From evidence to action: advancing multi-level policy and leadership for adult undernutrition

BACKGROUND: The Canadian Nutrition Society endorsed commitments aligned with the United Nations Decade of Action on Nutrition to advance policy action for adult undernutrition. Currently, undernutrition is not recognized as a condition impacting the Canadian health care system. The aim was to identify key insights and ongoing policy challenges and outline actionable steps for health leaders and governments to prioritize nutrition care amid shifting priorities. METHODS AND PROCEDURES: Evidence was integrated from a targeted undernutrition initiative, and findings were synthesized to develop a conceptual roadmap across health system levels. RESULTS: Challenges include limited awareness, inadequate financing for medical nutrition therapy, and insufficient dietetic workforce capacity. Actionable steps include national recognition of undernutrition through standardized metrics and language, provincial funding and workforce planning, and organizational data systems targeting standardized nutrition care processes, such as admission screening. At point-of-care, access to nutrition care, improved food service standards, and continuity across care transitions are essential. The conceptual roadmap delineates responsibilities across national/federal, provincial/territorial, organizational, and point-of-care levels. CONCLUSIONS: Addressing adult undernutrition requires coordinated, multi-level policy action and buy-in from health leaders and government. The conceptual roadmap provides a structured avenue to support integration of nutrition into health policy, improve accountability, and reduce the burden of undernutrition in Canada.