MALNUTRITION: A HUNGER THAT LASTS A LIFETIME

WHAT IS MALNUTRITION?

Malnutrition is defined as deficiency/ excess or imbalance of essentials nutrients required for healthy growth and development. Malnutrition signs and symptoms may include weight loss, irritation, lethargy and loss of appetite. Malnutrition exerts pressure not only from under-nutrition conditions but also from over-nutrition; obesity and diet based non communicable diseases.  Under-nutrition falls into four wide range of forms: stunting, wasting, underweight and micro nutrients deficiency.

WHAT ARE TYPES OF MALNUTRITION?

Malnutrition is considered as a global challenge. According to World Health Organization about 462 million people are underweight and nearly 1.9 billion people are overweight. There are two types of malnutrition which are as follows:

Under-nutrition

Under-nutrition occurs due to the absence of protein intake, micronutrients imbalance and low calorie dietary options.

• Underweight (Low weight as per age)
• Stunting (low height by age)
• Wasting (Low weights as per heights)

Over-Nutrition

Such situation arises due to over consumption of nutrients especially proteins, fats and other nutrients. It may lads towards over weight or obesity.

DOES UN TAKE ANY INITIATIVE TO ADDRESS MALNUTRITION?

World Health Organization (WHO) has initiated a program to cater the nutritional needs of most vulnerable children 15 different countries to avoid nutritional crisis. More than 30 million children are found wasted or acute malnutrition in 15 severely affected countries and 8million are severely wasted which is considered as the most deadly condition. Such high level of malnutrition is considered as alarming for health and growth of children and their communities.

In order to overcome the malnutrition circumstances 5 UN agencies including World Health Organization (WHO) , Food and Agriculture Organization (FAO), UN Refugee Agency (UNHCR), United Nations Children’s Fund (UNICEF) and World Food Program (WFP) has expedited the progress towards Global Action Plan on Child Wasting. They will extend their services to overcome adverse affects of malnutrition in 15 most adversely affected countries including Afghanistan, Chad, Congo, Burkina Faso, Ethiopia, Haiti, Mali, Madagascar, Kenya, Somalia, Negeria, Sudan, South Sudan , Niger and Yemen.

WHAT ARE CAUSES OF MALNUTRITION?

Malnutrition is considered as a most alarming condition which deteriorates the child/adults health and development. There are several major causes of malnutrition which are as follows:

• Unhealthy dietary conditions
• Recurrent illnesses
• Difficulty in managing foods to keep health
• Weight loss
• Wasting
•  Poor socioeconomic conditions like poverty and inflations
•  Absence of access towards nutritious foods
•  certain chronic illnesses like cancers, diarrhea, nausea or difficulty in swelling the food
• Lack of balanced diets in pregnancy, during breastfeeding and in childhood.
•  Certain health problems like depression, dementia and certain eating disorders like anorexia and bulimia may cause may malnutrition
•  The intake through dependent intravenous feedings due to serious illnesses

It is noteworthy that the less nutrition may cause serious issues like:

• Short term and long term health issues
• Slowing down the recovery time from wounds and diseases
• Probability to encounter infections increases.

In addition to all these, certain nutritional deficiencies may trigger some other health related problems like:

Vitamin A	Night Blindness
Vitamin B1	Beriberi
Vitamin B2	Ariboflavinosis
Vitamin B3	Pellagra
Vitamin B5	Paresthesia
Vitamin B6	Anemia
Vitamin B7	Dermatitis
Vitamin B9 & B12	Megaloblastic anemia
Vitamin C	Scurvy
Vitamin D	Rickets and osteomalacia
Vitamin E	Fertility issues
Vitamin K	Blood Clotting issues
Iodine	Goiter
Iron	Anemia

HOW MALNUTRITION AFFECTS IN LONG RUN?

If not taken seriously, malnutrition may lead towards under nutrition. Under nutrition is more common among children and may cause deaths. Higher mortality rates of children in third world countries is mostly due to under nutrition like children mortality in Thar Pakistan.

In addition to this, lack of nutrition among children may leads towards

• Stunted growth
• Lack of cognitive abilities and IQ development
• It increases chances of diabetes, cardiovascular diseases and obesity.
• May develop serious malnutrition conditions like marasmas and Kwashiorkor.
• May develop anemia

WHAT IS OVER NUTRITION?

An old proverb which says that excess of everything is bad, It’s accurately implies upon the concept of over nutrition. Over nutrition is also considered as another type of malnutrition, it usually occurs due to excessive intake of certain type of foods or nutrients.

Over nutrition is associated with certain health related implications because it directly leads towards obesity or overweight.  As we all know that, people who are obese or overweight are at greater risk of:

• heart failures,
• high blood pressures,
• diabetes,
• high level of cholesterol and
• cancer

 It is worth pondering that the rate of over nutrition all over the world is growing day by day.  The World Health Organization in its recent reports revealed that 5.7% of children globally are overweight and the obesity level among adults and children is also on the rise.

 As discussed earlier mal-nutrition is due to imbalance in food intake or dietary options which are employed.  It usually occurs when a person have too much or very little quantity of the food which is required for overall growth and development.  Mal-nutrition is associated with lack of essential vitamins minerals and other essential trace items which are required by the body to perform certain body related functions.

 It is observed that the people who are in abundance of food or some other sources which are included as a food or the people who have enough food are at the same time more vulnerable towards mal-nutrition.

The common symptoms of over nutrition may include:

• More frequent urination
• Eye irritations
• Dry lips
• Heartbeat irregularity

WHAT ARE COMMON SYMPTOMS OF MALNUTRITION AMONG ADULTS AND CHILDREN?

 It is observed that children present some other types of mal-nutrition symptoms than the adults.  The following are the symptoms which are shown by the children and adults:

• Low body mass index
• Lack of growth and development
• Lethargy
• Irritation
• Slow cognitive development and behavioral response which ultimately leads words learning problems
• It is noteworthy that the problems associated with malnutrition last longer than expected.
• Limited intake of essential food items
• Some people malnutrition is due to improper or imbalanced phone intake due to non availability or because of eating disorders or in capabilities to absorb certain nutrients.
• Such problems may arise due to cancers, liver disorders, and nausea or due to certain medications which limit eating.
• Any oral or dental problem may intensify the problem of eating due to certain poorly fitted dentures.  Such issues require immediate attention from medical practitioners.
• Mental health
• Under nutrition or malnutrition can also influence the people who are having depression, dementia or anorexia nervosa.

 It’s pertinent to mention that the recovery from mal-nutrition and its common issues is reversible if the intervention and treatment is timely.  It is noteworthy that the eating disorders can affect the overall living style of the people and those who are living close to the affectees.

WHAT ARE SOCIOECONOMIC AND MOBILITY IMPLICATIONS OF MALNUTRITION?

 There are certain factors which contribute towards eating disorders or development of certain unhealthy eating habits there are certain points which need to ponder on:

• The condition when a person is not capable of leaving the home and buy certain food items
• If a person is not physically fit to make a meal
• When a person is living alone and not motivated to cook for himself
• When a person having no or very little skills about cooking
• Most importantly if a person is not having money to buy certain food items for survival.
• Digestives system failures
• Gastrointestinal issues
• There are certain situations when the person is not able to absorb or digest certain food items in such cases even healthy diet cannot overcome mal-nutrition.

There are certain digestive system and stomach problems which causes certain gastrointestinal issues

• Crohn’s disease
• certain types of ulcers like ulcerative colitis
• celiac problem
• consistent diarrhea  and vomiting
• unhealthy use of alcohol

 In modern age, the most of people considered alcohol drinks as a status symbol but such drinks are deteriorating the bodily conditions adversary.  One must understand that what is important for growth and development and what may cause damage and diseases.  Excessive use of alcohol may lead towards gastritis or any sort of long term problem to the pancreas. 

Such issues may cause serious problem

• Digestion of food
• Incapability to absorb vitamins
• Unable to produce certain types of hormones which may assist in metabolism
• Interestingly alcohol contains certain level of calories which cause loss of appetite.

WHAT ARE CERTAIN RISK FACTORS?

 Lack of adequate food is the basic problem which is widespread throughout the world and which causes long term malnutrition.

 Even in the rich countries, there are certain risks of malnutrition which may include

• Among older adults especially in hospitals or living their lives in long term institutional cares
• Among those people who are socially isolated due to certain physical conditions mobility issues or other factors
• The people who are having low budgets
• The people who are dealing with certain serious illnesses like cancers
• the people who are facing difficulties in absorbing certain type of foods and nutritional items
• The people who are having bulimia nervosa or anorexia nervosa are also become victim of malnutrition

 THE MAJOR CRITERION FOR THE IDENTIFICATION OF RISK

There are certain tools for identification of malnutrition risks among people.  Among adults there is a one tool which is called as Malnutrition Universal Screening Tool (MUST) which was introduced in 2018.

 It is a tool designed by the experts for the identification of malnutrition or malnourishment among adults especially older adults.  It has five steps. So that the healthcare professionals may easily diagnose and treat the conditions of malnutrition

 The five steps are as under:

• Calculation of body mass index and provision of score
• Notification of unplanned weight loss and provision of score
• Mention the mental situation.  it means that the health professionals gave the status about the mental and physical condition of the individual
• Addition of scores from step one to three
• On the basis of the score certain local level guidelines may be developed

 The score may fall between 3 categories:

• Low risk
• Medium risk
• High risk

The medical practitioners may use only MUST tool for the identification of malnutrition and the risk of malnutrition among adults.  But this particular test or tool is unable to identify certain level of nutritional imbalances or deficiencies

 The malnutrition can also be identified through Body Mass Index and Mid Upper Arm Circumference (MUAC) among children to comprehend the intensity of the problem. In certain conditions the medical practitioners also prescribe certain blood tests to identify the nutritional imbalance.

WHAT ARE THE MEASURES TO CATER MALNUTRITION?

One of the best to prevent and overcome malnutrition is to consume balanced diet only. One must include healthy food items in diet such as:

• Fruits, vegetables and grain
• The use of breads and potatoes are also considered as nutritious alternatives
• Eggs
• Milk and yogurt
• Fish
• Pulses and nuts

So, in order to prevent malnutrition, the individuals must follow the strict guidelines about foods. Awareness about food groups, the inclusion of vitamins, minerals, proteins, fats and other trace elements in diet is necessary to make a food balanced and healthy. Certain level of imbalances or deficiencies may cause serious sort of malnutrition. 

The malnutrition can be diagnosed and treated through induction of food supplements.  Under such circumstances the person is prescribed to eat certain types of foods which are high in calories or to induce certain high calorie nutritional formulas to further restore weights that are lost by the body.

However over-nutrition is commonly treated with loss of weight, certain restrains on dietary intakes and lifestyle changes.  The loss of weight also facilitate in the reduction of secondary conditions like diabetes and heart issues.  The weight loss may include certain exercises, meditations and prohibition from certain medications. If over nutrition not taken seriously then it may leads towards certain health implications:

• Diabetes
• Cancers
• Hypertensions and depression
• Cardiovascular illnesses

But, while reducing weights one must be consistent on following the strict procedures and routines and avoid intake of unhealthy diets. The schedule of exercise, walk, meditations and meal timings expedite the overall process.

CONCLUSIONS

Malnutrition is a worldwide issue that influences individuals, everything being equal, however it is particularly predominant in kids and pregnant ladies. There are two principal kinds of lack of healthy nutrition: under-nutrition and over-nutrition. Under-nutrition is described by an absence of fundamental supplements, while over-nutrition is portrayed by an overabundance of calories. The two kinds of malnutrition can have serious wellbeing outcomes, including hindering, squandering, weakened mental turn of events, and expanded hazard of ongoing illnesses.

There are many variables that can add to lack of healthy diet, including destitution, food instability, unfortunate admittance to medical care, and deficient information about nourishment. There are likewise various individual factors that can build the gamble of malnutrition, like hereditary qualities, ongoing infections, and certain prescriptions.

Fortunately malnutrition is preventable. There are various mediations that can be viable in diminishing the predominance of malnutrition, including:

• Further developing admittance to protected and nutritious food
• Giving nourishment schooling
• Advancing breastfeeding
• Treating basic medical issue

Lack of healthy diet is a difficult issue, however one can be settled. By cooperating, we can assist with guaranteeing that everybody approaches the nutrition they need to carry on with a happy and useful life.

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