Introduction
Malnutrition in all forms includes undernutrition (wasting, stunting, and being underweight), insufficient vitamins and minerals, being overweight or obese, and developing diet-related noncommunicable diseases. Around 462 million adults worldwide were underweight in 2014, while 1.9 billion were overweight or obese. In 2020, it was estimated that 149 million children under five years were stunted (too short for their age), 45 million were wasted (too thin for their height), and 38.9 million were obese. Undernutrition is responsible for approximately 45 percent of deaths among children under five. These are most common in low and middle-income countries. At the same time, childhood overweight and obesity rates are rising in these countries. The global burden of malnutrition has serious and long-term developmental, economic, social, and medical consequences for individuals and their families, communities, and countries.
What Is Undernutrition?
When most people think of malnutrition, they visualize undernutrition. Undernutrition is a nutrient deficiency. An individual may be malnourished if a balanced diet is not taken or the body has difficulty absorbing enough nutrients. Undernutrition can cause visible fat and muscle wasting, but it can also be invisible. Therefore, one can be both overweight and malnourished. Undernutrition, like overnutrition, is classified into energy (calories) and micronutrients.
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Energy Undernutrition: Most people associate the term "malnutrition" with energy undernutrition, also known as protein-energy malnutrition (PEM). Energy deficiency is more common in developing countries. Protein-energy malnutrition can occur in children who are malnourished and lose weight. They may also struggle in school and with learning. Pregnant women with PEM are more likely to have underweight babies. Certain diseases, such as certain types of cancer, can also result in malnutrition. PEM comes in two varieties:
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Starvation (Marasmus): Marasmus is a type of malnutrition caused by a lack of total energy, which results in infertility, poor growth, and could even be fatal. The body breaks down its tissues to survive, resulting in an emaciated appearance.
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Protein Deficiency (Kwashiorkor): Even if there is some carbohydrate or fat in the diet, a lack of protein can cause PEM. This is referred to as kwashiorkor. Kwashiorkor patients have thin arms and legs as well as bloated abdomens.
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Micronutrient Undernutrition: Micronutrient malnutrition is a lack of one or more vitamins or minerals. When the diet is out of balance, vitamin or mineral deficiency occurs, and it can occur whether or not calorie intake is adequate. Iron and calcium are frequently deficient in the average diet. Iron deficiency affects up to 25 percent of the world's population, particularly young children, women, and pregnant women. In addition, according to research, teenagers and older adults do not get enough calcium from their diet.
Nutrient deficiency can be caused by a chronic health condition such as pernicious anemia (which causes a lack of vitamin B12), Crohn's disease, celiac disease, or infection in some cases. Symptoms do not usually appear immediately but rather develop over time. Malabsorption occurs when the digestive system cannot break down nutrients for proper absorption. This can result in micronutrient deficiency. Malabsorption can occasionally be treated with dietary changes but may also require medical treatment.
What Is Overnutrition?
Overnutrition occurs when one consumes more nutrients than the body requires daily. While many people associate malnutrition with a lack of nutrients, overconsumption is also classified as malnutrition due to the negative health consequences.
It is of two types:
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Energy Overnutrition: Unless there is an increase in physical activity, eating too many calories (or energy) will cause weight gain over time. It makes no difference whether those extra calories come from macronutrients (carbohydrates, fat, or protein) because the body stores whatever it does not need as fat. In developed countries, energy overnutrition is common. People suffering from this type of overnutrition may also suffer from micronutrient undernutrition if their foods are high in calories but low in micronutrients.
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Micronutrient Overnutrition: It occurs when an excessive amount of a specific nutrient is consumed. Most vitamins and minerals can be consumed in excess. This usually occurs when extremely high doses of dietary supplements are taken. It is uncommon to consume an excessive amount of any micronutrient from food. Micronutrient overnutrition, such as taking too many iron pills at once, can result in acute poisoning. It can also become chronic if large amounts of a specific vitamin (such as vitamin B6) are taken over weeks or months.
What Are the Signs and Symptoms of Overnutrition and Undernutrition?
Undernutrition can manifest as:
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Low body weight, prominent bones, and fat and muscle depletion.
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Thin arms and legs, with edema (fluid swelling) in the belly and face.
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Children's growth and intellectual development are stunted.
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Weakness, dizziness, and fatigue.
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Irritability, apathy, or inattention.
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Rashes and lesions, and inelastic skin.
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Brittle hair, hair loss, and pigment loss in the hair.
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Frequent and severe infections.
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Low body temperature, inability to warm up.
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Low blood pressure and heart rate.
Overnutrition can manifest as:
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Obesity.
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High blood pressure.
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Insulin resistance.
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Cardiovascular disease.
How Is It Diagnosed?
A physician can detect malnutrition based on a patient's overall appearance, behavior, body fat distribution, and organ function. Patients may be asked to keep a food diary for a set period. X-rays detect bone density, gastrointestinal problems, and heart and lung damage. Blood and urine tests are used to assess the patient's vitamin, mineral, and waste product levels.
How Is It Treated?
Nutritional supplements are used to treat undernutrition. This could include individual micronutrients or refeed with a custom, highly nutritious formula to replenish everything the body lacks. Severe undernutrition may require weeks of refeeding to correct. However, refeeding can be hazardous, particularly in the first few days. To adapt to undernutrition, the body undergoes numerous changes. Refeeding forces it to revert to its previous mode of operation, which is sometimes more than it can bear. To avoid and manage the complications of refeeding syndrome, which can be serious and even life-threatening, it is best to begin refeeding under close medical supervision.
Overnutrition is typically treated with weight loss, dietary, and lifestyle modifications. Losing excess weight can reduce the likelihood of developing secondary conditions like diabetes and heart disease. Diet and exercise plans, medications, and medical procedures may all be used in weight loss treatment. An underlying condition, such as thyroid disease or a mental health disorder, may also necessitate treatment. Depending on the route taken, weight loss can be quick or slow and gradual. However, once they have lost weight, the lifestyle changes they maintain will help them keep it off. This could include long-term support systems like counseling, behavioral therapy, support groups, and nutrition education.
Conclusion
Malnutrition is a worldwide issue. Poverty and a lack of nutrition knowledge are the leading causes in both the developed and developing worlds. A properly-balanced diet is essential for good health. A healthy, wholesome diet can address the majority of causes of malnutrition. Medical help can be taken if one experiences malnutrition symptoms.
