6 .Major malnutrition health problem

Malnutrition : bad of nutrition. Cause by INCORRECT Amount of nutrient

intake.

An optimal nutritional status is a powerful factor for health and well being . It is a major, modifiable and powerful element in promoting health, preventing and treating diseases and improving the quality of life .

Malnutrition may increase risk of (susceptibility to) infection and chronic diseases :

under-nutrition may lead to

increased infections and decreases in

physical and mental development.

over-nutrition may lead to obesity

as well as to metabolic syndrome or type 2 diabetes

Tow type of malnutrition

undernutrition Nutritional deficiency diseases may

classified as:

1-first type :that result directly from dietary lack of a specific essential nutrient.

2-second type :that result from the inability of the body to use a specific nutrient properly.

Protein Calorie malnutrition

Marasmus

kwashirkor

kwashiorkor in children of age 1-3 years in

past weaning years, which due to shift from high biological value protein to starchy food deficient in proteins.

characterized by edema. The classical syndrome is that

of retarded growth and development with mental apathy , muscular wasting , edema especially the liver (become big) .

Marasmus

in children under one year of age Marasmus is a severe form of

malnutrition that consists of the chronic wasting away of fat, muscle, and other tissues in the body.

Malnutrition occurs when your body does not get enough nearly all nutrients, especially protein and carbohydrates

A child with marasmus looks emaciated

Comparison between him Marasmus kwashiorkor

1- Definition :protein-energy malnutrition (PEM ) characterized by severe and prolonged restriction of all food i.e energy and protein as well as other nutrients

2- Essential Featuresa. Muscle wasting.b. Loss of sub-cutaneous fatc. Very low body weight

3- Age GroupUsually under one year of age

4- Important CauseEarly weaning

1- Definition :protein-energy malnutrition (PEM ) characterized by dificiency of protein e relatively adequate energy intake .

2- Essential Featuresa. Generalized oedemab. Hair changesc. Skin changed. Psychomotor changes

3- Age GroupUsually in children of 1-3 years

4- Important CauseLate weaning after extending

over two years

Comparison between him

Marasmus kwashiorkor

5- FrequencyOccure in poor people in people

in under developed countries who live in cities

6- Clinical Featuresa. Oedema is absentb. Skin changes ,hair ,apathy and

anorexia are seldon encountered

c. Abdomen may be distended.d. Liver is not fatty.

5- FrequencyOccures more frequently in rural

area

6- Clinical Featuresa. Ordema b. Hair become fine show flage

signc. Pigmentation desquamation

and ulceration of skind. Child is apathetic and

measureablee. Anorexiaf. Liver may be enlarged and

fatty.

Vitamin & micronutrient deficiency

Vitamin A deficiency Vitamin A deficiency cause : Night blindness. Conjunctive xerosis : xerosis means dryness Active corneal lesion : Cornea scars . effects the eyes and the lining of gut and the

respiratory system.

Increase risk of infection: children who lack Vit A are more likely to get gut, respiratory, and other infection and to die from them than children with enough Vit A. even mild VitA deficiency , with no sign of xerophthalmia may increase risk of infection and death .

Vitamin B deficiency

The deficiency of thiamin (B₁) causing beri-beri .

The deficiency of riboflavim (B₂) causing Ariboflavinosis .

Vitamin B deficiency

The deficiency of Niacin causing pellagra.

Vitamin C deficiency

Scurvy: It result from dietary lack of Vit C ,

scurvy usually occurs only on those consumes extremely poor diet that have a complete lack of fruit and vegetable

scurvy can effect infant who is only source of food is cow’s milk.

Vitamin D deficiency Vitamin D deficiency can result :

Osteomalacia : is the softening of the bones, osteomalacia in children is known as rickets, . It may show signs as diffuse body pains, muscle weakness, and fragility of the bones.

Osteoporosis : is a disease of bones that leads to an increased risk of fracture.

Rickets : is a softening of bones in children potentially leading to fractures and deformity. Rickets is among the most frequent childhood diseases in many developing countries.

osteoporosis

Rickets

Minerals deficiency

Calcium deficiency : Osteomalacia, osteoporosis, Rickets and tetany .

Phosphorus deficiency : affect growth and bone disease.

Magnesium deficiency : cause problem in acid-base problem, tremor, spasm and muscle action.

Minerals deficiency Iodine deficiency : Iodine participate in

the synthesis of thyroid hormones . Abnormal thyroid function leads to hypothyroidism or hyperthyroidism due to increase or decrease intake of iodine . Goiter is due to iodine deficiency .

Iron deficiency & Copper deficiency : cause anemia .

Goiter

Deficiency of Zinc

Mild deficiency : Stunted growth in children . Decreased tasting sensation . impaired immune function .

Sever deficiency : dwarfism . delayed sexual maturation. Hypopigmented hair .

overnutrition Overnutrition is a type of malnutrition

where there are more nutrients than required for normal growth, development, and metabolism..

The term can refer to: 1- obesity, brought on by general overeating

of foods high in caloric content, 2- Vitamin poisoning ، Iron poisoning, 3- Mineral overload : inborn errors of metal

metabolism, toxicity

8 .EXPLAIN METHODS OF ASSESSMENT OF

NUTRITIONAL STATUS

Introduction:

Nutritional Status :

- The state of a person’s health in terms of the nutrients in his or her diet.

- Or the condition of health of a person that is influenced by the intake and utilisation of nutrients.

The aim of nutritional assessment :

discover the nutritional problem in order to suggest the possible solution.

Methods of assessment of nutritional assessment:

Directmethods deal with the individual and measure objective

criteria

Nutrition is assessed by two methods:

Indirectmethods use

community indices that reflect the community

nutritional status/needs.

Ecological variables including agricultural crops :production Economic factors e.g. household income, population density, food availability and prices Vital health statistics :

morbidity, mortality and other health indicators e.g., infant and under-fives mortality, fertility indices and sanitary conditions

Indirect Methods of Nutritional Assessment

These are summarized as ABCD

A nthropometric methods C linical methods D ietary evaluation methods B iochemical, laboratory methods

direct Methods of Nutritional Assessment

Anthropometry Measurements:

It is the measurement of body height, weight, skin fold thickness , circumference of (arm , head and chest) & proportions .

It is an essential component of clinical examination of infants, children & pregnant women.

These measurements are compared to the reference data (standards) of the same age and sex group, in order to evaluate the nutritional status

Clinical Examination:

Clinical assessment It is an essential feature of all nutritional surveys.

It is the simplest & most practical method of ascertaining the nutritional status of a group of individuals.

It utilizes a number of physical signs, (specific & non specific), that are known to be associated with malnutrition and deficiency of vitamins & micronutrients

Dietary assessment Nutritional intake of humans is assessed by different methods.

These are: 24 hours dietary recall Food frequency questionnaire Dietary history food diary or record

D ietary evaluation methods

Biochemical & Laboratory assessment :

Laboratory Tests

- Hemoglobin estimation.- Stool ( for intestinal parasites ) & Urine ( for

albumen and sugar ) .

Biochemical Tests measure :

- Nutrient concentration ( e.g. serum )

- Detection of abnormal amounts of metabolites in urine ( e.g. urinary iodine )

- Enzymes concentration.

summary

Meaning of Malnutrition and his type Undernutrition Protein Calorie malnutrition 1- kwashirkor 2- Marasmus And the different Vitamin & micronutrient deficiency methods of assessment of nutritional

status In tow ways Direct & Indirect Direct summary in ABCD