Presented by:

Aiman Zahid
B.Ed. (weekend)
2nd semester
MPhil Botany
 Malnutrition
 Malnutrition is the condition that develops when the body is
deprived of vitamins, minerals and other nutrients it needs to
maintain healthy tissues and organ function.
 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.
 Malnutrition occurs in people who are either undernourished
or over nourished.
 Malnutrition

Over nutrition

Growth
failure Under nutrition
acute/chronic
underweight Mixed nutrition

Chronic micronutrie
Stunting/ nts
poor
development
Type1 nutrient Type 2
defi nutrient defi
Nitrogen
Acute malnutrition Sulfur
Wasting or nutritional Iron Zinc
thyamine Physical Reduced Magnesium
edema
Niacine signs overall sodium
Vit A growth
TYPE
S
 There are 3 clinical forms of acute malnutrition.
 Marasmus – severe weight loss or wasting Kwashiorkor –
bloated appearance due to water retention (bi-lateral edema).
Marasmus-kwashiorkor – a combination of both wasting and bi-
lateral edema.
 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 can affect both children and adults.
Kwashiorkor
 Kwashiorkor is characterized by bilateral pitting edema
(affecting both sides of the body) in the lower legs and feet
which as it progresses becomes more generalized to the arms,
hands and face.
 Edema 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.
Conti….

 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.
Conti…
 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
Comparison
 In developing countries, inadequate food intake is secondary to insufficient or
inappropriate food supplies or early cessation of breastfeeding. In some areas,
cultural and religious food customs 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 malnutrition.
 Children with chronic illness are at risk for nutritional problems for several
reasons, including the following:
 Anorexia, which leads to inadequate food intake.
 Increased inflammatory burden and increased metabolic demands can increase
caloric need.
 Any chronic illness that involves the liver or small bowel affects nutrition
adversely by impairing digestive and absorptive functions.
Ratio
 Globally, 51 million under-five year olds were wasted and 17 million were
severely wasted in 2013.
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.
 Stunting Target:
40% reduction in the number of children under-5 who are stunted
 Anemia Target:
50% reduction of anemia in women of reproductive age
 Low birth weight Target:
30% reduction in low birth weight
Reduce and maintain childhood wasting to less than 5%
 Data from Pakistan

 > 3.5 million/year , mothers & children die due to the

underlying cause of under nutrition (globally)
• > 55 million (10%) of children are wasted
 36 % of children -- underweight before the current
floods.
 • Researchers claim that up to 44 % of children of rural area
stunted.
 • A survey by the World Health Organization -the number of
underweight pre-school children (0-5 years of age) is 40 %
 symptoms

 Nutritional disorders can affect any system in the body and the senses of sight, taste and smell.
They may also produce anxiety, changes in mood and other psychiatric symptoms.
 Other symptoms include:
• Pale, thick and dry skin
• Bruising easily
• Rashes
• Changes in skin pigmentation
• Thin hair that is tightly curled and pulls out easily
• Achy joints 
• Bones that are soft and tender
• Gums that bleed easily
• Tongue that may be swollen or shriveled and cracked
• Night blindness
• Increased sensitivity to light and glare
Diagnosis

 Overall appearance, behavior, body fat distribution and organ

function can alert a physician to the presence of malnutrition.
Patients may be asked to record what they eat during a specific
period.
 X-rays can determine bone density and reveal gastrointestinal
disturbances, as well as heart and lung damage.

 Blood and urine tests are used to measure the patient's levels of
vitamins, minerals and waste products.
 Treatment

 Patients who cannot or will not eat or who are unable to absorb
nutrients taken by mouth may be fed intravenously (parenteral
nutrition) or through a tube inserted into the gastrointestinal
tract (enteral nutrition).
 Tube feeding is often used to provide nutrients to patients who
have suffered burns or who have inflammatory bowel disease.
This procedure involves inserting a thin tube through the nose
and carefully guiding it along the throat until it reaches the
stomach or small intestine.
 If long-term tube feeding is necessary, the tube may be placed
directly into the stomach or small intestine through an incision
in the abdomen.
Prevention

 Education of mother
 Counseling regarding family planning and spacing
between children
 Education of the parents regarding immunization of
the children