1 understanding malnutrition-1

8/2/2019 1 Understanding Malnutrition-1

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UNDERSTANDINGMALNUTRITION


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WHAT'S MALNUTRITION?

An imbalance between the nutrients the body needs & what it canget

VULNERABLE GROUPS : children, pregnant women & nursingmothers, sick people, people living with HIV/AIDS, old people


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NUTRIENTS?

Carbohydrates, proteins, fats, vitamins & minerals the body needsfor energy & to grow, develop & stay healthy


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CAUSES OF MALNUTRITION


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Three Types of MalnutritionAcute Malnutrition Chronic Malnutrition Underweight

Measured by Weight/Height Height/Age Weight/Age

A child looks

Thin, Emaciated Short Thin/Emaciated

and/or Short

Causes

Sudden, short-term lack of

nutrients (often too little food)

Generally longer term

nutritional problems

(quality of food)

Quantity of food, quality

of food or both

Reversible ? Easily with the right treatment

Possibly not once child

goes beyond 24-36

months

Defined as Global Global Global

ModerateSevere

(Marasmus/ Moderate Severe Moderate Severe

26 mois 52 mois


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Acute Malnutrition


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Acute Malnutrition or Wasting

Indicator

Weight for Height index

It develops rapidly in association with a sudden shortageor repeated shortages.

Aggravating factors :

- hunger gaps or lean seasons

- severe epidemics

- sudden or repeated changes of diet- war or conflict

Severe cases of acute malnutrition are responsible for

most infant deaths

He's too thin ! Thin, emaciated


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Global Acute Malnutrition or GAM

GAM =

PERCENTAGE

or PREVALENCE

of cases in a

given population

Severe

Acute

Malnutrition

SAM

Moderate

Acute

Malnutrition

MAM

Marasmus Kwashiorkor


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Moderate Acute Malnutrition (MAM)

Moderate weight loss(weight-height ratio 70% to 80% of average)

Severe Acute Malnutrition (SAM)

Major weight loss (weight-height ratio less than 70%)

with very high risk of death


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Marasmus

ACUTE MALNUTRITION

Child appears old & withered with protruding ribs & prominent joints.

Child has nothing in reserve to fight potentially fatal diseases (pneumonia, diarrhoea,

measles )

Most common form of acute malnutrition.

The child wastes away & is chronically thin.


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Kwashiorkor

Child has swollen stomach & oedema

swellings in feet, legs and or face caused by

accumulation of fluid.

Probable cause is diet lacking proteins & other nutrients. Oedema appear in BOTH feet and

spread up if child is not treated.

Like marasmus, kwashiorkor reduces the body's resistance to infection & can be a direct

cause of death.


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Chronic Malnutrition


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Chronic malnutrition or stunting

Girl aged 21 months

Boy aged 8 years

He's small for his age!

A child who is malnourished for a prolonged period will not grow normally

Develops slowly & silently as a

result ofpoverty

Poor diet ( e.g. just cereals)

Poor sanitation (e.g. No drinking water)

Children of the same age

Height-for-age index


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QUICK QUIZ

- What does chronic malnutrition cause ?

- What causes chronic malnutrition ?

- What does acute malnutrition cause?

- What causes acute malnutrition ?

- Name 2 forms of Severe Acute Malnutrition


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Micronutrient Deficiencies


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Iron

Your body needs iron to :-Produce hemoglobin(red blood cells that carry O2)- Transport electrons (energy carriers) in your cells- Ensure enzymes (which make cells work) do their job

Most common nutritional problem in world Causes ANEMIA

Iron deficiency

Anemia from

iron deficiency

Anemia(Vitamin A, B12, B9, C

deficiency, malaria, parasitic

Infestation, hereditary disease )

Causes varyin differentpopulations


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Impact of iron deficiency

Affects

- Physical & productive capability

- Ability to think effectively

- Capacity to fight disease

- Capacity to resist disease

Children

- Learning difficulties

- Behavioural problems

- Height/growth deficiencies

Pregnant women

- Severe anemia : 20% of deaths in childbirth

- Risk of miscarriage or birth defects

- Risk of premature delivery

- Risk of low birthweight


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Solutions

Iron & folic acid (Vitamin B9) supplements (during pregnancy)

Mosquito nets (to prevent malaria)

Regular deworming/anti-parasite medication

Eating food rich in iron

- Heminic iron (animal products)

body absorbs 5-35%

- Non-heminic iron (vegetables - cereals)

body absorbs 1-5%


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Vitamin A

Public health problem-More than 250 million pre-school-age chidren- More than 3 millions children have xerophthalmia (eye can'tproduce tears) of whom 10% go blind

2 types of Vitamin A

-Retinol (animal origin)- Carotenoids (plant origin)

1st vitamin ever discovered (1913)

Helps fight infection


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Vitamin A deficiency

Vitamin A is essential for :-synthesising visual pigments needed for seeing in the dark- organ growth (bones, lungs, intestins, skin)

- production of melanin & keeping your skin healthy

- body's defences against disease (immune system)

Consequences of Vitamin A deficiency

- xerophthalmia (Eye problems 90% / Blindness 10%)

- Skin problems (dry skin)

- Night blindness

- Susceptibility to infection

- Bone-growth problems


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Solutions

Vitamin A supplements

Children : From : 6 months to 59 months (every 6 months)

- 100 000 UI between 6 and 11 months

- 200 000 UI thereafter

Women : 6 weeks after giving birth

Eating food rich in Vitamin A

- Plant sources : Fruit, vegetables & orange-coloured roots

- Animal sources: Liver, meat, eggs, butter, milk & milk products


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Iodine

Iodine is essential for :

-Thyroid gland & hormones that affect growth & development- Growth of cells

- Mental development

Iodine deficiency in the world :

- 1.989 billion people of whom 285 million are pre-school-age

children particularly pregnant women & young children


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Consequences of idoine deficiency

- Hypothyroidism (Impaired thyroid hormone synthesis)

- Spot urine test

Clinical- Goiter (Thyroid swells)

- Mental retardation (all ages)

- Cretinism

- Perinatal death (still-born babies,

miscarriages)


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Solution

Add iodineto salt


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Zinc

Consequences of zinc deficiency

-Growth problems (main cause of stunting)- Delayed sexual maturity (boys)

- Complications in pregnancy & childbirth- Infections : Diarrhoea supplements help

- Appetite loss

- Diminished immune response

- Skin rashes

Prevalence (?) an estimated 27% of the population does notconsume enough zinc


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Micronutrient deficiency ... has a huge cost for society

Major & multiple impact on the health of individuals

Pregnant women, infants, children

Important economic implications

Diminished intellectual capacity learning difficulties

Reduced productivity

Increased health costs

Loss of human & social capital

Reduction of GDP


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Food Fortification

Vitamin A in cooking oil

Iron, zinc, folic acid & B

vitamins in wheat flour

Iodine in salt


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Hygiene

Wash hands with soap

Keep area around house clean

Clean drinking water

Use latrines or toilets or cover

excrement with soil

WASH strategy


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QUICK QUIZ

- What does iron deficiency cause ?

- What does iodine deficiency cause ?

- What does Vitamin A deficiency cause ?

- Which vegetables are rich in Vitamin A ?


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How observant are YOU ?

Describe a child with MARASMUS ...

Describe a child with Kwashiorkor


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Malnutrition can be avoided Solutions exist

Malnutrition can be treated If it is caught in time!

Thank you

1 understanding malnutrition-1

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