Overview of Malnutrition

Malnutrition Overview

• Malnutrition is a cellular imbalance between nutrient/energy supply and the body's demand for these to ensure growth, maintenance, and specific functions (WHO).
• Types of malnutrition include under-nutrition and over-nutrition. Under-nutrition involves insufficient nutrients, and over-nutrition involves excess nutrients. Both can lead to nutritional disorders.

Causes of Malnutrition

• Primary causes:
• Low income/purchasing power
• Scarcity of food supply
• Ignorance/erroneous food habits
• Overpopulation
• Secondary causes:
• Obesity, insulin resistance, and diabetes
• Hepatobiliary disorders
• Metabolic and renal diseases
• Diarrhea and intestinal malabsorption
• Infections (especially respiratory)

Disorders Due to Malnutrition

• Protein-energy malnutrition:
• Kwashiorkor (children 1-3 years old) - characterized by edema and enlarged liver with fatty infiltrates, caused by sufficient calorie intake but insufficient protein.
• Marasmus - severe protein-energy malnutrition, characterized by energy deficiency and emaciation.
• Under-nutrition of vitamins and minerals:
• Calcium deficiency (Rickets)
• Iodine deficiency (Goiter)
• Iron deficiency (Anemia)
• Zinc deficiency (growth retardation)
• Vitamin B1 deficiency (Beriberi)
• Vitamin B3 deficiency (Pellagra)
• Vitamin C deficiency (Scurvy)
• Vitamin D deficiency (Rickets)

Differences Between Kwashiorkor and Marasmus

• Kwashiorkor: Occurs in children 6 months to 3 years. Subcutaneous fat is preserved. Edema, enlarged fatty liver, less prominent ribs. Muscle wasting is mild or absent. Poor appetite. Needs adequate protein.
• Marasmus: Occurs in infants under one year. Subcutaneous fat is not preserved. No edema, no fatty liver, very prominent ribs. Severe muscle wasting. Alert and irritable. Needs adequate protein, fats, and carbohydrates.

Types of Beriberi

• Wet beriberi: Generalized edema, acute cardiac symptoms, prompt response to thiamine administration.
• Dry beriberi: Edema not present, neurological symptoms.

Niacin Deficiency (Pellagra)

• Pellagra is caused by a lack of vitamin B3 (niacin).
• Symptoms include inflamed skin, diarrhea, dementia, and sores in the mouth.

Goiter

• Goiter is a neck swelling from enlarged thyroid gland.
• Commonly due to iodine deficiency or thyroid gland inflammation.

Anemia

• Iron-deficiency anemia is common. Caused by insufficient iron intake/absorption and/or blood loss from various sources (intestinal, uterine, or urinary).

Rickets

• Rickets is softening of bones in immature mammals.
• Due to vitamin D, phosphorus, or calcium deficiency/impaired metabolism.

Malnutrition Prevention and Management

• Plumpy'mum: 75g sachet (408 kcal), promotes healthy development of fetus/child, prevents/treats acute malnutrition in pregnant and breastfeeding women and girls. One sachet per day per woman.
• Plumpy'Doz: 50g sachet (270 kcal), food supplement for children 6 months and older. One sachet per day per child.
• Plumpy'Sup: 100g sachet (540 kcal), supplements breastfeeding and usual diet, approximately 75 kcal/kg/day for 2 months for children 6 months and older.
• F-75 Therapeutic milk: 400g tin (75 kcal/100ml), for the initial phase of treatment of severe acute malnutrition according to WHO protocol. Children 6 months or older.
• F-100 Therapeutic milk: 400g tin (100 kcal/100ml), for the nutritional rehabilitation phase of treatment for severe acute malnutrition. Children 6 months or older.
• Plumpy'Nut: 92g sachet (500kcal), for treatment of severe acute malnutrition without medical complications and with appetite. Children 6 months or older, 150-185 kcal /kg/day for 4 to 8 weeks.
• Enov/Nutributter: 20g sachet, prevents malnutrition and contributes to healthy child development, for children 6 to 23 months. One sachet per day per child.
• Therapeutic CMV: 800g tin, for reconstitution with other ingredients of F-75 and F-100 therapeutic milk. Children with severe acute malnutrition.
• Appéti'mix: 4kg bucket, high protein, high calorie paste enriched with vitamins and minerals, intended for mass catering to combat undernutrition in the elderly.

This quiz covers the essential aspects of malnutrition, including its definition, causes, and types. It explores key terms such as under-nutrition and over-nutrition, as well as associated disorders like protein-energy malnutrition. Test your knowledge on this critical public health issue.