Malnutrition in Children: A Major Threat to the Under Nourished Children

Malnutrition in children is a significant global health issue that affects millions, particularly in low- and middle-income countries. It encompasses both undernutrition, which includes stunting, wasting, and micronutrient deficiencies, and overnutrition, leading to obesity. Malnutrition during childhood has severe implications, including impaired growth and cognitive development, increased susceptibility to infections, and higher mortality rates. The causes are multifaceted, ranging from inadequate dietary intake and poor healthcare to socioeconomic factors and lack of education. Addressing malnutrition requires comprehensive strategies, including improving food security, enhancing maternal and child healthcare services, promoting breastfeeding, and implementing effective public health policies. Collaborative efforts from governments, non-governmental organizations, communities, and families are essential to combat this issue and ensure that all children have the opportunity to reach their full potential.

1. MALNUTRITION MALNUTRITION IN CHILDREN : A MAJOR THREAT TO GLOBAL CHILDREN Name: Gurjant Singh Course: MSc. Botany Enroll No. : 27202111753 Subject: Genetics & Cytogenetics Guru Nanak Dev University, Amritsar

2. Contents Introduction Classification of Malnutrition WHO’s Classification on Malnutrition Burden of Malnutrition Clinical Forms of Classification Marasmus Kwashiorkor Clinical Signs of Kwashiorkor Conceptual framework for the causes of Malnutrition in Society Causes of Under Nutrition Chronic illnesses that commonly are associated with nutritional deficiencies include the following Who is vulnerable to under nutrition?

3. Cont … Millennium Development Goal 1 Millennium D evelopment G oal 2 Country’s Nutritional Profil Trends of nutritional status of young children in india . Clinical impact of Pediatric Malnutrition Conclusion

4. Introduction The world Health Organization (WHO) defines 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 ”

5. Cont … MALNUTRITION is abroad term Commonly used as an alternative to under nutrition but technically it also refers to over nutrition. People are malnourished if their diet doesn’t provide adequate calories and protein for growth and maintenance or they are unable to fully utilise the food they eat due to illness (under nutrition). They are also malnourished if they consume too many calories (over nutrition). (UNICEF)

6. Classification of Malnutrition

7. WHO Classification on Malnutrition

8. Burden of Malnutrition

9. Clinical Forms of Malnutrition There are 3 clinical forms of acute malnutrition. MARASMUS – sever weight Loss or wasting. KWASHIORKOR – bloated apperance due to Water retention. MARASMIC-KWASHIORKOR – a combination of both wasting and bi-lateral oedema.

10. MARASMUS A rapid deterioration in nutritionl 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 can affect both children and adults. The child is at risk for : Hypoglycemia Hypothermia Fluid overload/heart failure Infection

11. KWASHIORKOR 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 faces. 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 is classified by the severity of the oedema, as follows: +Mild: both feet ++ Moderate :both feet, plus Lower legs, hands or lower arms. +++ Severe: generalised oedema including both feet, legs, hands, arms and face.

12. Clinical S igns of K washiorkor

13. Conceptual F ramework for the causes of M alnutrition in S ociety

14. Causes of under N utrition nder 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 casualty: 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 household to attain good nutrition and these are described as basic causes of under nutrition.

15. Cont … Inadequate food intake is th ecommon Malnutrition worldwide. In developing countries, inadequate food is secondary to insufficient or inappropriate food supplies or early cessation of breastfeeding. In some areas, cultural and religious food customes may play a role. Inadequate sanitation further endangers children by increasing the risk of infectious diseases that increase nutritional losses and alters metabolic demands. In developed countries, inadequate food intake is a less common cause of malnutrition. Instead, diseases and,in particular, chronic illnesses play an important role in the etiology of malnutrition. Children with chronic illnesses are at risk of nutritional problems for several reasons, including the following:

16. Cont.... Anorexia, which leads to inadequate food intake. Increased inflammatory burden and increased metabolic demands can increase caloric need. Any chronic illnesses that involves the liver or small bowel affects nutrition adversely by impairing digestive and absorptive functions .

17. Chronic illnesses that commonly are associated with nutritional deficiencies include the following Crystic fibrosis Chronic renal failure Childhood malignancies Congenital heart diseases Neuromuscular diseases Chronic inflammatory bowel diseases

18. Who is vulnerable to under nutrition? Group vulnerable to under nutrition typically include those with increased Nutrients 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 population, inaccessible population) as well as political vulnerability (minority groups). Older people, the disabled, people with Chronic illnesses and people living with HIV and AIDS.

19. Cont.... The world health organization estimate that by the year 2015, the prevalence of malnutrition will have decreased to 17.6% globally, with 113.4 million children younger than 5 years affected As measured by low weight for age. The overwhelming majority of these children, 112.8 million, will live in developing countries with 70% of these children in Asia, particularly the south central region, and 26% in Africa. An additional 165 million (29.0%) children will have stunted length/height secondary to poor nutrition. In Sub-Saharan Africa, 30% of the children have PEM.

20. Millennium D evelopment G oal 1 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 similarproportions for Severely wasted children.

21. MDG-2 There is only one target for millennium development goal 2: To ensure that children universally- including both boys and girls- will be able to complete a full course of primary education by 2015 .

22. Country’s Nutrition Profiles Countries in early nutrition transition Moderate levels of overweight and obesity, moderate levels of under nutrition in specific population and age groups and widespread micronutrients deficiencies. Egypt,Jordan , Lebanon,Libyan Arab jamahiriya , Morocco , Palestine and Syrian Arab Republic. Countries inadvanced Nutrition transition High levelss of overweight and obesity, and moderate levels of nutrition and micronutrient defeciencies. Islamic Republic of Iran and Tunisia and all member countries of the gulf cooperation council (GCC) except Yemen.

23. Trends of nutritional status of young children in I ndia .

24. Clinical impact of P ediatric M alnutrition

25. Conclusion: Malnutrition in children is a critical global issue impacting health, development, and survival. Addressing it requires improved access to nutritious food, enhanced maternal and child healthcare, breastfeeding promotion, and effective public health policies. Collaborative efforts from governments, NGOs, communities, and families are vital. Prioritizing nutrition can break the cycle of poverty and illness, ensuring a healthier future for the next generation.

26. THANK YOU! Gurjant Singh