Tea and Toast Syndrome

Tea and Toast Syndrome is a form of malnutrition commonly experienced by elderly people who are unable or unwilling to prepare meals. An elderly person with nobody left to cook for, or without the skills to cook, will revert to a diet of simple foods such as bread, cheese and crackers, and canned foods. The diet will often dwindle to tea and toast, resulting in a deficiency of vitamins and other nutrients.

Patients also present with hyponatremia, which occurs when the concentration of sodium in the blood is abnormally low. Sodium is an electrolyte, and it helps regulate the amount of water that's in and around your cells[1].

Some signs and symptoms of malnutrition in older adults may include: unintended weight loss, tiredness and fatigue, muscle weakness or loss of strength, constipation, dizziness, syncope, gastritis, peptic ulcers, paleness of the skin, poor wound healing, depression, problems with memory, a weak immune system, and anemia. In addition, the lack of vital nutrients will also create complications of other illnesses, even the common cold, can be much more severe.

The syndrome often manifests itself as hyponatremia, a low concentration of the electrolyte sodium in the bloodstream, due to the lack of salt in the diet. Hyponatremia can lead to various neurological problems ranging from headaches and a decreased ability to think, to seizures and coma in the most severe cases.

According to an article in the New York Times, as many as 60% of seniors living at home are either malnourished or at risk of becoming malnourished[2].

Factors that lead to the syndrome include poverty, social isolation, psychological issues such as depression, chronic illnesses that cause a lack of appetite, dental problems that result in difficulty chewing and swallowing foods, a decline in cognitive functioning, alcoholism, and physical disabilities and limitations.

Potential signs and symptoms of the tTea and Toast Syndrome can include those of 'normal' malnutrition such as general weakness and cognitive impairment.

[1] Filippatos et al: Hyponatremia in the elderly: challenges and solutions in Clinical Interventions in Aging – 2021. See here.
[2] Eric Nagourney: Tea and Toast and a Danger That Can Be Hard to Spot in New York Times - April 12, 2005