Malnutrition Overview Lecture PDF Jan 2024

MALNUTRITION OVERVIEW ANRI HUMAN PHYSIOTHERAPY DEPARTMENT, UNIVERSITY OF PRETORIA MAM INTRODUCTION Underweight SAM Overweight/obesity...

MALNUTRITION OVERVIEW ANRI HUMAN PHYSIOTHERAPY DEPARTMENT, UNIVERSITY OF PRETORIA MAM INTRODUCTION Underweight SAM Overweight/obesity Nutrients Deficiency Excess Food energy Starvation / marasmus Obesity, DM, CVD Fat Malabsorption of vitamins / CVD Starvation / Stunted brain development Protein Kwashiorkor None Sodium Hyponatremia Hypertension / hypernatremia  Conditions associated with malnutrition: Macro and INTRODUCTION CONT. Decreased mental agility (cognition) micro nutrients Mental disorders Cancer Failure to thrive Delayed / decreased brain development Nutrients Deficiency Excess Iron Anemia Cirrhosis / CVD Vitamin B2 Cracking of skin / ulcers None Vitamin D Rickets / osteoporosis / Dehydration / vomiting / chronic inflammation constipation Calcium Osteoporosis / tetany / Fatigue / depression / arrhythmias confusion / anorexia CHILDHOOD MALNUTRITION Link with SDG Children < 5 years Stunting, underweight,Vit A deficiency, anaemia MDT (who)? Protein energy malnutrition (PEM) due to: lack of food, clean water, poor sanitation and social unrest (lack of food resources) Childhood morbidity and mortality (especially low and middle-income countries)  Screening ASSESSMENT (at risk, ill) ECI Differential Dx: cancer, chronic illness, goiter (enlarged thyroid) skin, eyes, hair, mouth and bones Severity: pallor, weight, oedema, weightgain, mm height; weight; skin fold wasting thickness; waist and hip ratio; body mass index; Clinical assessment MUAC and HC Anthropometric assessment Dietary assessment Biochemical Laboratory assessment Serum proteins, creatinine / hydroxyproline 24 hour diet details Haematological Breast & / complimentary feeding At risk: RTHC, anemia, CBC, iron, vitamin levels Feeding techniques wasting, developmental delay, Microbiology Food habits and calorie intake calculations failure to thrive etc Parasites / infections  MANAGEMENT OF PEM (WHO GUIDELINES) Organisation of care Treat electrolyte imbalance Proper triage Treat micronutrient deficiencies Stabilisation and rehabilitation Initial re-feeding Prevent hypoglycemia Catch-up growth Prevent and treat hypothermia Stimulation and support Treat dehydration Prepare for follow-up Monitor  WITH THANKS TO DR M. COCHRANE & MRS M. RAS-GREYLING FOR THEIR INPUT UNICEF-WHO-The World Bank joint child malnutrition estimates (jme_unicef_who_wb) Anthropometric Indicators Measurement Guide (anthropometry-2003-ENG) WHO updates on the management of severe acute malnutrition in infants and children WHO Website (IMCI): http://www.who.int/child- adolescent-health.