True cost of undernutrition in UK to be revealed in new landmark study

Southampton researchers are part of a new collaboration that will assess the economic impact of undernutrition across the UK.

The ambitious research programme aims to deliver the most comprehensive assessment of this in more than a decade.

It will be delivered by a new collaboration between the University of Southampton (UoS), the NIHR Biomedical Research Centre: Southampton (BRC) and the British Association for Parenteral and Enteral Nutrition (BAPEN).

What is undernutrition?

Undernutrition occurs when a person does not receive enough energy, protein or other nutrients to meet their body's needs.

Over time, this can negatively affect body weight and composition, physical function and overall health. It can lead to anaemia, vulnerability to infection, night blindness,

reduced fertility. In some cases, it can lead to heart failure.

Undernutrition contributes to worse patient outcomes, increased complications and longer hospital stays. It remains one of the UK's most under-recognised yet significant public health and clinical challenges.

Evidence consistently shows that identifying and treating undernutrition early can improve patient outcomes. It can also reduce pressure on overstretched services.

Creating a 'comprehensive picture'

The programme will generate new evidence on the cost of undernutrition to health and social care systems. It will cover England, Scotland, Wales and Northern Ireland.

This will provide a vital foundation for future policy, advocacy and improvements to nutritional care.

Following a competitive tender process, a joint UoS and BRC team have now been appointed to undertake the research.

The team brings together internationally recognised experts. This includes in nutritional science, health economics, gastroenterology, geriatrics and healthcare policy.

Professor Philip Calder is Professor of Nutritional Immunology at UoS and the NIHR BRC: Southampton.

“This project represents a unique opportunity to bring together the latest clinical, economic and population health data to create the most comprehensive picture of undernutrition's impact across the UK,” he said.

“By examining the burden across different care settings and nations, we hope to generate evidence that is both academically rigorous and directly relevant to the real-world challenges facing health and social care services.”

Understanding the scale of today’s challenge

The research will build on BAPEN's 2015 report that was delivered with the NIHR BRC Southampton. This estimated that malnutrition (including undernutrition) in England alone cost £19.6 billion per year. This is equivalent to more than 15% of public expenditure on health and social care at the time.

Ten years on, the UK's population, patterns of ill health, models of care and economic landscape have changed significantly. This creates an urgent need for evidence to reflect today's reality.

“UoS and our NIHR BRC have a long history of leading research into nutrition and health,” said Professor Calder. “We are delighted to be working with BAPEN on this important update.

“Ten years after the original report, there is a clear need for contemporary evidence that reflects today's healthcare landscape and the challenges facing both patients and services.”

Dr Nick Thompson is a Consultant Gastroenterologist and BAPEN President.

“Undernutrition affects millions of people across the UK,” he said.

“It contributes to poorer health outcomes, and increases demand on already stretched health and social care services. It has a profound impact on patients, families and carers. Yet much of the evidence currently used to demonstrate its impact is now more than a decade old.

“This new research represents an important investment in understanding the true scale of the challenge today.

“Robust, up-to-date evidence will strengthen the case for improving nutritional care. It will support policymakers and healthcare leaders. Ultimately, it will help improve outcomes for patients across the UK.  

“We are delighted to be working with the University of Southampton on this landmark project.”

The results of the report will support ongoing efforts. These aim to ensure nutritional care is recognised as a critical component of improving population health.

The research will also align with broader ambitions. These include prevention, community-based care and improving patient outcomes.

The research is now underway. It is expected that the report will be published in 2027.