Malnutrition: Definition, Symptoms and Treatments

Prologue:

Malnutrition, a widespread and persistent problem, continues to afflict millions of people worldwide, causing devastating consequences for their health and well-being. Despite remarkable advancements in various sectors, malnutrition remains a significant challenge that demands urgent attention. In this blog post, we will delve into the concept of malnutrition, explore its various forms, and shed light on its far-reaching impact on individuals, communities, and societies as a whole.

Researchers published the findings in the Journal of MDPI (Multidisciplinary Digital Publishing Institute) in 2020, according to which malnutrition was highly prevalent among hospitaliszed older adults and was associated with increased mortality, longer hospital stays, and higher healthcare costs.

The PubMed Central has reported in 2018, approximately 1 in 3 individuals worldwide suffer from at least one form of malnutrition, be it undernutrition, micronutrient deficiencies, or overweight and obesity.

In 2018, NIH data reports as many as 22 percent of elderly individuals of Australia have inadequate nutrition and more than forty-five percent are at danger of being undernourished. 

What is Malnutrition?

Malnutrition refers to a state of inadequate nutrition, resulting from an imbalance between the nutrients a person consumes and the nutrients their body requires to function optimally. Contrary to popular belief, malnutrition encompasses both undernutrition and overnutrition, manifesting in different forms and affecting diverse populations.

According to a review study from the Australian Institute of Health and Welfare 2018, countryside residents have worse health conditions than people living in urban regions of Australia.

Types of Malnutrition:

Undernutrition:

Undernutrition occurs when individuals do not receive sufficient nutrients, including proteins, carbohydrates, fats, vitamins, and minerals. It is a prevalent form of malnutrition that affects millions of people worldwide, particularly in developing countries and marginaliszed populations.

Researchers in 2018 published a review (in Australian Institute of Health and Welfare), according to which the adults evaluated by dietitians had an assessment of inadequate nutrition at an average prevalence of 70.4 percent. Between 20-50% of in patients in Australian hospitals can be affected by malnutrition upon their admission to hospital, and hospital acquired malnutrition (HAM) can also occur as a result of hospital admissions.

It encompasses two primary conditions:

Acute Malnutrition:

Also known as wasting, it refers to a severe deficiency of nutrients that leads to rapid weight loss and physical deterioration, primarily affecting children.

Chronic Malnutrition:

Commonly known as stunting, it occurs due to prolonged nutrient deficiencies, resulting in impaired growth and development. Stunting reflects the cumulative effects of inadequate nutrition, recurrent infections, and poor health conditions.

Overnutrition:

Overnutrition, on the other hand, arises from an excessive intake of nutrients, often in the form of energy-dense but nutritionally poor foods. Over time, this can lead to obesity, cardiovascular diseases, diabetes, and other health complications. Overnutrition is prevalent in both developed and developing countries, making it a dual burden alongside under nutrition.

It has been reviewed in 2023 in Nutrients that in a single investigation of 285 young people, it was discovered that the blood concentrations of the vitamin A and E were two to ten percent a lesser in obese individuals than in individuals who were of a healthy weight.

A study published in the PLOS ONE in 2022, investigated the relationship between overnutrition, specifically obesity, and cardiovascular health. The study followed a large cohort of adults over a long period and found that obesity was strongly associated with an increased risk of cardiovascular diseases, such as hypertension, heart disease, and stroke.

Signs and symptoms

Recogniszing the signs and symptoms of malnutrition is crucial for timely intervention and prevention of its detrimental consequences. Let’s explore the common indicators that can help identify malnutrition in its early stages, empowering individuals and healthcare professionals to take prompt action.

Undernutrition indicators:

The nutritional state is measured using a variety of indicators. These could be things like nutritional consumption, physical activity, biological substances, therapeutic deficiencies, and the constitution of the body. 

In 2009, a review study in the Australian Family Physician clearly discussed that adults who are underweight or fatty may unintentionally lose weight as a result of nutritional deficiency (masked undernutrition). The hazards of losing muscular mass quickly apply to the two types of patients.

Shared below are some of the most common symptoms occurred due to undernutrition:

Unintentional Weight Loss –

One of the hallmark signs of malnutrition is unexplained and unintentional weight loss. It may occur gradually or suddenly, and individuals may notice their clothes becoming loose or experiencing a significant drop in body weight. Unintentional weight loss can be particularly concerning when it exceeds 5% of a person’s usual weight within a month or 10% within six months.

Fatigue and Weakness –

Malnutrition often leads to persistent fatigue and weakness due to the lack of vital nutrients necessary for energy production. Individuals may feel excessively tired, lack motivation, and struggle with day-to-day activities that were previously manageable. Generalized weakness and reduced stamina are common indicators of malnutrition’s impact on physical health.

Poor Wound Healing –

Inadequate nutrition impairs the body’s ability to heal wounds effectively. Malnourished individuals may experience delayed wound healing, increased susceptibility to infections, and poor recovery after surgeries or injuries. If wounds show slow progress in healing or become recurrent, it is crucial to consider malnutrition as a potential underlying cause.

Changes in Hair and Skin –

Malnutrition can manifest in noticeable changes in hair and skin health. Dry, brittle hair, hair loss, and sparse, thinning eyebrows may indicate nutrient deficiencies. Similarly, dry and flaky skin, dermatitis, easy bruising, and a pale complexion can be signs of malnutrition. The lack of essential nutrients affects the health and integrity of these tissues.

Muscle Wasting and Weakness –

Muscle wasting and weakness are prevalent in cases of severe or prolonged malnutrition. Loss of muscle mass, particularly noticeable in the arms and legs, can result in reduced strength, mobility issues, and difficulty performing everyday tasks. This symptom is particularly prominent in individuals experiencing protein and calorie deficiencies.

Changes in Cognitive Function –

Malnutrition adversely affects cognitive function, especially in children. For example, stunted growth, delayed milestones, and learning difficulties may indicate chronic malnutrition during crucial developmental stages. In adults, malnutrition can cause poor concentration, memory problems, and mental fog.

Digestive Issues –

Malnourished individuals may experience a range of digestive issues, including loss of appetite, bloating, constipation, diarrhea, and nausea. These symptoms can stem from both nutrient deficiencies and a disrupted digestive system due to inadequate food intake.

Weakened Immune System –

Malnutrition weakens the immune system, making individuals more susceptible to infections, illnesses, and delayed recovery. 

Kwashiorkor –

a significant lack of protein, results in retained water and an outstretched belly. On the opposite side, the illness marasmus, which is brought on by extreme low-calorie diets causes shrinking and a large loss of fat and muscle.

Overnutrition indicators:

In overnutrition, the body receives more energy (calories) than it requires for its daily functions and physical activity. The excess energy is stored in the form of fat, leading to weight gain and an increase in body fat percentage. Over time, if energy intake consistently exceeds energy expenditure, it can lead to obesity and a range of associated health problems. Key factors contributing to overnutrition include:

Obesity –

Overnutrition is a primary contributor to the development of obesity. Excess energy intake leads to weight gain, and when it becomes chronic, it can lead to obesity, defined as having a body mass index (BMI) of 30 or higher. Obesity is associated with numerous health risks, including cardiovascular diseases, diabetes, certain cancers, musculoskeletal disorders, and respiratory problems.

According to investigations, individuals categorized as overweight or obese are far more likely to exhibit insufficient dietary intake as well as decreased circulating levels of specific minerals and vitamins than individuals constituting healthy weight.

Metabolic Disorders –

Overnutrition can disrupt normal metabolic processes, leading to metabolic disorders such as insulin resistance, dyslipidemia (abnormal blood lipid profile), and metabolic syndrome. These conditions increase the risk of developing type 2 diabetes, heart disease, and other chronic health conditions.

Nutrient Imbalances –

While overnutrition involves excessive calorie intake, it does not necessarily guarantee adequate intake of essential nutrients. Consuming a diet high in processed foods and low in nutritious foods can result in nutrient deficiencies despite consuming an excess of calories. 

In 2017, a BioMed Central research survey of almost 17,000 kids and grown-ups showed that individuals who consumed junk food consumed more calories, fat, and sodium compared to individuals who avoided it, as well as substantially lower quantities of vitamins A and C.

Psychological and Emotional Impact –

Overnutrition and obesity can have psychological and emotional consequences, including poor body image, low self-esteem, depression, and anxiety. The societal stigma associated with obesity can also negatively impact individuals’ mental well-being.

Causes and Contributing Factors:

Malnutrition is a global issue that can be brought on by social, economic, and health-related factors.

According to a NIH study including roughly 369,000 youngsters, individuals considered obese have an almost four-fold increased risk of developing type 2 diabetes versus those in their age group who have a normal body mass index (BMI).

The World Obesity Federation reports that approximately 672 million adults worldwide are obese and an additional 1.3 billion are overweight. The rise in unhealthy diets, sedentary lifestyles, and an obesogenic environment contribute to the increasing prevalence of overweight and obesity.

Insufficient Food Availability –

Limited access to nutritious food due to poverty, conflicts, natural disasters, and inadequate agricultural practices contribute to undernutrition.

Inadequate Dietary Diversity –

Diets lacking in variety and quality fail to provide essential nutrients, exacerbating malnutrition.

Poor Sanitation and Hygiene –

Lack of access to clean water, sanitation facilities, and proper hygiene practices increases the risk of infectious diseases, leading to malnutrition.

Socioeconomic Factors –

Poverty, illiteracy, gender inequality, and social marginalization play a significant role in perpetuating malnutrition, particularly in vulnerable populations.

High-Calorie, Nutrient-Poor Foods –

Consumption of processed foods, sugary beverages, fast food, and snacks that is high in calories but low in essential nutrients like vitamins, minerals, and dietary fiber.

Portion Sizes –

Large portion sizes, frequent snacking, and excessive intake of energy-dense foods contribute to overeating and excessive calorie intake.

Sedentary Lifestyle –

Lack of physical activity and sedentary behaviors, such as prolonged sitting or engaging in minimal exercise, reduce energy expenditure, making it easier to consume more calories than the body needs.

Treatment and prevention

The treatment approach for malnutrition may vary depending on the individual’s age, specific nutrient deficiencies, severity of malnutrition, and any underlying medical conditions. Therefore, a healthcare professional’s guidance and individualized care are crucial for developing an appropriate treatment plan for malnutrition.

A study published in BMJ 2020 describes that delivering vitamin and mineral supplements, including zinc, iron, and iodine tablets, as well as dietary habits awareness to those who are vulnerable for inadequate nutrition, represents a few of the most efficient approaches to avert malnutrition.

The consequences of malnutrition are far-reaching, impacting physical and cognitive development, immune function, and overall well-being. However, with the right interventions, malnutrition can be treated, and its prevalence can be reduced. There are some effective treatment and prevention strategies to combat malnutrition and promote optimal nutrition for individuals of all ages which are given below:

Nutritional Rehabilitation

Nutritional rehabilitation is the cornerstone of malnutrition treatment. It involves providing individuals with a balanced and varied diet that meets their specific nutrient needs. Depending on the severity of malnutrition, healthcare professionals may recommend therapeutic foods or nutrient-dense supplements to restore nutritional status. 

Medical Management

The need for healthcare might occur in situations involving serious malnutrition. This can involve addressing underlying medical conditions, such as gastrointestinal disorders, infections, or metabolic disorders, that contribute to malnutrition. Medications may be prescribed to treat specific symptoms or complications associated with malnutrition.

Micronutrient Supplementation

Micronutrient deficiencies are common in malnutrition. Supplementation of specific vitamins and minerals may be prescribed to correct deficiencies. For example, iron supplementation may be given for anemia due to iron deficiency, vitamin A supplements may be provided to combat vitamin A deficiency, and calcium and vitamin D supplements may be recommended for individuals with bone health concerns.

Monitoring and Follow-up

Regular monitoring of nutritional status is essential to evaluate the progress of treatment. This may involve regular weight checks, assessment of growth (in children), laboratory tests to assess nutrient levels, and other relevant measurements. Adjustments to the treatment plan can be made based on these assessments.

Psychosocial Support

Malnutrition often has psychological and social implications. Providing psychosocial support, such as counseling and education, can help individuals and their families understand the importance of nutrition, improve feeding practices, and address emotional issues related to malnutrition. Support groups and community-based interventions can also play a vital role in fostering recovery and promoting overall well-being.

Prevention of Malnutrition:

Promoting Nutritional Education:

Raising awareness about the importance of a balanced diet and adequate nutrition is a key to preventing malnutrition. Educational programs should target individuals of all ages, emphasizing the value of diverse food choices, proper meal planning, and healthy cooking techniques. Promoting nutrition education in schools, communities, and healthcare settings can empower individuals to make informed decisions about their dietary intake. Increasing people’s knowledge of good eating habits, breast-feeding, and cleanliness habits equips them to make decisions that are in their best interests.

Improving Access to Nutritious Food:

According to the WHO, approximately 460,000,000 people and an estimated 150 million little ones are believed to be suffering from malnutrition and nearly more than 2 billion people of all ages are believed to be overweight or obese.

Enhancing access to nutritious and affordable food is crucial in combating malnutrition. This can be achieved through various measures such as agricultural development, improving infrastructure for food storage and transportation, and supporting local food production initiatives. Social safety nets, such as food assistance programs, can help vulnerable population’s access nutritious food during times of economic hardship or emergencies. 

Addressing Socioeconomic Factors:

Tackling malnutrition requires addressing underlying socioeconomic factors such as poverty, inequality, and lack of education. Governments and organizations should focus on poverty alleviation, empowering women and marginalized groups, and promoting equitable distribution of resources. These efforts can create an enabling environment where individuals have better access to education, healthcare, and employment opportunities, reducing the risk of malnutrition.

Enhancing Water, Sanitation, and Hygiene (WASH) Practices:

Improving WASH practices is vital for preventing malnutrition, particularly in children. Access to clean water, proper sanitation facilities, and hygiene education helps prevent waterborne diseases and reduces the risk of infections that can lead to malnutrition. Investing in WASH infrastructure and implementing hygiene promotion programs can significantly contribute to malnutrition prevention.

Collaboration and Policy Reform 

Addressing malnutrition requires a multi-sectorial approach involving governments, NGOs, healthcare professionals, and the private sector to develop comprehensive policies, improve food systems, and enhance infrastructure. 

Key Takeaway

Malnutrition is a complex condition that can have severe consequences for individuals’ health and well-being. It encompasses both undernutrition and overnutrition, with each form presenting unique challenges and impacts. Recogniszing the signs and symptoms of malnutrition is crucial for early detection and intervention. With millions of lives at stake, it is crucial that we prioritize efforts to treat and prevent malnutrition on both individual and societal levels. Treatment strategies focus on nutritional rehabilitation, medical management, and psychosocial support to restore health and improve outcomes. Prevention efforts emphasisze nutritional education, improving food access, addressing socioeconomic factors, and promoting healthy lifestyles. By implementing comprehensive approaches that target both treatment and prevention, we can strive to combat malnutrition and its detrimental effects on individuals, families, and communities. It is within our power to make a difference, to advocate for change, and to ensure that every individual has access to the nourishment they need to thrive. 

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