Definning Malnutrition a note on with comprehensive details

Everything on Malnutrition

1. DEFINING MALNUTRITION
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2. PRESENTATION OUTLINE:
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Definition of Malnutrition
Forms of Malnutrition
Group Work-Causes Of Malnutrition
Forms Of Undernutrition
Terms, Definition And Classification Of Acute Malnutrition

3. DEFINITION OF
MALNUTRITION
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Malnutrition is a condition in which the body is
deficient in energy(or excess) , protein and
micronutrients, causing measurable adverse effects
on the body functions.

4. 1) Over Nutrition-Over nutrition occurs when consuming a diet
that is more than the body needs or amount the body needs to
remain healthy.
2) Under nutrition-Caused by inadequate intake or poor
absorption of nutrients in the body. (PEM)
3) Micronutrient deficiency (hidden hunger)- is a nutritional
disorder in which there is a lack of one or more of the
micronutrients required for health.
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Forms of Malnutrition

5. Types of acute malnutrition
•Its caused by a decrease in food consumption and/or illness
•Types:
–Severe Acute Malnutrition (SAM) –defined by the
presence of bilateral pitting oedema or severe wasting
–Moderate Acute Malnutrition (MAM) – defined by
moderate wasting
–Global Acute Malnutrition – comprises both MAM and
SAM
•Why focus on acute malnutrition?
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6. Child Mortality
•53% of child mortality
associated with
undernutrition
•Severe wasting is an
important cause of these
deaths
•Proportion associated
with acute malnutrition
often increases
dramatically in
emergency contexts
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7. Group work-Causes of Malnutrition
•Participants working in groups, identify the
immediate, underlying and basic causes of
malnutrition.
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8. Forms of Undernutrition
•Under nutrition is a consequence of a deficiency in nutrients in
the body and can take the form of:
–Acute malnutrition (bilateral pitting oedema or wasting)
–Stunting
–Underweight
–Micronutrient deficiencies
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9. “STUNTING”
WASTING
AND
STUNTING
Height-for-Age (HFA) reflects
skeletal growth
Weight-for-Age (WFA) is a
composite index and is used as a
measure of ‘underweight’
“WASTING”
Weight for Height/Length reflects
recent weight loss or gain

10. The 3 children have the same age
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Same
weight
Same
height
?

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Normal Wasted Stunted Stunted & Obese
WfA = 0 Z WfA < -3 Z WfA < -3 Z WfA = 0 Z
WfH = 0 Z WfH < -3 Z WfH < 0 Z WfH > +3 Z
HfA = 0 Z HfA = 0 Z HfA < -2 Z HfA < -2 Z

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Terms  Definitions
 
 
Acute malnutrition
 
•Bilateral pitting oedema
•MUAC < 12.5 cm Or WHZ< -2
 
 
Moderate acute
malnutrition (MAM)
 
 
•MUAC <12.5 cm and ≥ 11.5 cm

Or WH z-score < -2 and ≥ -3
 
 Severe acute
malnutrition (SAM)
 •Bilateral pitting oedema +/++/+++
•MUAC < 11.5 cm Or WHZ < -3
•A child with SAM has an elevated
risk of death
 
 
Clinical manifestations
of SAM
•Marasmus (severe wasting)
•Kwashiorkor (oedema)
•Marasmic kwashiorkor

13. CLASSIFICATION OF ACUTE
MALNUTRITION
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INDICATORS CLASS of AGE Moderate Acute
MALNUTRITION
Severe Acute
MALNUTRITION
Bilateral
Oedema
All No Yes
W/L(H)
WHO
2006
Children <-2 to – 3 Z-score< - 3Z-score
W/H % Adolescents 70 to <80% <70%
BMI Adults 16 to 17 <16
MUAC Children: >6 mo
Adults
PW
LM
11.5 to <12.5 cm
18.0 to <21.0 cm*
<21.0 cm
<21.0 cm
* Provisional cut off
<11.5 cm
<160 cm*
With recent weight
loss

14. Conceptual framework for undernutrition
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15. IMMEDIATE CAUSES
•At the first level are dietary intake and disease: factors that
directly impact on an individual’s nutritional status. These are
known as the immediate causes of undernutrition.
•Dietary sufficiency in terms of energy and essential nutrients is
critical for the normal growth and development of infants and
young children.
•For infants, breast milk is recognized as the best source of
bioavailable nutrients.
•In addition, breast milk provides the infant with maternal
antibodies which protect against infection and also factors
which promote development of the infant’s gastrointestinal tract
and immune system.
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16. Immediate causes of undernutrition
(Inadequate Food Intake)
•Breastfeeding also provides a simple way to avoid
contamination of food in early childhood.
•The WHO recommends that infants are exclusively breastfed
for the first 6 months of life.
•After 6 months of age, children must be provided with
complementary foods that are adequate in terms of quality,
quantity and diversity to ensure that all energy and nutrient
requirements are met.
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17. Immediate causes of undernutrition
(Inadequate Food Intake)… Cont
•The energy and nutrient requirements for children must be met to
ensure appropriate growth and development in childhood.
• Acute or chronic insufficiency in energy or other nutrients such
as vitamins and minerals can have immediate and life-long
impacts on child health and functional capacity.
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18. Immediate causes of undernutrition (infections)
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Acute Respiratory Tract
(ARI) Infections s
Undernutrition affects ARI by:
• Increasing severity
• Increasing risk of death
ARI affects nutritional status by:
• Reducing appetite
• Increasing metabolic rate resulting in
muscle breakdown
Measles Undernutrition affects measles by:
•Increasing duration
•Increasing severity, especially if deficient in
vitamin A
•Increasing risk of death
 
Measles affects nutritional status by:
• Reducing appetite
• Decreasing levels of plasma vitamin A
• Prolonging immune suppression resulting
in increased risk of ARI and diarrhoea
• Increasing metabolic rate resulting in
muscle breakdown.
• Increasing the loss of proteins into the gut
Malaria Undernutrition affects malaria by:
Increasing severity in deficiencies of vitamin A
and zinc
Malaria affects nutritional status by:
• Reducing appetite
• Increasing metabolic rate
• Destroying red blood corpuscles leading to
anemia
• Impairing foetal development leading to
low birth weight
Diarrhoea or dysentery
(e.g. shigellosis)
Undernutrition affects diarrhoea by:
• Increasing duration
Diarrhoeal disease affects nutritional
status by:
• Reducing absorption
• Reducing appetite

19. UNDERLYING CAUSES
•Factors affecting dietary intake and health status – those that
operate at the household and community levels – are on the second
level of the framework and are known as the underlying causes of
undernutrition.
•They comprise household food security, care for women/children
and health environment/health services and are underpinned by
income poverty.
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20. Underlying causes of
undernutrition
•Food availability: enough food is
available on a consistent basis from
that generated by domestic
production or imports
•Food access: the ability of
households or individuals to obtain
nutritious food
•Food Stability (or resilience): a
community’s ability to withstand
future shocks (environmental,
financial etc)
•Food utilization: people must be
sufficiently healthy to absorb and use
the nutrients ingested
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21. Underlying causes of undernutrition
(Social and care environment )
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•Caring practices are dependent on resources such as income and
time as well as cultural factors and attitudes to modern health
services, water supplies and sanitation.
•Economic constraints also impact the frequency of feeding and
dietary variety available for children.
•The time mothers have available to play with and stimulate their
children in early life is also important for mental development
and can have life-long effects.
•An environment with good quality sanitation and a sufficient
supply of clean drinking water is critical to reduce the incidence
and spread of disease in families and communities.

22. BASIC CAUSES
•The third level, the basic causes of undernutrition, are a broad
set of factors that operate at the sub-national, national and
international levels and range from structural and natural
resources, social and economic environments to political and
cultural contexts.
Political, economic, legal and ideological factors (including
religion, culture and tradition) may defeat the best efforts of
people to attain good nutrition
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23. Potential actors that need to become involved in efforts to reduce
undernutrition.
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24. THE END
•THANK YOU!!!
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