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What is Malnutrition ?
• Malnutrition is the condition that results
from eating a diet in which
certain nutrients are lacking, in excess
(too high an intake), or in the wrong
proportions. The verb form is
"malnourish"; "malnourishment" is
sometimes used instead of "malnutrition".
Now..
Why do people fall so sick regularly ?
Why do people get tired doing some
physical activity ?
Having trouble in understanding ?
• These are all symptoms of malnutrition...
In India almost every 2nd child suffers from it.
• Malnutrition grabs a child from mother’s womb
itself and continues affecting it till his 2 years of
age.
A <5 year old child is the most vulnerable to
Malnutrition.
Dietary Practices
Deriving too much of one's diet from a
single source, such as eating almost
exclusively corn or rice, can cause
malnutrition. This may either be from a
lack of education about proper
nutrition, or from only having access to
a single food source.
Over-nutrition caused by overeating is
also a form of malnutrition. In the
United States, more than half of all
adults are now overweight — a
condition that, like hunger, increases
susceptibility to disease and disability,
reduces worker productivity, and
lowers life expectancy. Overeating is
much more common in the United
States, where for the majority of
people, access to food is not an issue.
Many parts of the world have access to
a surplus of non-nutritious food, in
addition to increased sedentary
lifestyles.
Junk Food
Often fast food, low in cost and
nutrition, is high in calories and
heavily promoted. When these
eating habits are combined with
increasingly urbanized,
automated, and more sedentary
lifestyles, it becomes clear why
weight gain is difficult to
avoid.However, overeating is also
a problem in countries where
hunger and poverty persist. In
China, consumption of high-fat
foods has increased while
consumption of rice and other
goods has decreased. Overeating
leads to many diseases, such as
heart disease and diabetes, that
may result in death.
Agricultural Productivity
• Local food shortages can be caused by a lack of arable land, adverse
weather, lower farming skills such as crop rotation, or by a lack of
technology or resources needed for the higher yields found in
modern agriculture, such as fertilizers, pesticides, irrigation,
machinery and storage facilities. As a result of widespread poverty,
farmers cannot afford or governments cannot provide the resources
necessary to improve local yields. The World Bank and some
wealthy donor countries also press nations that depend on aid to cut
or eliminate subsidized agricultural inputs such as fertilizer, in the
name of free market policies even as the United States and Europe
extensively subsidized their own farmers. Many, if not most, farmers
cannot afford fertilizer at market prices, leading to low agricultural
production and wages and high, unaffordable food prices. Reasons
for the unavailability of fertilizer include moves to stop supplying
fertilizer on environmental grounds, cited as the obstacle to feeding
Africa by the Green Revolution pioneer Norman Borlaug.
The Mother of them all….
• In Bangladesh, poor socioeconomic position was
associated with chronic malnutrition since it
inhibits purchase of nutritious foods such as milk,
meat, poultry, and fruits. As much as food
shortages may be a contributing factor to
malnutrition in countries with lack of technology,
the FAO(Food and Agriculture Organization) has
estimated that eighty percent of malnourished
children living in the developing world live in
countries that produce food surpluses.
* Over 7000 people die
everyday in India due to hunger.
* Over 25 lakh people die every
year due to hunger in India.
* Despite substantial
improvement in health since
independence and a growth rate
of 8 percent in recent years,
under-nutrition remains a silent
emergency in India, with almost
50 percent of Indian children
underweight and more than 70
percent of the women and
children with serious nutritional
deficiencies as anemia.
Effects on Women
Researchers from the Centre for World Food
Studies in 2003 found that the gap between levels
of undernutrition in men and women is generally
small, but that the gap varies from region to region
and from country to country.
• Women have unique nutritional requirements, and in
some cases need more nutrients than men; for example,
women need twice as much calcium as men. Studies on
nutrition concerning gender bias within households
look at patterns of food allocation, and one study from
2003 suggested that women often receive a lower share
of food requirements than men.[Gender discrimination,
gender roles, and social norms affecting women can
lead to early marriage and childbearing, close birth
spacing, and under nutrition, all of which contribute to
malnourished mothers. Frequent pregnancies with short
intervals between them and long periods of
breastfeeding add an additional nutritional burden
Effects on Children
The World Health Organization estimates that malnutrition
accounts for 54 percent of child mortality worldwide, about 1
million children. Even mild degrees of malnutrition double the
risk of mortality for respiratory and diarrheal disease mortality
and malaria.[This risk is greatly increased in more severe cases
of mal
• There are three commonly used measures for detecting malnutrition
in children: stunting (extremely low height for age), underweight
(extremely low weight for age), and wasting (extremely low weight
for height). These measures of malnutrition are interrelated, but
studies for the World Bank found that only 9 percent of children
exhibit stunting, underweight, and wasting. According to a 2008
review an estimated 178 million children under age 5 are stunted,
most of whom live in sub-Saharan Africa. A 2008 review of
malnutrition found that about 55 million children are wasted,
including 19 million who have severe wasting or severe acute
malnutrition. Measurements of a child’s growth provide the key
information for the presence of malnutrition, but weight and height
measurements alone can lead to failure to recognize kwashiorkor
and an underestimation of the severity of malnutrition in children.
Children under height under 5
Undernourished
MSU Study
• A study done by experts in the food and nutrition
department of Maharaja Sayajirao University of
Baroda (MSU), found that there was a big divide in the
children aged six to fourteen of the urban and rural
areas of the Vadodara district. The study found that
75% of 3,000 children in the rural areas of this district
were malnourished, whereas 15% of the 23,000
children studied in the urban areas were overweight.
• The study used anthropometrical surveys to calculate
these numbers, focusing on the Body Mass
Index (BMI) as the main indicator of nutrition
“HUNGaMa”
• New Delhi - "HUNGaMA" (Hunger and
Malnutrition) is the name of the first study carried
out after years concerning the problem of child
malnutrition. According to the report just
submitted by the country's Prime Minister, Dr.
Manmohan Singh, half the children who live in
the 100 poorest districts of India suffer from
atrophy or malnutrition already at the age of two.
The Minister noted that 42% of Indian children
are malnourished and defined malnutrition a
"national shame" for India.
UNICEF Data
• According to the latest 2009 data, provided by
UNICEF, there are about 61 million malnourished
children in the Asian country, one third of the global
total. The current rates are alarming, 59% of children
under 5 is suffering from atrophy. In addition,
because of poor information campaigns, 92% of
mothers had never heard of "malnutrition". In fact,
fewer than half of nursing mothers, and almost none
know what malnutrition is. The study was carried out
by the foundation Naandi in 112 districts of India,
interviewing 73 000 families.
Steps Taken by The Indian
Government
• The Akshaya Patra Foundation runs the world's
largest NGO-run midday meal programme serving
freshly cooked meals to over 1.3 million hungry
school children in government and government-aided
schools in India. This programme is conducted with
part subsidies from the Government and partly with
donations from individuals and corporate. The meals
served by Akshaya Patra complies with the nutritional
norms given by the government of India and aims to
eradicate malnutrition among children in India.
Integrated Child Development Scheme
The Government of India has started a program called Integrated Child
Development Services (ICDS) in the year 1975. ICDS has been instrumental in
improving the health of mothers and children under age 6 by providing health
and nutrition education, health services, supplementary food, and pre-school
education.The ICDS national development program is one of the largest in the
world. It reaches more than 34 million children aged 0–6 years and 7 million
pregnant and lactating mothers. Other programs impacting on under-nutrition
include the National Midday Meal Scheme, the National Rural Health Mission,
and the Public Distribution System (PDS). The challenge for all these programs
and schemes is how to increase efficiency, impact and coverage.
The National Rural Health Mission
• The National Rural Health Mission of India mission was created for the
years 2005–2012, and its goal is to "improve the availability of and access
to quality health care by people, especially for those residing in rural areas,
the poor, women, and children."
• The subset of goals under this mission are:
• Reduce infant mortality rate (IMR) and maternal mortality ratio (MMR)
• Provide universal access to public health services
• Prevent and control both communicable and non-communicable diseases,
including locally endemic diseases
• Provide access to integrated comprehensive primary healthcare
• Create population stabilisation, as well as gender and demographic balance
• Revitalize local health traditions and mainstream AYUSH
• Finally, to promote healthy life styles
• The mission has set up strategies and action plan to meet all of its goals.
Treatment at home
• If you are treated under supervision at home, the healthcare professional
helping you will discuss with you changes you should make to your diet.
• Recommended diet plans will depend on your individual circumstances,
but it is likely you will be advised to gradually increase your intake of
energy (calories), protein, carbohydrates, fluids, minerals and vitamins.
• You may also be advised to take special oral nutritional supplements in
addition to these dietary changes. These supplements can increase your
energy and protein intake, reducing the risk of complications (such as
infections) and hospital admission.
• You will be helped to set targets and your progress will be regularly
monitored.
• Depending on the cause of your malnutrition, you may need additional
help. For example, you may benefit from help from a carer if poor mobility
makes it difficult for you to shop for food or cook.
Treatments at Hospital
• If you are admitted to hospital with malnutrition you may be seen by a number of
different health professionals who will be involved in your care. This may include:
• a doctor who specialises in treating digestive conditions (a gastroenterologist)
• a dietitian
• a nurse specialising in nutrition
• a social worker
• If you don't have any problems swallowing food, you may be treated with dietary
changes, with or without nutritional supplements.
• If you are unable to swallow food, you may require an artificial feeding method,
such as a feeding tube. There are two types of feeding tubes:
• a nasogastric tube – a tube passed down your nose and into your stomach
• a percutaneous endoscopic gastrostomy (PEG) tube – a tube surgically placed
directly into your stomach through your abdomen (tummy)
• If a feeding tube is not suitable, nutrition directly into your vein (parenteral
nutrition) may be necessary.
Prakash

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Prakash

  • 1.
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  • 4. What is Malnutrition ? • Malnutrition is the condition that results from eating a diet in which certain nutrients are lacking, in excess (too high an intake), or in the wrong proportions. The verb form is "malnourish"; "malnourishment" is sometimes used instead of "malnutrition".
  • 6. Why do people fall so sick regularly ?
  • 7. Why do people get tired doing some physical activity ?
  • 8. Having trouble in understanding ?
  • 9. • These are all symptoms of malnutrition... In India almost every 2nd child suffers from it. • Malnutrition grabs a child from mother’s womb itself and continues affecting it till his 2 years of age. A <5 year old child is the most vulnerable to Malnutrition.
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  • 11. Dietary Practices Deriving too much of one's diet from a single source, such as eating almost exclusively corn or rice, can cause malnutrition. This may either be from a lack of education about proper nutrition, or from only having access to a single food source. Over-nutrition caused by overeating is also a form of malnutrition. In the United States, more than half of all adults are now overweight — a condition that, like hunger, increases susceptibility to disease and disability, reduces worker productivity, and lowers life expectancy. Overeating is much more common in the United States, where for the majority of people, access to food is not an issue. Many parts of the world have access to a surplus of non-nutritious food, in addition to increased sedentary lifestyles.
  • 12. Junk Food Often fast food, low in cost and nutrition, is high in calories and heavily promoted. When these eating habits are combined with increasingly urbanized, automated, and more sedentary lifestyles, it becomes clear why weight gain is difficult to avoid.However, overeating is also a problem in countries where hunger and poverty persist. In China, consumption of high-fat foods has increased while consumption of rice and other goods has decreased. Overeating leads to many diseases, such as heart disease and diabetes, that may result in death.
  • 13. Agricultural Productivity • Local food shortages can be caused by a lack of arable land, adverse weather, lower farming skills such as crop rotation, or by a lack of technology or resources needed for the higher yields found in modern agriculture, such as fertilizers, pesticides, irrigation, machinery and storage facilities. As a result of widespread poverty, farmers cannot afford or governments cannot provide the resources necessary to improve local yields. The World Bank and some wealthy donor countries also press nations that depend on aid to cut or eliminate subsidized agricultural inputs such as fertilizer, in the name of free market policies even as the United States and Europe extensively subsidized their own farmers. Many, if not most, farmers cannot afford fertilizer at market prices, leading to low agricultural production and wages and high, unaffordable food prices. Reasons for the unavailability of fertilizer include moves to stop supplying fertilizer on environmental grounds, cited as the obstacle to feeding Africa by the Green Revolution pioneer Norman Borlaug.
  • 14. The Mother of them all….
  • 15. • In Bangladesh, poor socioeconomic position was associated with chronic malnutrition since it inhibits purchase of nutritious foods such as milk, meat, poultry, and fruits. As much as food shortages may be a contributing factor to malnutrition in countries with lack of technology, the FAO(Food and Agriculture Organization) has estimated that eighty percent of malnourished children living in the developing world live in countries that produce food surpluses.
  • 16. * Over 7000 people die everyday in India due to hunger. * Over 25 lakh people die every year due to hunger in India. * Despite substantial improvement in health since independence and a growth rate of 8 percent in recent years, under-nutrition remains a silent emergency in India, with almost 50 percent of Indian children underweight and more than 70 percent of the women and children with serious nutritional deficiencies as anemia.
  • 17. Effects on Women Researchers from the Centre for World Food Studies in 2003 found that the gap between levels of undernutrition in men and women is generally small, but that the gap varies from region to region and from country to country.
  • 18. • Women have unique nutritional requirements, and in some cases need more nutrients than men; for example, women need twice as much calcium as men. Studies on nutrition concerning gender bias within households look at patterns of food allocation, and one study from 2003 suggested that women often receive a lower share of food requirements than men.[Gender discrimination, gender roles, and social norms affecting women can lead to early marriage and childbearing, close birth spacing, and under nutrition, all of which contribute to malnourished mothers. Frequent pregnancies with short intervals between them and long periods of breastfeeding add an additional nutritional burden
  • 19. Effects on Children The World Health Organization estimates that malnutrition accounts for 54 percent of child mortality worldwide, about 1 million children. Even mild degrees of malnutrition double the risk of mortality for respiratory and diarrheal disease mortality and malaria.[This risk is greatly increased in more severe cases of mal
  • 20. • There are three commonly used measures for detecting malnutrition in children: stunting (extremely low height for age), underweight (extremely low weight for age), and wasting (extremely low weight for height). These measures of malnutrition are interrelated, but studies for the World Bank found that only 9 percent of children exhibit stunting, underweight, and wasting. According to a 2008 review an estimated 178 million children under age 5 are stunted, most of whom live in sub-Saharan Africa. A 2008 review of malnutrition found that about 55 million children are wasted, including 19 million who have severe wasting or severe acute malnutrition. Measurements of a child’s growth provide the key information for the presence of malnutrition, but weight and height measurements alone can lead to failure to recognize kwashiorkor and an underestimation of the severity of malnutrition in children.
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  • 25. MSU Study • A study done by experts in the food and nutrition department of Maharaja Sayajirao University of Baroda (MSU), found that there was a big divide in the children aged six to fourteen of the urban and rural areas of the Vadodara district. The study found that 75% of 3,000 children in the rural areas of this district were malnourished, whereas 15% of the 23,000 children studied in the urban areas were overweight. • The study used anthropometrical surveys to calculate these numbers, focusing on the Body Mass Index (BMI) as the main indicator of nutrition
  • 26. “HUNGaMa” • New Delhi - "HUNGaMA" (Hunger and Malnutrition) is the name of the first study carried out after years concerning the problem of child malnutrition. According to the report just submitted by the country's Prime Minister, Dr. Manmohan Singh, half the children who live in the 100 poorest districts of India suffer from atrophy or malnutrition already at the age of two. The Minister noted that 42% of Indian children are malnourished and defined malnutrition a "national shame" for India.
  • 27. UNICEF Data • According to the latest 2009 data, provided by UNICEF, there are about 61 million malnourished children in the Asian country, one third of the global total. The current rates are alarming, 59% of children under 5 is suffering from atrophy. In addition, because of poor information campaigns, 92% of mothers had never heard of "malnutrition". In fact, fewer than half of nursing mothers, and almost none know what malnutrition is. The study was carried out by the foundation Naandi in 112 districts of India, interviewing 73 000 families.
  • 28. Steps Taken by The Indian Government
  • 29. • The Akshaya Patra Foundation runs the world's largest NGO-run midday meal programme serving freshly cooked meals to over 1.3 million hungry school children in government and government-aided schools in India. This programme is conducted with part subsidies from the Government and partly with donations from individuals and corporate. The meals served by Akshaya Patra complies with the nutritional norms given by the government of India and aims to eradicate malnutrition among children in India.
  • 31. The Government of India has started a program called Integrated Child Development Services (ICDS) in the year 1975. ICDS has been instrumental in improving the health of mothers and children under age 6 by providing health and nutrition education, health services, supplementary food, and pre-school education.The ICDS national development program is one of the largest in the world. It reaches more than 34 million children aged 0–6 years and 7 million pregnant and lactating mothers. Other programs impacting on under-nutrition include the National Midday Meal Scheme, the National Rural Health Mission, and the Public Distribution System (PDS). The challenge for all these programs and schemes is how to increase efficiency, impact and coverage.
  • 32. The National Rural Health Mission
  • 33. • The National Rural Health Mission of India mission was created for the years 2005–2012, and its goal is to "improve the availability of and access to quality health care by people, especially for those residing in rural areas, the poor, women, and children." • The subset of goals under this mission are: • Reduce infant mortality rate (IMR) and maternal mortality ratio (MMR) • Provide universal access to public health services • Prevent and control both communicable and non-communicable diseases, including locally endemic diseases • Provide access to integrated comprehensive primary healthcare • Create population stabilisation, as well as gender and demographic balance • Revitalize local health traditions and mainstream AYUSH • Finally, to promote healthy life styles • The mission has set up strategies and action plan to meet all of its goals.
  • 34.
  • 35. Treatment at home • If you are treated under supervision at home, the healthcare professional helping you will discuss with you changes you should make to your diet. • Recommended diet plans will depend on your individual circumstances, but it is likely you will be advised to gradually increase your intake of energy (calories), protein, carbohydrates, fluids, minerals and vitamins. • You may also be advised to take special oral nutritional supplements in addition to these dietary changes. These supplements can increase your energy and protein intake, reducing the risk of complications (such as infections) and hospital admission. • You will be helped to set targets and your progress will be regularly monitored. • Depending on the cause of your malnutrition, you may need additional help. For example, you may benefit from help from a carer if poor mobility makes it difficult for you to shop for food or cook.
  • 36. Treatments at Hospital • If you are admitted to hospital with malnutrition you may be seen by a number of different health professionals who will be involved in your care. This may include: • a doctor who specialises in treating digestive conditions (a gastroenterologist) • a dietitian • a nurse specialising in nutrition • a social worker • If you don't have any problems swallowing food, you may be treated with dietary changes, with or without nutritional supplements. • If you are unable to swallow food, you may require an artificial feeding method, such as a feeding tube. There are two types of feeding tubes: • a nasogastric tube – a tube passed down your nose and into your stomach • a percutaneous endoscopic gastrostomy (PEG) tube – a tube surgically placed directly into your stomach through your abdomen (tummy) • If a feeding tube is not suitable, nutrition directly into your vein (parenteral nutrition) may be necessary.