malnutrition Awareness Week gives us an opportunity to focus on a problem that is too often missed. But the goal is bigger than awareness. The goal is a healthcare system where malnutrition is identified early, treated effectively, and addressed across the continuum—from the hospital to the community and into the home. We have the tools to move in that direction. Now we need to put them to work.

Laura Borth is policy director of the Defeat Malnutrition Today coalition. Bob Blancato is executive director of the National Association of Nutrition and Aging Services Programs.