Surge in number of people in hospital with nutrient deficiencies, NHS figures show

The number of Brits being hospitalised for malnutrition and nutritional deficiencies has almost tripled in a decade.

Official figures show there were more than 800,000 admissions in England and Wales last year with conditions linked to poor nutrition, including ‘Victorian’ illnesses scurvy and rickets. 

Iron deficiency was the biggest problem, NHS data revealed, with admissions for the bone-weakening condition shooting up by 149 per cent since 2013.

Experts said the ‘shocking’ statistics show the grim toll food poverty is taking on the nation’s health. 

But they also warned that the dire situation would only get worse in the coming months, as people are forced to make further cuts amid the cost of living crisis.

Malnutrition occurs when a diet does not include the right amount of nutrients, with unintentional weight loss, a low body weight and feeling tired and weak being key signs.

Cases of the illnesses plummeted in the 1900s after key vitamins were added commonly eaten foods, such as breakfast cereals, plant-based milks and margarine. 

Brits facing the pinch, however, have been forced to cut back on fruit and vegetables and eat cheaper junk food, which lacks vital vitamins and minerals. 

Analysis of hospital data, shared with The Guardian, showed there were 824,519 admissions with a diagnosis linked to at least one nutritional deficiency in 2022/23, up from 293,686 a decade ago.

More than half of all admissions had an iron deficiency as either their main diagnosis or something which was noticed afterwards. 

The NHS treated more than double the cases it did a decade ago, logging 490,005 in 2022/23, compared to 196,685.  

Cases of patients being treated for vitamin B deficiencies — B12, folate and other B vitamins — also tripled from 57,406 a decade ago to 167,562 last year. 

Protein energy malnutrition, meanwhile, which is caused by insufficient calories or protein, rose from 5,746 to 9,390 cases. 

The figures do not provide a breakdown of the ages of adult patients, or where they are in the country. 

However, senior medics said they were treating increasing numbers of children with iron and vitamin deficiencies and rickets, caused by a lack of vitamin D and calcium.

Professor Sir Michael Marmot, a professor of epidemiology at University College London, who led a landmark review into health inequalities in England published in 2010, labelled the figures ‘really shocking’.

He told The Guardian: ‘The sceptic in me always asks: is this real, or increased recognition of the problem? But that massive increase — wow. It seems likely that there’s got to be a real component.’ 

Professor Kamila Hawthorne, chair of the Royal College of GPs (RCGP), told the newspaper: ‘As a nation we shouldn’t be having malnourished children. We shouldn’t be having children with rickets. 

‘We should not be having people with iron deficiencies or low folic acid. There’s that sense of this isn’t right; what’s happening here?’ 

Medics were increasingly facing ‘moral distress’ over the issue, she said, given ‘it’s not like you can prescribe money or food’.  

She added: ‘There are definitely cases we hear about of parents going without meals so their children can eat. We’re hearing of a lot of people going to food banks who would never have dreamt of going to a food bank before.’

The National Institute for Health and Care Excellence defines a person as being malnourished if they have a body mass index (BMI) of less than 18.5; or unintentional weight loss greater than 10 per cent within the past three to six months.

Those with a BMI of less than 20 and unintentional weight loss greater than 5 per cent of their body weight within the past three to six months, are also deemed malnourished. 

Experts have previously warned that a move towards vegetarian and vegan diets, could cut out key ingredients needed to help get sufficient levels of vitamin B or iron. 

Researchers at Queen’s University Belfast warned that going plant-based was adding to malnutrition in wealthy countries.

But this is unlikely to fully explain such substantial increases in iron and B vitamin deficiencies, logged by the NHS data, they said today.

Experts, however, acknowledged that the data does not account for a potential rise in increased testing over the last decade. 

This could explain increases in rarer deficiencies, such as vitamin A and thiamine, which are typically monitored in the growing population of bariatric surgery patients, they added. 

Rebecca McManamon, a consultant dietitian and spokesperson for the British Dietetic Association, said testing for iron deficiency was very common, including among A&E patients suffering from with fatigue or breathlessness. 

‘Most GPs would be requesting these tests on a daily basis. It’s fair to say there is more awareness, but not enough to explain this increase,’ she added. 

The NHS warns that malnutrition is a ‘common problem’ that affects millions in the UK, with under-fives, over-65s and those with long-term health conditions most at risk. One in 10 elderly people are malnourished or at risk of malnutrition, it says.

Earlier this year, doctors warned that the cost of living crisis was fuelling a rise in malnutrition cases, with Brits relying on cheap, processed and high-calorie food, leaving them lacking in basic vitamins and minerals.

Brits have told of having just £40 a week to feed their families and skipping meals due to sky-high food prices, while food banks have reported spikes in demand.

Last year Department for Work and Pensions data also showed that around one in six people in the UK were in relative poverty, measured as ‘relative low income’ before housing costs in 2021/22.