Malnutrition, malnutrition in India, malnutrition in children

Malnutrition definition

The term malnutrition is defined as the condition of the body that is the result of improper nutrition status, the nutrient supply from the diet may be excess or deficient. Malnutrition can result from excess or deficiency of one or more nutrients. In simple words, malnutrition is the state where there is an imbalance between the body’s needs and nutrition supply from the diet.

Types of Malnutrition

• Undernutrition: It is a condition that results from inadequate food intake for a long duration. Example- Protein Energy Malnutrition(PEM)
• Starvation: Starvation is the term used to define the condition of continuation of under-nutrition state over a long period of time.
• Specific Deficiency: It is a pathological condition caused due to a lack of a specific individual nutrient. Example- Anaemia caused due to iron deficiency, scurvy due to vitamin C deficiency.

• Nutritional Imbalance: It is a pathological condition which causes due to the disproportion of many essential nutrients in the diet with or without any absolute deficiency. For example- bone deformities can be caused due to imbalance of calcium and phosphorus.

• Overnutrition:  It is a physiological state which results due to overconsumption of food for a long duration. Example- Obesity.

Malnutrition Symptoms

Symptoms of malnutrition may include the following -

• depression
• most of the times feeling cold
• lack of appetite
• irritability and tiredness
• not concentrating properly on anything or unable to concentrate
• loss of weight, body tissue, and muscle mass
• frequently getting sick and taking a longer time than normal to heal
• Specifically in children followings can be seen -
• lack of growth
• irritability 
• lack of energy and feeling tired  
• slow intellectual and behavioral development, possibly learning difficulties can result from this
• low body weight 

Causes of Malnutrition/Etiological Factors

• One of the main causes of malnutrition is the availability of foods -
• When per capita food availability is low it has a major impact on the nutritional status.
• Low availability of food increases the price of the food and this, in turn, reduces an average person purchasing capacity and this directly impacts the nutrition status.
• The foods that are available in the world are distributed improperly because more than 50% of the world's population lives in China, Far East, and India but only 28% (among which 19% is animal foods) of available foods are supplied to these parts of the world. Therefore the per capita food availability in these parts of the world is very uneven. This type of maldistribution of foods may cause poor feeding capacity and in turn, it causes malnutrition.
•  In certain parts of the world limited choice of food items can cause malnutrition because in India as much as 60-80% of food energy comes from one or two staple foods and if due to any reason one crop of stable food fails, a crisis may arise. Other than this because of the limited amount of food items we Indians miss out on certain important micronutrients.
• Problems of storage and distribution of food grains. It is frustrating to know that almost 10% of food grains are lost in the field by rodents and pest infestation. Another 10% or so is lost during postharvest handling. Also storing facilities are also inefficient and this causes the food grains to deteriorate by rodents, birds, moisture, bacteria, insects, and fungi. Besides high losses and low food production, the food distribution system has many problems.
• Poverty is one of the main factors in not able to purchase high-quality nutritious foods that leave a gap in the nutritional fulfillment of the body and this causes malnutrition.
• Overpopulation decreases the per capita availability of food to everyone. Therefore mainly average people in poverty are unable to buy nutritious foods because they cost more as the availability is less.
• Some customs, taboos, and superstitions can also cause malnutrition.
• Some other causes of malnutrition are -
• Some particular health conditions can lead to malnutrition these are
• Eating disorder for example anorexia nervosa
• Mental health problems such as depression, anxiety can affect your mood and feel undesired to eat
• Long-term medical problems such as diarrhea, liver disease, cancer, fever, vomiting, etc. cause loss of appetite and this, in turn, can result in malnutrition. Another possibility is if you are healing after surgery and your body needs are increased but you are not providing enough calories that your body requires at that time, this can cause a malnourished condition.
• Some medicines have unpleasant side-effects such as decreasing your appetite, having diarrhea, feeling sick. If this continues for a long period of time it can turn into a malnourished condition.
• Social isolation and living alone can cause malnutrition.
• Alcohol or drug abuse can cause malnutrition. 
• Children may become malnourished due to the following reasons -
• Childhood cancers, cystic fibrosis, congenital heart disease, and cerebral palsy, these long-term medical conditions cause loss of appetite, interrupted digestion, and many other problems. Also, some children refuse to eat food and if family members do not take proper care then the child may become malnourished.

Diagnosis

If your doctor suspects that you may be malnourished then your doctor may carry out the following diagnostic tests -

• Tests for specific nutrient levels for example vitamins or iron
• Blood tests for monitoring and general screening
• Prealbumin test because malnutrition mainly affects albumin levels and this albumin test may also indicate kidney or liver disease.

Treatment of Malnutrition

It is recommended that if you are diagnosed with malnutrition then you should go to a dietitian for the treatment of malnutrition. Treatment mainly includes dietary changes and supplementation. Dietary changes that may be suggested by your dietitian are -   

• have a healthier and balanced diet
• take drinks that are high in calories
• eat fortified foods as they contain more nutrients
• take a high caloric diet with high protein
• if needed your dietitian may also advise some supplements but before prescribing any supplements dietitian will you properly then after if the doctor feels you need a certain supplement then the doctor may prescribe you that.

If you have some adverse health conditions such as dysphagia or problems in swallowing then you maybe recommend an alternative way of feeling that is tube feeding. This tube mainly passes through the nose and down to the stomach, this is also known as nasogastric feeding.

Malnutrition in children can be treated in the following ways -

• by including more nutritious calories in the diet
• by giving proper treatment to any underlying conditions that are causing a lack of appetite
• by providing mineral and vitamin supplements (before giving any supplements to your children you first must consult with a dietitian or a similar healthcare provider
• Severally malnourished children need to be rehydrated and fed with great care. They usually require special care in the hospital.

It is important that treatment should be monitored regularly to check for improvements and if improvements are not seen then it is possible that they may be referred to specialist services.

Prevention of Malnutrition

The best possible way to prevent malnutrition is to healthy and a balanced diet. You need to eat different varieties of foods from all the main food groups -

• You need to take carbohydrate-rich foods for example potato, bread, rice, etc.
• Milk and milk products. (persons having an allergy to milk can take the alternative of milk)
• Take plenty of vegetables and fruits
• Protein-rich foods should be taken often such as eggs, meat, fish, etc.

NOTE: It is recommended that you should consult a dietitian or similar health care professional before changing your food pattern.