Malnutrition- defnition, types, factors influencing and prevention

1. Epidemiology of non-communicable
diseases-MALNUTRITION
BY
S.KARTHIKA, ASST.PROF,
MMCON, MMU, MULLANA
AMBALA,HARYANA

2. Malnutrition is a health problem
occurring due to relative or
absolute deficiency or excess of
nutrients in human body and
causing pathological changes.

3. TYPES OF PROBLEM OF
MALNUTRITION
 Under nutrition
 over nutrition
 disproportional nutrients causing
imbalance
 specific nutrient deficiency
There are 2 types of malnutrition that can
occur are
 protein energy malnutrition
 Micro nutrient malnutrition

4. CAUSES
 Infectious disease
 food habits
 Food taboos
 personal choice for food
 customs, beliefs, culture, attitude etc.

5.  cooking practices
 women’s status
 lack of knowledge
 poverty
 poor sanitary environment

6. ASSESSMENT
o Clinical examination : WHO expert
committee has classified signs into 3
categories
o Signs which are not related to nutrition –
alopecia, pyorrhea
o Signs which need further investigation-
malar pigmentation, corneal vascularisation
o Signs which are of value- calf tenderness,
absence of knee jerks, enlargement of
thyroid gland, Bitot’s spot

7. 2. Anthropometry
Weight, height, skin fold thickness, arm
circumference, head and chest
circumference.
3. bio-chemical tests
4. Assess the dietary intake
5. Morbidity & mortality data

8. TYPES OF
MALNUTRITION A] protein energy malnutrition: 2 types
 Kwashiorkor Marasmus
 Due to decreased intake due to decreased
of proteins. Intake of calories.
 clinical features
 edema in lower leg, face loss of subcuta-
& lower arms. neous fat.
 Irritabilty Muscle wasting

9.  poor appetite weight for height
is low
 sparse, silky, often have
diarrhea
easily pulled out hairs
 hepatic enlargement quiet & apathetic

10. ASSESSMENT OF PEM
o Growth chart
o comparison of weight of child with the
weight of normal child of same age.
o comparison of height of child with
height of normal child at same age.

11. B] MICRONUTRIENT
MALNUTRITION
 Deficiency of vitamins & minerals
 deficiency of vitamin A
 night blindness
 conjuctival xerosis
 bitot’s spots
 corneal xerosis
 keratomalacia

12.  Deficiency of vitamin D- rickets,
osteomalacia
 Deficiency of vitamin E- no clear indication
 Deficiency of vitamin K – bleeding disorders
 Deficiency of vitamin B
 vit B1 – beri-beri wernick’s encephalopathy
 vit B2 – angular stomatitis
 niacin -pellagra-
diarrhea,dermatitis,dementia
 pyridoxine B6- peri-pheral neuritis

13.  deficiency of folate
 megaloblastic anaemia
 Glossitis
 Cheilosis
 Gastro intestinal disturbances such as
diarrhea, distention & flatulence.
 deficiency of vit B12
 pernicious anaemia
 demyelinating neurological lesions
 Infertility.
 deficiency of vit C- scurvy

14.  Deficiency of minerals:
 calcium – rickets , osteomalacia
 phosphorous – rare
 sodium – muscular cramps
 magnesium – irritability, tetany, hyper
reflexia
 iron – anemia, impaired cell mediated
immunity, reduced resistance to infection.
 iodine – hypothyroidism, cretinism, deaf-
mutism, severe mental retardation, goitre
 fluorine – dental caries

15. Prevention and control of
malnutrition (A) under nutrition
 identification of affected individuals
 special feeding programmes – (400-600
kcal)
 health education
 promotion of breast feeding and
improvement of infant and child feeding
practices
 improving the purchasing power of
people.

16.  Educating the selection of right kind of food
 Correction of harmful taboos and dietary
prejudices.
 Decreasing the infectious diseases by
appropriate measures.
 Kitchen gardening
 Proper planning of budget with expenditure
on food.

17. OVER NUTRITION
 OBESITY IS DEFINED AS ABNORMAL
DEPOSITION OF ADIPOSE TISSUE A
RISK FACTOR FOR CHRONIC, NON
COMMUNICABLE DISEASES SUCH
AS HYPERTENSION, CORONARY
ARTERY DISEASE, DIABETES
MELLITUS.

18. RISK FACTORS
 Over eating
 Physical inactivity
 Genetic factors
 Emotional disturbances
 Endocrinological factors
 Alcohol intake
 Drugs such as corticosteriods

19. ASSESSMENT OF
OBESITY
 BODY WEIGHT
 SKIN FOLD THICKNESS
 WAIST HIP RATIO

20. PREVENTION AND CONTROL
OF OVERNUTRITION
 Identification of people having obesity
 Creating awareness among public
regarding dietary habits
 Regular physical exercise
 Surgical treatment
 Health education
 Food intake according to energy
requirement.