Malnutrition and Its Implications

Malnutrition is a health condition that arises from an imbalance in nutrient intake. It can manifest in two primary ways: undernutrition, resulting from inadequate nutrient intake, and overnutrition, which is associated with excessive nutrient intake. In this blog post, we will focus on undernutrition, its causes, and its implications.

What Is Malnutrition

Undernutrition occurs when the body fails to receive sufficient nutrients, leading to various health issues. It's a misconception that undernutrition is a problem confined to less developed regions; it is, in fact, a global issue affecting individuals in developed countries as well.

Undernutrition can arise from various factors such as inadequate nutritional intake, increased energy expenditure, or a failure to absorb nutrients properly. When fasting extends beyond 24 hours, the body begins to use muscle proteins for energy, leading to a reduction in muscle mass, weakness, and apathy. There is also a significant reduction in plasma proteins, leading to generalized edema, a condition characterized by an excess of fluid in the body's interstitial spaces.

Two Forms of Malnutrition: Kwashiorkor and Marasmus

Protein-Energy Malnutrition (PEM) is a form of malnutrition resulting from a severe reduction in protein and calorie intake. It manifests in two primary forms: Kwashiorkor and Marasmus.

Kwashiorkor

Kwashiorkor is often linked to diets rich in carbohydrates but extremely poor in proteins. It is characterized by a swollen abdomen caused by edema, hepatic steatosis (fatty liver), skin depigmentation, growth retardation, muscle weakness, and facial swelling. The mortality rate associated with Kwashiorkor can reach 30-60%.

Marasmus

Marasmus, on the other hand, is a result of the body's adaptation to malnutrition supported by both protein and caloric deprivation. The body reacts to the poor energy intake by exploiting all the energy reserves at its disposal, including the essential ones. This condition is characterized by an extreme loss of adipose and muscle tissue, leading to dry skin, hypothermia, muscle atrophy, irritability, and stunted growth.

The Impact of Vitamin Deficiencies

Malnutrition can also be linked to a deficit in the intake of micronutrients, including water, mineral salts, and vitamins. Insufficient intake of vitamins in the diet leads to a condition known as hypovitaminosis. This deficit can be due to an absolute nutritional deficiency, increased needs, or digestive tract pathologies.

Below is a summary of some vitamins, their sources, and the clinical effects of their deficiency:

• Vitamin A (retinol)
  Found in carrots, fish, eggs, and liver. Deficiency can cause eye and vision problems.
• Vitamin B1 (thiamine)
  Found in cereals, fruits, and dairy products. Deficiency can lead to Beriberi and nervous system problems.
• Vitamin B2 (riboflavin)
  Found in cereals, fruit, dairy products, and liver. Deficiency can cause damage to the mucous membranes.‍
• Vitamin B3 (niacin)
  Found in dairy, beans, and peas. Deficiency can lead to Pellagra.‍
• Vitamin B6 (pyridoxine)
  Found in carrots, fish, and meat. Deficiency can lead to anemia and neuropathies.‍
• Vitamin B9 (folate)
  Found in green leafy vegetables and fruits. Deficiency can lead to anemia, small intestine atrophy, ulcers, and spina bifida in the fetus.‍
• Vitamin B12 (cobalamin)
  Found in fish, meat, and dairy products. Deficiency can lead to spinal cord issues and anemia.‍
• Vitamin C (ascorbic acid)
  Found in fruits and green leafy vegetables. Deficiency can lead to scurvy.‍
• Vitamin D (cholecalciferol)
  Found in dairy, fish, and sunlight. Deficiency can lead to rickets and osteomalacia.‍
• Vitamin E (tocopherol)
  Found in cereals, eggs, and oils. Deficiency can lead to anemia and neuropathies.‍
• Vitamin K
  Found in vegetables, liver, and intestinal bacterial flora. Deficiency can impact blood clotting.