Malnutrition
What is Malnutrition?
Malnutrition or
Malnourishment is a condition that results from eating a diet in which
nutrients are either not enough or are too much such that the diet causes
health problems. It may involve calories, protein, carbohydrates,
vitamins or minerals. Not enough nutrients is called Under nutrition or
Undernourishment while too much is called overnutrition. Several
different nutrition disorders may develop, depending on which nutrients are
lacking or consumed in excess.
According to the WorldHealth Organization (WHO), malnutrition is the gravest single threat to global
public health.
Obese people, who
consume more calories than they need, may suffer from the subnutrition aspect
of malnutrition if their diet lacks the nutrients their body needs for good
health.
Poor diet may lead to a
vitamin or mineral deficiency, among other essential substances, sometimes
resulting in scurvy - a condition where an individual has a vitamin C (ascorbic
acid) deficiency.
According to theNational Health Service (NHS), UK, it is estimated that around three million
people in the UK are affected by malnutrition (sub nutrition).
According to the Foodand Agriculture Organization (FAO), the number of people globally who were
malnourished stood at 923 million in 2007, an increase of over 80 million since
the 1990-92 base period. Malnutrition at an early age leads to reduced physical
and mental development during childhood. Stunting, for example, affects more
than 147 million preschoolers in developing countries, according to SCN's World
Nutrition Situation 5th report.
Globally, as well as in
developed, industrialized countries, the following groups of people are at
highest risk of malnutrition (sub nutrition):
⦁ Elderly people, especially those who are
hospitalized or in long-term institutional care
⦁ Individuals who are socially isolated
⦁ People on low incomes (poor people)
⦁ People with chronic eating disorders,
such as bulimia or anorexia nervous
⦁ People convalescing after a serious
illness or condition.
What are the
consequences of malnutrition?
According to World
Health Organization, Malnutrition affects people in every country. Around 1.9
billion adults worldwide are overweight, while 462 million are underweight. An
estimated 41 million children under the age of 5 years are overweight or obese,
while some 159 million are stunted and 50 million are wasted. Adding to this
burden are the 528 million or 29% of women of reproductive age around the world
affected by anaemia, for which approximately half would be amenable to iron
supplementation.
Many families cannot afford or access enough nutritious foods like fresh
fruit and vegetables, legumes, meat and milk, while foods and drinks high in
fat, sugar and salt are cheaper and more readily available, leading to a rapid
rise in the number of children and adults who are overweight and obese, in poor
as well as rich countries. It is quite common to find undernutrition and
overweight within the same community, household or even individual – it is
possible to be both overweight and micronutrient deficient.
In Children
Malnutrition in children
is common globally and results in both short and long term irreversible
negative health outcomes. Which includes?
1. Stunting referring to a child who is too
short for his or her age. Stunting is the failure to grow both physically and
cognitively and is the result of chronic or recurrent malnutrition. The
devastating effects of stunting can last a lifetime.
2. Overweight referring to
a child who is too heavy for his or her height. This form of malnutrition
results from expending too few calories for the amount of food consumed and
increases the risk of no communicable diseases later in life.
3. Wasting referring to a child who is too
thin for his or her height. Wasting, or acute malnutrition, is the result of
recent rapid weight loss or the failure to gain weight. A child who is
moderately or severely wasted has an increased risk of death, but treatment is
possible.
4. Some Children suffer from more than one
malnutrition - Overweight and stunted or Stunted and wasted
Forms of Malnutrition
Each form of
malnutrition depends on what nutrients are missing in the diet, for how long
and at what age.
The most basic kind is
called protein energy malnutrition . It results from a diet lacking in energy and
protein because of a deficit in all major macro nutrients, such as
carbohydrates, fats and proteins.
Marasmus is caused by a
lack of protein and energy with sufferers appearing skeletally thin. In extreme
cases, it can lead to kwashiorkor, in which malnutrition causes swelling
including a so-called 'moon face'.
Other forms of
malnutrition are less visible - but no less deadly. They are usually the result
of vitamin and mineral deficiencies (micro nutrients), which can lead to
anaemia, scurvy, pellagra, beriberi and xeropthalmia and, ultimately, death.
Deficiencies of iron,
vitamin A and zinc are ranked among the World Health Organization's (WHO) top
10 leading causes of death through disease in developing countries
Treatment for Malnutrition
NICE (NationalInstitute for Health and Clinical Excellence), UK, has guidelines for
malnutrition treatment
NICE guidelines say that
individuals who are receiving nutritional support, as well as their caregivers
(UK: carers):
⦁ Should be fully informed about their
treatment
⦁ Should be given tailored information
⦁ Should be given the opportunity to
discuss diagnosis, treatment options and relevant physical, psychological and
social issues.
⦁ Should be given contact details of
relevant support groups, charities and voluntary organizations.
When a diagnosis of
either malnutrition or malnutrition risk has been made, the healthcare
professional (either a doctor or dietician) who is responsible for the patient
will devise a targeted care plan.
The care plan
Aims for treatment will
be set out, which should include the treatment for any underlying
conditions/illnesses which are contributory factors to the malnutrition.
Typically, treatment
will include a feeding program with a specially planned diet, and possibly some
additional nutritional supplements.
Severely malnourished
patients, or individuals who cannot get sufficient nutrition by eating or
drinking may need and should receive artificial nutritional support.
Diet
A good healthcare
professional will discuss eating and drinking with the patient and provide
advice regarding healthy food choices. The aim is to make sure the patient is
receiving a healthy, nutritious diet.
Preventing malnutrition
Malnutrition is caused
mainly by not consuming what the National Health Service (NHS), UK, calls
"the right balance of nutrients from major food groups". These
include:
⦁ Carbohydrates
⦁ Fruit and vegetables
⦁ Protein
⦁ Dairy - vegans are able to find abundant
nutrients from non-animal sources
⦁ Fats
The average human should
drink at least 1.2 liters of fluid per day.