Malnutrition is caused by relative or absolute deficiency or excess of nutrients and can manifest as undernutrition or overnutrition. The main types of undernutrition are protein-energy malnutrition (PEM), which includes kwashiorkor and marasmus, and micronutrient malnutrition. PEM is caused by inadequate intake of proteins or calories and results in edema, wasting, and other signs. Micronutrient deficiencies can result in conditions like night blindness, anemia, and neurological impairments. Malnutrition has multiple causes including poverty, diseases, customs, and lack of knowledge. It is assessed using tools like growth charts, biochemical tests, and morbidity rates. Prevention focuses on identification, feeding programs, education, and increasing access to nutrit

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.