malnutrition by Dr: Najeeb Memon mnajeeb80@gmail.com

2. DR: NAJEEB MEMON
Asst: Professor
COMMUNITY MEDICINE & P.H.S
LUMHS, JAMSHORO
e mail mnajeeb80@gmail.com

3. MALNUTRITION

4. MALNUTRITION
(Bad Nourishment)
 A Pathological state OR
resulting from
Relative OR Absolute
Deficiency
Excess of One OR
More Essential Nutrients
Excess of
One OR More
Essential Nutrients

7.  The World Health Organization (WHO) defines
malnutrition as
the cellular imbalance between
to ensure
growth,
maintenance, and
specific functions
supply of nutrients
& energy
and the body's demand
for them
Primary: inadequate food intake
Secondary: result of disease
Mixed

8. Malnutrition comprises both;
1. Under nutrition
2. Over nutrition

9. UNDERNUTRITION
ACUTE
UNDERNUTRITION
CHRONIC
UNDERNUTRITION
• Marasmus
• kwashiorkor
• Marasmic- kwashiorkor
• Wasting
TYPES OF UNDERNUTRITION
• Stunting
• Underweight
There were 925 million undernourished people in the world in 2010,
an increase of 80 million since 1990.
Nearly 17% of people in the developing world are undernourished.
Affects all age groups;
vulnerable groups are
young children ,
pregnant women, &
lactating women .

10. MANIFESTATIONS OF OVERNUTRITION
 In the more developed countries of the world, over nutrition is
encountered much more frequently than under nutrition.
10
The health hazards from
over nutrition are:
1. Obesity,
2. Diabetes,
3. Hypertension,
4. CVD,
5. Renal diseases,
6. Disorders of liver &
gall bladder.

11. (Too short for their Age)
(Very Thin)
(Show both Signs)
(Energy defic:
Extreme thinness)
(protein defici:
Edema lower
legs)
(Short / Thin or Both)

12. Marasmus: (6m – 15m)
(Energy deficiency )
Extreme thinness
Kwashiorkor (Displaced Child) 1-3 Ys
(protein deficiency)
Edema lower legs
Marasmic-Kwashiorkor
 (Show both Signs)

14. Age group affected
 PEM (45%) = 1 to 2 years
 PEM (69%) = 1 to 3 years
Marasmus = 6 months to 15 months
Kwashiorkor = 1 to 3 years
Usually b/w 6 months & 3 years

15. Factors related to Malnutrition
 Social and Economic
 Poverty
 Ignorance
 Inadequate weaning practices
 Cultural & social practices
 Vegetarian
 Low fat diets

16. Biologic factors
 Maternal malnutrition, prematurity
 Start life with poor stores
 Infectious disease
 Diarrhea, TB, measles, Malaria, AIDS
 Environmental
 Unsanitary living, poor quality water
 Droughts, floods, wars, forced migrations

17. TYPES OF MALNUTRITION
 Anemia or Iron Deficiency
 Iodine Deficiency
 Vitamin A Deficiency
 Lack of Thiamin (Vit: B1) – Beri-Beri
 Lack of Niacin (vit: B3) – Pellagra
 Lack of Vitamin C- Scurvy
 Lack of vitamin D – Rickets
 Malnutrition due to a lack of energy and protein foods

18. •How
maternal
&
child
nutrition
are
linked

19. Anthropometric Measures
Children:
 Weight-for-age (underweight)
 Reflects chronic or acute malnutrition or both
 Height-for-age (stunting)
 Reflect chronic (prolonged, cumulative) malnutrition
 Weight-for-height (wasting)
 Reflects acute and recent malnutrition

20. Anthropometric Measurements
Adults:
 Body Mass Index (BMI)
 Low weight-for-height ( kg/m2) reflects chronic &/or
acute
 Mid-upper arm circumference (MUAC)
 Thin reflects chronic &/or acute

21. Treatment of Malnutrition
Follow WHO Guidelines
 1. Treat/prevent hypoglycaemia
 2. Treat/prevent hypothermia
 3. Treat/prevent dehydration
 4. Correct electrolyte imbalance
 5. Treat/prevent infection
 6. Correct micronutrient deficiencies
 7. Initiate refeeding
 8. Facilitate catch-up growth
 9. Provide sensory stimulation & emotional support
 10. Prepare for follow-up after recovery

22. Prevention of Malnutrition
 Primary Prevention
 Health Education to mothers about good nutrition and
food hygiene through Lady Health Workers
 Immunization of children.
 Growth monitoring on Growth Charts specially of all
children under 3 years of age
 Secondary Prevention
 Mass Screening of high risk populations, using simple tools
like (Weight for age) or MUAC.
 Tertiary Prevention
 Good Nutritional Care, supplementary feedings and
rehabilitation,
 counseling of mothers.

23. Interventions Proven to Reduce Malnutrition When Linked with
Health Services
(Essential Nutrition Actions)
Vitamin A
and iron
Iodized salt
Breastfeeding
Mother’s
nutrition
Complementary
feeding
Sick/severe
cases

24. THANX