Malnutrition

Malnutrition is the condition that results from taking an unbalanced diet in which certain nutrients are lacking, in excess, or in the wrong proportions.

Malnutrition is a serious disease and the effects during the first two years of life are irreversible. Malnourished children grow up with worse health and lower educational achievements. Their own children also tend to be smaller.

The World Health Organisation and the United Nations cites malnutrition as

• the greatest single threat to the world’s public health, especially in children
• by far the biggest contributor to child mortality, present in half of all cases
• Underweight births and inter-uterine growth restriction cause 2.2 million child deaths per year.
• Poor or non-existent breastfeeding causes 1.4 million deaths.
• Other deficiencies, such a lack of vitamin A or zinc, account for another 1 million deaths.
• responsible for 58% of the total mortality in 2006.
• being caused by poverty, food prices, dietary practices, agricultural productivity, natural disasters, political problems and war not only in developing nations. Many individual cases of malnutrition are a mixture of several of these factors.

Causes

There are a number of causes of malnutrition:

• inadequate or unbalanced diet
• problems with digestion or absorption
• certain medical conditions.

Malnutrition can occur if a person does not eat enough food. Starvation is a form of malnutrition, but malnutrition can also develop easily due to the lack of a single vitamin. In some cases, malnutrition is very mild and causes no symptoms. However, sometimes it can be so severe that the damage done to the body is permanent.

Iodine deficiency

Malnutrition, in the form of iodine (salt) deficiency, is the most common preventable cause of mental impairment worldwide.

Even moderate iodine deficiency, especially in pregnant women and infants, lowers intelligence by 10 to 15 I.Q. points, shaving incalculable potential off a nation’s development. The most visible and severe effects — disabling goiters, cretinism and dwarfism — affect a tiny minority, usually in mountain villages. But 16 % of the world’s people have at least mild goitre, a swollen thyroid gland in the neck.

The following table shows the results of deficiencies and excess of some food substances:

 Dietary practices

Lack of breastfeeding

A lack of breastfeeding can lead to malnutrition in infants and children. Possible reasons for the lack in the developing world may be that the average family thinks bottle feeding is better.

Diets from a single source

Deriving too much of one’s diet from a single source, such as eating almost exclusively corn or rice, can cause malnutrition. This may either be from a lack of education about proper nutrition or from only having access to a single food source.

Overeating

Many tend to think malnutrition only in terms of hunger, however, overeating is a contributing factor as well. Many parts of the world have access to a surplus of non-nutritious food, in addition to increased sedentary lifestyles. In turn, this has created a universal epidemic of obesity.

Symptoms

Symptoms vary and depend on what is causing the malnutrition. However, some general symptoms include fatigue, dizziness and weight loss.

Kwashiorkor is an acute form of childhood protein-energy malnutrition characterised by

• edema,
• irritability,
• anorexia,
• ulcerating dermatoses and
• an enlarged liver with fatty infiltrates.

The presence of edema caused by poor nutrition defines kwashiorkor.

Marasmus is a form of severe protein-energy malnutrition characterised by energy deficiency.

A child with marasmus looks emaciated. Body weight may be reduced to less than 80% of the average weight that corresponds to the height.

Marasmus occurrence increases prior to age 1, whereas kwashiorkor occurrence increases after 18 months. It can be distinguished from kwashiorkor in that kwashiorkor is protein wasting with the presence of edema. The prognosis is better than it is for kwashiorkor.

Emaciation occurs when a person loses substantial amounts of much needed fat and often muscle tissue, making the person look extremely thin. The cause of emaciation is a lack of nutrients, starvation or disease.

Cachexia is a wasting syndrome with loss of weight, muscle atrophy, fatigue, weakness and significant loss of appetite in a person who is not actively trying to lose weight. Even if the affected patient eats more calories, they will lose lean body mass as can be seen in patients with cancer, AIDS, TB and chronic obstructive lung disease.

Malnutrition increases the risk of infection and infectious disease; for example, it is a major risk factor in the onset of active tuberculosis. In communities or areas that lack access to safe drinking water, these additional health risks present a critical problem. Lower energy and impaired function of the brain also represent the downward spiral of malnutrition as victims are less able to perform the tasks they need to in order to acquire food, earn an income, or gain an education.

Treatment

Improving nutrition is widely regarded as the most effective form of assistance.Emergency measures include providing deficient micronutrients through fortified sachet powders, such as peanut butter, or directly through supplements.

Therefore treatment usually consists of replacing missing nutrients, treating symptoms as needed and treating any underlying medical condition.

Speak to a healthcare provider if any of the following symptoms develop:

• Fainting
• Lack of menstruation
• Lack of growth in children
• Rapid hair loss.

Prognosis

The outlook depends on the cause of the malnutrition. Most nutritional deficiencies can be corrected. However, if malnutrition is caused by a medical condition, that illness has to be treated in order to reverse the nutritional deficiency.

Complications

If untreated, malnutrition can lead to mental or physical disability, illness and possibly death.

It is therefore essential to eat a good, well-balanced diet to prevent most forms of malnutrition and to avoid any of the grave consequences of malnutrition, especially in children.

The orange ribbon—an awareness ribbon for malnutrition