Malnutrition

Presented by SHWETA SINGH

1. MALNUTRITION Presented by- SHWETA SINGH M.PHARM 1 ST YEAR

2. Food is the prime necessity of life. The food we eat is digested and assimilated in the body and used for its maintenance and growth. Food also provide energy for doing work. INTRODUCTION

3. The process of providing or obtaining the food necessary for health and growth. NUTRITION

4.   A diet that contain adequate amounts of all the necessary nutrients require for the health growth and activity such as Carbohydrate, proteins, fats, vitamins and minerals. BALANCE DIET

5. Malnutrition is defined as imbalance between the body’ s need and the intake of nutrients, which can lead to nutritional disorders. Malnutrition is the condition that develops when the body does not get the right amount of the vitamins, minerals, and other nutrients it needs to maintain healthy tissues and organ function. MALNUTRITION

6. NUTRIENTS MICRONUTRIENTS Micronutrients are vitamins and minerals needed by the body in very small amounts. However, their impact on a body’s health are critical, and deficiency in any of them can cause severe and even life-threatening conditions. MACRONUTRIENTS Macronutrients are nutrients that provide calories or energy and are required in large amounts to maintain body functions and carry out the activities of daily life. There are three broad classes of macronutrient: Proteins Carbohydrates Fats

7. DEFINITION “ACCORDING TO WHO” Malnutrition as "the cellular imbalance between the supply of nutrients and energy and the body's demand for them to ensure growth, maintenance, and specific functions” MALNUTRITION

8. Types of malnutrition

9. Types of malnutrition

10. PROTEIN -ENERGY MALNUTRITION ( pem )   ( PEM ), sometimes called  protein-energy undernutrition  ( PEU ), is a form of malnutrition that is defined as a range of conditions arising from coincident lack of dietary protein and/or energy (calories) in varying proportions. The condition has mild, moderate, and severe degrees. Types include: [ Kwashiorkor  (protein malnutrition predominant) Marasmus  (deficiency in calorie intake) Marasmic kwashiorkor  (marked protein deficiency and marked calorie insufficiency signs present, sometimes referred to as the most severe form of malnutrition)

11. Kwashiorkor is characterized by bilateral pitting oedema (affecting both sides of the body) in the lower legs and feet which as it progresses becomes more generalised to the arms, hands and face. Oedema is the excessive accumulation of fluid in body tissues which results from severe nutritional deficiencies.  All cases of kwashiorkor are classified as severe acute malnutrition. KWASHIORKOR

12. Kwashiorkor is classified by the severity of the oedema , as follows: + Mild: both feet ++ Moderate: both feet, plus lower legs, hands or lower arms. +++ Severe: generalized oedema including both feet, legs, hands, arms and face.

13. Clinical signs of kwashiorkor include: Loss of appetite Apathy and irritability Changes in hair colour (yellow/orange) Dermatosis is described based on the severity of signs as follows: + Mild : Discolouration or a few rough patches ++ Moderate : Multiple patches arms and/or legs +++ Severe : Flaking, raw skin, fissures

14. A rapid deterioration in nutritional status in a short time can lead to marasmus , one form of acute malnutrition. Marasmus is the most common form of acute malnutrition in nutritional emergencies and, in its severe form, can very quickly lead to death if untreated. It is characterized by severe wasting of fat and muscle which the body breaks down to make energy. Wasting (Low weight-for-height)can affect both children and adults. MARASMUS

15. The child at risk for: Hypoglycemia Hypothermia Fluid overload/ heart failure Infection A wasted child can be classified as either moderately or severely acutely malnourished based on body measurements.

16. Conceptual framework for the cause of malnutrition in society

17.  Under nutrition has many inter-related causes which need to be identified in order to effectively design an emergency response. The UNICEF conceptual framework for under nutrition is a useful tool for understanding the causes of under nutrition. It describes three levels of causality: Immediate, Underlying and Basic The immediate cause of under nutrition is due to an imbalance between the amount of nutrients absorbed by the body and the amount of nutrients required by the body as a consequence of too little food intake or infection. The underlying causes of under nutrition can be grouped under the three broad categories of food insecurity, inadequate care and poor public health. Political, legal and cultural factors may defeat the best efforts of households to attain good nutrition and these are described as basic causes of under nutrition.

18. Immediate cause Reduced dietary intake Reduced absorption of macro- and/or micronutrients Increased losses or altered requirements Increased energy expenditure (in specific disease processes) Underlying causes food insecurity inadequate care and poor public health Basic causes Political, legal and cultural factors

19.  Groups vulnerable to under nutrition typically include those with increased nutrient requirements: children, pregnant and lactating women. However, risk of under nutrition is related to more than just physiological vulnerability. Groups within the population can be at risk of under nutrition due to geographical vulnerability (displaced populations, inaccessible populations) as well as political vulnerability (minority groups). Older people, the disabled, people with chronic illness and People living with HIV and AIDS WHO ARE VULNERABLE TO UNDER NUTRITION ?

20.   Globally, 51 million under-five year olds were wasted and 17 million were severely wasted in 2013. Globally, wasting prevalence in 2013 was estimated at almost 8% and nearly a third of that was for severe wasting, totaling 3%. In 2013, approximately two thirds of all wasted children lived in Asia and almost one third in Africa, with similar proportions for severely wasted children.

21. The problem of malnutrition can be solved by taking action simultaneously at various levels- family, community, national and international levels and it also requires coordinated approach of many disciplines- nutrition, food technology, health administration, health education, etc. ➢ Action at the family level The instrument for combating malnutrition at the family level is nutrition education. Harmful food taboos and dietary prejudices can be identified and corrected. The promotion of breast-feeding and improvement in infant and child feeding practices are the two areas where nutrition education can have a considerable effect. PREVENTION OF MALNUTRITION

22. Attention should also be focused on the nutritional needs of expectant and nursing mothers and children in the family. The shortage of protective foods can be met to some extent by planning a kitchen garden or keeping poultry. Other activities include mother and child health, family planning, immunization services. Community health workers and the multipurpose workers impart nutrition education to the families.

23. ➢ Action at the community level Increasing the availability of food both in quantity and quality. The Applied Nutrition Programme is an attempt at production of various types of protective foods by the community for the community. The integrated child development services (ICDS) programme to deliver a basic minimum package of supplementary nutrition, immunization, health check-ups, health and nutrition education. Significant improvement in overall living conditions such as health education, improvement of water supply, control of infectious diseases.

24. ➢ Action at the national level • The strategies and approaches undertaken at the national level in India are: ✓Rural development • The nutritional upliftment of people • To raise the living standards and purchasing power of the people ✓Increasing agricultural production Application of modern farming practices, the expansion of cultivated areas, the use of fertilizers, better seeds. Effective food distribution system by marketing, land tenure and food price policies.

25. ✓Stabilization of population By birth spacing and a small family norm. ✓Nutrition intervention programmes Prevention and control of endemic goitre through iodized common salt Control of anemia through distribution of iron and folic acid tablets Supplementary feeding programmes for preschool children ✓Nutrition related health activities National malaria eradication programme Programmes of immunization and improvement of environmental sanitation Programmes of family planning

26. ➢Action at the International level: World food programme in 1963 to stimulate and promote economic and social development as a means of providing enough safe food to those in need. Several international agencies such as the FAO, UNICEF, WHO, World bank, are working in close collaboration helping the national governments in different parts of the world in their battle against malnutrition.

27. 1.World Health Organization. Nutrition. [7 December 2010]. URL:   www​. who.int /topics/nutrition/en/index​.html . 2.World Health Organization. 10 facts on nutrition. [7 December 2010]. URL:  www​. who.int /features​/ factfiles /nutrition/en/index.html . 3.Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, et al. Maternal and child undernutrition : global and regional exposures and health consequences. Lancet. 2008;371:243–60. [ PubMed ] 4.Shetty P. Malnutrition and undernutrition . Medicine. 2003;31:18–22. 5.Victora CG, Adair L, Fall C, Hallal PC, Martorell R, Richter I, et al. Maternal and child undernutrition 2. Maternal and child undernutrition : consequences for adults health and human capital. Lancet. 2008;371:23–40. [ PMC free article ] [ PubMed ] reference

28. THANK YOU !