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MALNUTRITION

Definition:
Malnutrition (literally bad nutrition) is a disparity between the amount of food and other nutrients that the body needs and the amount that it is receiving. This imbalance is most frequently associated with undernutrition, but it may also be due to overnutrition.

Malnutrition can occur if you do not eat enough food. Starvation is a form of malnutrition.
You may develop malnutrition if you lack of a single vitamin in the diet. 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, even though you survive.

Malnutrition continues to be a significant problem all over the world, especially among children. Poverty, natural disasters, political problems, and war all contribute to conditions -- even epidemics -- of malnutrition and starvation, and not just in developing countries.

Several Primary Causes:


Hunger, the most insidious, is mainly a deficiency of calories and protein. The main cause of hunger is poverty. Hunger is most devastating when it attacks children, since it can affect their mental and physical development for the rest of their lives, thus deepening the poverty cycle since they have less access to education and opportunities for work later in life. However, hunger also seriously affects adults, impeding their productivity and creating a host of associated health problems, making their lives even more difficult. The terrible effects and legacy of HIV/AIDS are also tightly linked to hunger and malnutrition. The W.H.O. estimates the size of this group at roughly 1.2 billion people.

Micronutrient and/or protein deficiency is shown in a very large group of malnourished people. They either do not receive adequate amounts of vitamins and minerals (micronutrients), or the correct proportion of protein in their diets. This can also have very debilitating effects on people and societies. The health symptoms may not be immediately visible to either the individuals themselves or to health workers, or they can take years to manifest themselves. The result is lost productivity, and a great increase in health care costs which negatively affects other government attempts to improve the quality of life - aside from the enormous social cost. The worldwide size of this group is estimated at 2 billion people.

Over-consumption, taking in many more calories than required, is often accompanied by a deficiency in vitamins and minerals. Many food companies sometimes exploit the human inclination towards fatty and sugary foods by offering consumers cheap and often nutritionally empty products. Compounded with their reduced physical activity and greater meat consumption, these people, the overweight and obese, are a fastgrowing segment of the world's population. Ironically they often live, as the middle and upper class, in those countries where hunger is prevalent, such as in India and China. The health care costs, missed productivity and environmental costs associated with this group are huge. The W.H.O. estimates this group to be 1.2 billion people worldwide.

The common thread that affects all of these groups, 4.4 billion people, is malnutrition.

In more wealthy industrialized nations malnutrition is usually caused by:


Poor diet - if a person does not eat enough food, or if what they eat does not provide them with the nutrients they require for good health, they suffer from malnutrition. Poor diet may be caused by one of several different factors. If the patient develops dysphagia (swallowing difficulties) because of an illness, or when recovering from an illness, they may not be able to consume enough of the right nutrients. Mental health problems - some patients with mental health conditions, such as depression, may develop eating habits which lead to malnutrition. Patients with anorexia nervosa or bulimia may develop malnutrition because they are ingesting too little food. Mobility problems - people with mobility problems may suffer from malnutrition, simply because they either cannot get out enough to buy foods, or find preparing them too arduous.

Digestive disorders and stomach conditions some people may eat properly, but their bodies cannot absorb the nutrients they need for good health. Examples include patients with Crohn's disease or ulcerative colitis. Such patients may need to have part of the small intestine removed (ileostomy). Individuals who suffer from Celiac disease have a genetic disorder that makes them intolerant to gluten. Patients with Celiac disease have a higher risk of damage to the lining of their intestines, resulting in poorer food absorption. Patients who experience serious bouts of diarrhea and/or vomiting may lose vital nutrients and are at higher risk of suffering from malnutrition.

Alcoholism - an alcoholic is a person who suffers from alcoholism - the body is dependent on alcohol. Alcoholism is a chronic (long-term) disease. Individuals who suffer from alcoholism can develop gastritis, or pancreas damage. These problems also seriously undermine the body's ability to digest food, absorb certain vitamins, and produce hormones which regulate metabolism. Alcohol contains calories, reducing the patient's feeling of hunger, so he/she consequently may not eat enough proper food to supply the body with essential nutrients.

In poorer, developing commonly caused by:

nations

malnutrition

is

Food shortages - in poorer developing nations food shortages are mainly caused by a lack of technology needed for higher yields found in modern agriculture, such as nitrogen fertilizers, pesticides and irrigation. Food shortages are a significant cause of malnutrition in many parts of the world. Food prices and food distribution - it is ironic that approximately 80% of malnourished children live in developing nations that actually produce food surpluses (Food and Agriculture Organization). Some leading economists say that famine is closely linked to high food prices and problems with food distribution.

Lack of breastfeeding - experts say that lack of breastfeeding, especially in the developing world, leads to malnutrition in infants and children. In some parts of the world mothers still believe that bottle feeding is better for the child. Another reason for lack of breastfeeding, mainly in the developing world, is that mothers abandon it because they do not know how to get their baby to latch on properly, or suffer pain and discomfort.

What are some signs and symptoms of malnutrition?

Loss of fat (adipose tissue) Breathing difficulties, a higher risk of respiratory failure Depression Higher risk of complications after surgery Higher risk of hypothermia - abnormally low body temperature The total number of some types of white blood cells falls; consequently, the immune system is weakened, increasing the risk of infections. Higher susceptibility to feeling cold Longer healing times for wounds

Longer recover times from infections Longer recovery from illnesses Lower sex drive Problems with fertility Reduced muscle mass Reduced tissue mass Tiredness, fatigue, or apathy Irritability

In more severe cases:


Skin may become thin, dry, inelastic, pale, and cold Eventually, as fat in the face is lost, the cheeks look hollow and the eyes sunken Hair becomes dry and sparse, falling out easily Sometimes, severe malnutrition may lead to unresponsiveness (stupor) If calorie deficiency continues for long enough, there may be heart, liver and respiratory failure Total starvation is said to be fatal within 8 to 12 weeks (no calorie consumption at all)

Marasmus
Marasmus is one component of protein-energy malnutrition (PEM). It is a severe form of malnutrition caused by inadequate intake of protein and calories , and it usually occurs in the first year of life, resulting in wasting and growth retardation. Marasmus accounts for a large burden on global health. The World Health Organization (WHO) estimates that deaths attributable to marasmus approach 50 percent of the more than ten million deaths of children under age five with PEM.

Signs of Marasmus:
Very thin body, bones prominent Wrinkled and dry skin, especially in the buttocks and arms Hair is thin and soft Face like an old man's Cries often

A child suffering from Marasmus.

Kwashiorkor
The term kwashiorkor , meaning "the disease of the displaced child" in the language of Ga, was first defined in the 1930s in Ghana. Kwashiorkor is one of the more severe forms of protein malnutrition and is caused by inadequate protein intake. It is, therefore, a macronutrient deficiency. Generally, kwashiorkor occurs when drought, famine , or societal unrest leads to an inadequate food supply. Proteindepleted diets in such areas are mostly based on starches and vegetables, with little meat and animal products. A lack of maternal understanding regarding balanced diets further contributes to the problem. Finally, infections and other disease states negatively impact nutrient intake, digestion, and absorption.

Signs of Kwashiorkor:
Legs and hands are swollen with water (edema) Skin has dark brown to black patches which can be peeled off Hair is thin and can easily be pulled out Face is flabby or moon-faced Sad; does not smile Belly is enlarged Very slow learner

Difference between a normal and a child suffering from Kwashiorkor.

A child suffering from Kwashiorkor.

Difference between Marasmus and Kwashiorkor:


Marasmus patients suffer from a peeling and alternately pigmented skin. Kwashiorkor patients are characterized by a distended stomach, burns on the skin and diarrhea. Marasmus affects kids because of a lack of nutritional elements in the diet. Kwashiorkor affects kids who do not receive enough protein in the diet. Marasmus affects infants and very young kids. Kwashiorkor affects kids who are a bit older.

Marasmus patients need to be treated with additional doses of vitamin B and a nutritious diet. Kwashiorkor patients are treated by adding more protein in their diet.

Treatment:
Breast-feed the baby 1 to 2 hours after delivery. Continue breastfeeding as long as the mother has milk. Start supplementary feeding when the baby is 4 months. Do not use condensed milk as breast milk substitute. For severe cases, bring the child to the nearest health center, hospital, or clinic. Consider this as an emergency. The child usually has diarrhea or lung infection. Avoid delay of treatment. After emergency condition is controlled, treatment and nutrition rehabilitation must be continued at home.

Treat the existing infection or illness and prevent its recurrence.


Prepare nutritious and appetizing food.

If a child has no appetite, encourage small but frequent feedings. Do not force him or her to eat. Minimize giving junk foods, soft drinks, and artificially colored or flavored snack food with "empty calories. Encourage the child to have regular meals. Snacks should be given 2 hours before meals. Provide stimulating materials to hear, see, touch, taste, and smell.

Provide a warm, loving environment.


Seek help and support of community leaders.

Prevention is better than cure


Preventing malnutrition:

Malnutrition is caused mainly by not consuming "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 a day.

Eating a good, well-balanced diet helps to prevent most forms of malnutrition.

But still
not all person can afford to have proper nutrition.

Pulitzer Prize-winning photo of a Sudanese girl suffering from malnutrition as a vulture patiently awaits her demise.

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