Malnutrition and Nutrient Deficiencies

Malnutrition indicates a poor nutritional state.
It encompasses deviations from adequate nutrition, including undernutrition, overnutrition, and specific deficiencies or excesses of vitamins and minerals.
Malnutrition arises from deficiencies, imbalances or excesses of nutrients, or from undiversified diets (incorrect food combinations).
Malnourished children who are ill are more likely to die.

A spectrum diagram showing the different types of malnutrition, including undernutrition and overnutrition, and the specific micronutrient deficiencies.
Specific micronutrients shown are Calcium, Vitamin D, B vitamins (including Niacin, Thiamin, and Folate), Iron, Iodine, and Vitamin A.

Undernutrition results from insufficient food energy intake, causing an energy imbalance and a persistent negative energy balance.
Children under five (U5) show a strong correlation to malnutrition; 45% of child deaths are linked to it.

These are two types of undernutrition.
Kwashiorkor is more common in older children and exhibits edema, scaly skin, wounds, blisters, and severe eye problems. It's linked with higher overall mortality. Treatment includes complex deficiencies and antibiotics with potential hospitalization.
Marasmus appears in younger children and shows a thinner physique and dry skin. Eye problems and lower mortality are typical. Treatment involves dietary management with high calories, protein, fruits, and vegetables.

Micronutrient deficiencies are referred to as "hidden hunger."
Hidden hunger occurs when foods lack sufficient vitamins and minerals to meet individual needs.
Billions of people face hidden hunger worldwide, often without experiencing physical hunger.
Micronutrient deficiencies are a global issue and are linked with a range of other factors.
Examples of commonly deficient micronutrients are iron, zinc, iodine, calcium, and Vitamin A.
Individuals deficient in these micronutrients are often trapped in a cycle of poverty and malnutrition.

Micronutrient deficiency manifests as diseases like Vitamin A deficiency (night blindness), Iron deficiency (anemia), and Iodine deficiency (goiter).
These deficiencies negatively impact child growth, development, and overall productivity.
They contribute to a compromised immune system and heightened risk of infections.
They also can impair economic growth.

The key signs and symptoms include: dryness and itching of the conjunctiva; night blindness; xerophthalmia (xerosis, Bitot spots); Keratomalacia; Dry, rough skin; Dry, brittle hair; Loss of smell and taste; Loss of appetite; Anemia and fatigue; Poor growth; Low immunity; And Increased risk of cancer.

Key signs include anemia, fatigue, increased sleepiness, lack of concentration, inability to focus, headaches, and brittle nails with possible spoon-shaped nails and white lines.

Overnutrition is caused by excessive energy intake exceeding the body's energy requirements. It leads to persistent positive energy balance.
Overnutrition typically manifests as overweight or obesity.
Overnutrition is classified using the Body Mass Index (BMI).
Adiposity, is better assessed by waist circumference (cm), including abdominal/visceral obesity.

BMI scores are used to assess levels of weight and health in individuals, ranging from underweight to excessively obese.
The different BMI categories show different health outcomes, ranging from weakness and poor health to cardiovascular diseases.
Physical symptoms become more pronounced as BMI declines; cardiovascular diseases and diabetes risk increase as BMI increases.

A visual representation classifying different levels of obesity based on BMI.
The categories included are underweight, normal, overweight, and different levels of obese.

General obesity involves body fat distribution throughout the body, with different shapes, such as "apple" (upper body) and "pear" (lower body) shapes.
Visceral or abdominal obesity specifically focuses on fat accumulation around internal organs, which correlates with increased cardiovascular risks.
It is distinguished from general obesity and is associated with more significant health risks.

Table showing the relationship between BMI classifications, waist circumference, and the increased risk of cardiovascular disease.
- Higher values of waist circumference and BMI show a higher risk.

Guidelines to measure and track waist circumference and waist hip ratio to assess body composition and health risks.
Specific measurements for men and women are presented.

Inadequate intakes of both macronutrients and micronutrients correlate with poor health outcomes and these effects can be immediate or long-term.
Different malnutrition combinations exist in any individual.
Hidden hunger prevention requires a varied diet rich in fruits and vegetables (FV).
Eating a variety of diets, from different food groups, and the right quantity are essential for preventing malnutrition.