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Understanding Malnutrition

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.

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