2. Food is anything edible that provides the body
with nutrients.
Nutrients are chemical substances in food that are
released during digestion and provide energy to
maintain, repair or build body tissues. Nutrients
include macronutrients and micronutrients.
– Macronutrients include carbohydrates, protein and
fat (needed in large amounts).
– Micronutrients include vitamins and minerals
(needed only in small amounts).
DEFINITION OF FOOD
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3. DEFINITION OF NUTRITION
Nutrition is The
process of
providing or
obtaining the
nutrients
necessary for
health and
growth.
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4. MALNUTRITION
Malnutrition is the condition that
develops when the body does not get
the right amount of the vitamins,
minerals, and other nutrients it needs
to maintain healthy tissues and organ
function.
Definitions
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5. Meaning of Malnutrition
Malnutrition refers to deficiencies, excesses, or
imbalances in a person’s intake of energy and/or
nutrients.
The term malnutrition addresses 3 broad forms:
• Undernutrition, which includes wasting (low
weight-for- height), stunting (low height-for-age)
and underweight (low weight-for-age);
• Micronutrient-related malnutrition, which
includes deficiencies or excessive vitamins and
minerals
• Over-nutrition which includes overweight and
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7. In other words; malnutrition is when the
body does not have enough of the required
nutrients (under-nutrition) or has excess of
the required nutrients (over-nutrition).
Under-nutrition Over-nutrition
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8. Categories of Malnutrition
There are two categories of malnutrition:
a. Acute Malnutrition
b. Chronic Malnutrition
Children can have a combination of
malnutrition both acute and
chronic
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9. • Acute malnutrition is a form of under-nutrition
caused by a decrease in food consumption and/or
illness that results in sudden weight loss or oedema
(fluid retention).
• Acute malnutrition can be moderate (MAM) or
severe (SAM)
• MAM and SAM are determined by the patient’s
degree of wasting and presence of bi-lateral oedema.
• SAM is further classified into: Marasmus and
Kwashiorkor. Patients may present with a
combination, known as Marasmic Kwashiorkor
a. Acute Malnutrition
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10. b. Chronic Malnutrition
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Refers to prolonged malnutrition that may begin
in the prenatal period and continue over the
lifetime of a child. This can lead to significant
developmental and cognitive deficits and
significantly increases the risk of death.
Chronic undernutrition is manifested as
stunting and underweight
Chronic malnutrition is determined by a patient’s
expected height for a given age
11. Causes of Malnutrition
Infection and disease
Commonly seen in children in low socio-economical areas
E.g. malaria, whooping cough, diarrhoea
Inadequate food supply
Impacts vulnerable groups [children, lactating female, elderly] on
their body composition
Inappropriate feeding – cessation of breast feeding due to
having to return to work/caring for the family
Child becomes malnourished as doesn’t get essential nutrients
from the milk
Milk supplies can dry up if the mother isn’t getting enough
nutrition
Milk powders would be mixed with unclean water – making the
child unwell
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12. Factors contributing to malnutrition
Poverty
Poor feeding practises [stopping feeding baby via breast]
Lack of land
Insufficient food production
Ignorance on part of mothers
Exploitation
Diarrhoea
No potable water
High price of fertiliser
Drought
Measles
Too many children to feed
Lack of credit or credit too expensive to buy food
Health care too far away
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13. Terms
Under nutrition = inadequate food intake
[precursor of PEM]
Protein energy malnutrition [PEM] = a
deficiency of both protein and energy [world’s
most widespread malnutrition problem] including
Kwashiorkor and Marasmus types [and possible
overlap of the two]
Acute PEM = caused by recent severe food
restriction and characterised in children by
thinness for height [WASTING]
Chronic PEM = caused by long term food
shortage and characterised in children by short
height for age [STUNTING]
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14. What Is Protein Energy Malnutrition?
Protein-energy malnutrition or PEM is the
condition of lack of energy due to the
deficiency of all the macronutrients and
many micronutrients. It can occur suddenly
or gradually. It can be graded as mild,
moderate or severe. In developing countries, it
affects children who are not provided with
calories and proteins. In developed countries,
it affects the older generation.
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15. Classification Of Protein Energy
Malnutrition
PEM can be classified into two types:
Primary PEM
Secondary PEM
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16. Primary PEM
This type of protein-energy malnutrition is
found in children. It is rarely found in the
elders, the main cause being depression. It
can also be caused due to child or elder
abuse. In children, PEM is primarily of two
types:
Kwashiorkor
Marasmus
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17. Kwashiorkor
Kwashiorkor is acute malnutrition that
occurs mostly in children. This condition
results from severe protein deficiencies. It
is also known as “edematous malnutrition”
because it is associated with oedema. The
patients suffering from Kwashiorkor have
an emaciated appearance all over the
body. The ankles, feet and belly swell with
liquid.
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18. Kwashiorkor is most common in rural
areas, especially in the sub-Saharan
regions. The famine struck areas or
the areas with low food supply are
more prone to this disease. Also, the
areas where people are unaware of
proper diet and nutrition have more
cases of Kwashiorkor.
Kwashiorkor
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19. Causes of Kwashiorkor
Protein is required by our body to repair the
cells and make new cells. It is an important
nutrient during pregnancy and a child’s growth.
Lack of proteins shuts down the growth and
normal body functions, and this leads to
Kwashiorkor. Kwashiorkor is mostly found in
countries with a limited food supply. Lack of
knowledge on a balanced diet and regional
dependence on low protein food can also
develop this condition.
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20. Symptoms of Kwashiorkor
Following symptoms indicate the presence of
Kwashiorkor:
Change in skin and hair colour and texture
Loss of weight
Swelling (oedema) of the ankles, feet, and belly
Irritation
Compromised immune system
Failure to gain muscle mass
Fatigue
Diarrhoea
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21. Marasmus
Weight Loss
Fat and muscle depletion
Most common in developing countries.
More common than Kwashiorkor
Prevalent in children younger than those
affected by Kwashiorkor
Cell-mediated immunity is impaired, making
the children more susceptible to infections.
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22. Secondary PEM
It is caused due to disorders in the
gastrointestinal tract.
It can be caused due to infections,
hyperthyroidism, trauma, burns, and other
critical illnesses.
It decreases appetite and impairs nutrient
metabolism.
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23. Symptoms of Protein Energy Malnutrition
The symptoms of protein-energy
malnutrition or PEM are as follows:
Apathy and irritability
The patient becomes weak and
inefficient.
Impaired cognition and
consciousness.
Temporary lactose deficiency
Diarrhoea
Gonadal tissues atrophy
Causes amenorrhea in women
Causes libido in both men and
women
Weight loss
Shrinking of muscles
Protrusion of bones
The skin gets thin, pale, dry,
inelastic and cold
Hair fall
Impaired wound healing
Risk of hip fractures and ulcers
increases in elderly patients
Heart size and cardiac output
decreases in severe cases
A decrease in respiratory rate and
vital capacity
Liver, kidney or heart failure
Acute PEM might also prove fatal
24. Treatment of Protein Energy Malnutrition
Protein Energy Malnutrition can be treated in the
following ways:
Oral feeding
Avoiding lactose
Supportive care
Reduction in poverty
Improving nutritional education and public health
measures
Starvation can be treated by providing a balanced diet
Multivitamin supplements
Treat infections and fluid and electrolyte
abnormalities, in severe cases
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25. PEM can be treated by providing a balanced
diet. The micronutrients should be taken twice,
the daily recommended allowance until
recovery.
Treatment of Protein Energy Malnutrition
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