Malnutrition refers to getting either too little or excess of certain nutrients. It can lead to severe health problems, eye problems, stunted growth, diabetes and heart diseases. Did you know that one in four of the world’s children are stunted?
Malnutrition is a severe global problem that affects millions and billions of people around the world. People are at risk of malnutrition depending on their lifestyle, environment, and resources. In this article, we will take a close look at what malnutrition is, its types, signs and symptoms, effects, causes and prevention and treatment techniques.
What is Malnutrition?
It is a condition that is a result of either a deficiency in nutrients or overconsumption. There are two main types of malnutrition.
The first is undernutrition which refers to insufficient calories, proteins, or micronutrients in the body. It leads to low stunting (height-for-age), wasting (weight-for-height), and underweight (weight-for-age).
The second type is overnutrition which is the overconsumption of specific proteins, fat, calories, or other types of nutrients. In general, it is widely referred to as obesity or overweight.
Undernourished people often tend to have low vitamin and mineral content in their body, particularly Vitamin A, zinc, iron, and iodine. However, the deficiencies in micronutrients can also be caused due to overnutrition.
It is very much possible for a person to be overweight or obese due to over-consuming calories and yet not receive sufficient minerals and vitamins to the body. This happens as foods that contain sugar or oil are high in calories and lead to overnutrition.
Organ failure, eating disorder, severe infection, or physical trauma such as a head injury can result in malnutrition. It often occurs in the older adult population, particularly in those with dementia or Alzheimer’s disease. Tooth loss and other dental issues, loss of appetite and functional decline are some of the factors that contribute to malnutrition among older adults.
What Are The Signs And Symptoms Of Malnutrition?
The signs and symptoms of malnutrition in a person depend on its type. It is important to be able to recognize them in order for your healthcare professionals to identify and treat the condition.
Signs of Undernutrition
Undernourished people may show one or many of the following symptoms.
- Weight loss
- Hollow cheeks and sunken eyes
- Loss of fat and muscle mass
- Dry hair and skin
- A swollen stomach
- Delayed wound healing
- Depression and anxiety
- Difficulty concentrating
In more severe cases:
- Difficulty breathing
- Dry and sparse hair, easy falling out.
- The skin may become thin, pale, dry, inelastic, and cold
- The cheeks appear hollow and the eyes sunken, as fat disappears from the face
There may be a respiratory failure and heart failure eventually, and the person might become unresponsive. Complete starvation can be fatal within 8 to 12 weeks.
Children’s growth may be slow, and they may be tired and irritable most of the time. Further, their behavioural and intellectual development slows down due to which they find it difficult to learn things quickly.
There may be long-term effects on mental function even with treatment. Also, digestive problems may persist, and in some cases, these may last for life.
Adults who were severely undernourished during their adulthood, they generally make a total recovery with the help of treatment.
Another cause of undernourishment is a deficiency in micronutrients. Some of the common symptoms are:
Zinc: Loss of appetite, delayed healing of wounds, stunted growth, hair loss, diarrhoea
Vitamin A: Dry eyes, increased risk of infection, night blindness
Iodine: Enlarged thyroid glands (goitres), growth and development issues, decreased production of thyroid hormone
Iron: Impaired brain function, stomach problems, issues with regulating body temperature
This condition increases the risk of death, as undernourishment leads to severe problems, both physically and health-wise.
Signs of Overnutrition
The major sign of overnutrition is obesity and overweight. However, it can also result in nutrient deficiencies.
According to research, people who are obese or overweight are very likely to have insufficient consumption and low blood levels of certain minerals and vitamins compared to people with a healthy weight.
Symptoms of Malnutrition
Healthcare professionals assess the symptoms of malnutrition while screening for the condition. Some of the tools that are used to identify the condition include body mass index (BMI) and weight loss charts, physical examinations, and blood tests to know the status of micronutrients in the body. When it comes to identifying micronutrient deficiencies a person with overnutrition, it can get a bit difficult.
What Causes Malnutrition?
The condition is a result of environmental and medical factors. Some of its major causes are as follows:
Low food consumption
May be due to an illness such as dysphagia, where it becomes difficult to swallow food. Another contribution is the ill-fitting dentures.
Mental health disorders
Conditions such as depression, schizophrenia, dementia, anorexia nervosa, and bulimia can lead to malnutrition.
Inability to obtain or prepare food
Some people are physically ill and hence cannot find the energy to go out and buy food and prepare meals for themselves. Further, people who live in isolation are at a very high risk of malnutrition. On the other hand, there are people who cannot afford to buy food while there are some whose cooking skills are impaired due to their physical difficulties.
Digestive problems and stomach conditions
Even a healthy diet fails to help if the body is not able to efficiently absorb nutrients. Some of the major conditions that cause malabsorption are celiac disease, Chron’s disease, and bacterial overgrowth in the intestines.
People with Crohn’s disease or ulcerative colitis may have to get a part of the small intestine removed so that they will be able to absorb nutrients.
Celiac disease is a genetic disorder involving gluten intolerance. It may damage the lining of the intestines and poor food absorption.
Vomiting, persistent diarrhoea, vomiting, or both can lead to a loss of essential nutrients.
Heavy consumption of alcohol can lead to insufficient intake of calories, protein, and micronutrients. Also, it damages the pancreas or results in gastritis which can make is very difficult to digest food, produce hormones that regulate metabolism, and absorb certain vitamins.
The person may not feel hungry as alcohol contains calories; hence, do not eat much proper food to supply their body with healthy nutrients.
Children who do not get breastfed tend to develop conditions of malnutrition. This happens mainly in under-developed nations or developing countries. According to the World Food Program, almost 14 per cent of the population in developing countries is malnourished.
It comes as no surprise that malnutrition essentially affects developing countries. However, the part that shocks us the most is how widely spread this particular problem is in these countries. More than one in nine people suffer from malnutrition in developing countries.
Further, half of all pregnant women in these countries are anaemic. Anaemia is a possible result of malnutrition and causes more than 1 lakh deaths each year during childbirth. Also, women, in general, tend to suffer more from malnutrition because of the sexist norms relating to the issue.
What Are The Risk Factors Of Malnutrition?
In some parts of the world, long-term and widespread malnutrition can be due to lack of food.
On the other hand, people at risk of malnutrition in wealthier nutrition are:
- Socially isolated individuals
- Older people, particularly those who are hospitalized or in long-term institutional care
- People who have difficulty absorbing nutrients
- People who are recovering from a severe illness or condition
- People on low incomes
- People with chronic eating disorders, such as anorexia nervosa or bulimia
What Is The Diagnosis of Malnutrition?
Right diagnosis and treatment can prevent a further rise in complications of malnutrition.
There are many ways to identify malnourished individuals or those who are at risk of it. One such tool is the Malnutrition Universal Screening Tool (MUST) tool.
This particular tool has been designed mainly to identify adults, especially older individuals who are at a high risk of malnourishment or who already are malnourished. There are five steps to be followed that can be done by a healthcare professional, which will help them diagnose and treat the condition.
Step 1: Measure height, weight, calculate Body Mass Index (BMI) and give a score.
Step 2: Give a score by noting down the percentage of unplanned weight loss. Say for example, for a person with unplanned weight loss of 5 to 10, give a score of 1, a 10 per cent weight loss would receive a score of 2.
Step 3: Identify any physical or mental health condition and give a score. For example, if a person as keeping ill and did not take food for five days, they would score a 3.
Step 4: Add all the scores taken from steps 1, 2, and 3 and take an overall risk score.
Step 5: Develop a care plan by using local guidelines.
If a person’s score is 0, it means that they are at very low risk of malnutrition. Further, a score of 1 means medium risk and 2 means high risk.
However, it is important to note that MUST tool can only help identify the risk of malnutrition or malnutrition and does not identify certain nutrient deficiencies or imbalances.
What Is The Treatment For Malnourishment?
According to the MUST screening score, the following might happen:
Low Risk: It is advisable to take an ongoing screening at the hospital as well as at home.
Medium Risk: The person may be put under observation, their food intake will be noted for three days, and further will receive an ongoing screening.
High Risk: The person will have to take treatment from a nutritionist and other specialists if needed. They will also receive ongoing care.
Help and advice on food intake and dietary habits are required for all risk levels.
The type of treatment depends on the intensity or severity of malnutrition as well as the presence of any underlying complications or conditions. The doctor will prepare a plan with defined goals for treatment. The person will usually be receiving a feeding program with a diet planned especially to fit their health condition along with a few nutritional supplements, if possible.
For individuals who are severely malnourished, artificial nutritional support such as a tube or intravenous may be required. The patient’s progress will be monitored closely, and regular reviews of their treatment will be done to make sure they are getting the needed nutrients.
Diet: A registered dietician will discuss with the patient about some healthy choices that they should incorporate and recommend a nutritious diet plan to them which will supply them the right amount of calories and sufficient nutrients to maintain a healthy body. For those who are undernourished, the dietician will include additional calories to bring it up to the required level.
Monitoring Progress: Regularly monitoring will ensure the right intake of calories and nutrients. It may be adjusted according to the patient’s requirement. For patients who receive artificial nutritional support, they will be able to start eating normally as soon as they can.
What Is The Prevention For Malnutrition
As they say, prevention is better than cure; it is important to take preventive measures in order to make sure that you are not at risk of malnourishment. The preventive measures include consuming a range of nutrients from different types of food.
You should balance your intake and consume only the required number of calories, proteins, vitamins, fats, carbohydrates, and minerals. Further, drinking plenty of fluids, particularly, water is important.
People with ulcerative colitis, alcoholism, Crohn’s disease, celiac disease, and other health problems will receive appropriate treatment for their condition.
Malnutrition refers to undernutrition and overnutrition. Individuals who are undernourished may experience weight loss, mood changes, and fatigue or develop vitamin and mineral deficiencies. On the other hand, overnutrition can result in overweight, obesity and insufficient micronutrient intakes and deficiencies.
Both these types can lead to health issues if not addressed, and will eventually become severe, which may also lead to death.
If you see yourself or someone around you showing symptoms of malnourishment, specifically undernourished, it is best to talk to a doctor as soon as possible and get the necessary treatment.