Malnutrition is a state in which the physical condition is impaired due to inadequate dietary intake or disease. There are two types of malnutrition: over nutrition which includes obesity and related diseases, and under nutrition which includes acute conditions like marasmus and kwashiorkor as well as chronic conditions like stunting. Malnutrition has immediate, underlying, and basic causes. Immediate causes are inadequate dietary intake or disease. Underlying causes include household food insecurity, inadequate care practices, and unhealthy environments. Basic causes relate to lack of resources and inequitable social, economic, and political systems.

1. Definition: Malnutrition is a state in which the physical condition is impaired to the point where s/he can
no longer shows an adequate level of performance in physical work, mental capacity, resisting and recovering
from illness, maintaining adequate level of growth.
Type: According to the nutritional status malnutrition are 2 types. They are given below:
1. Over Nutrition: Obesity, Diabetes, Hypertension, Cardiovascular diseases, Renal diseases, Disorders of
liver and gall bladder.
2. Under Nutrition:
A. Acute under Nutrition: Marasmus, Kwashiorkor, Marasmic- kwashiorkor, Wasting etc.
B. Chronic Under nutrition: Stunting, Underweight.
According to the sources of nutrients malnutrition are 2 types. They are given below:
1. Protein Energy Malnutrition: Marasmus, Kwashiorkor, Marasmic- kwashiorkor.
2. Micronutrient Malnutrition: Vitamin A deficiency disorder, Iodine deficiency disorder, Nutritional
Anaemia & other deficiencies.
Causes ofMalnutrition:
The UNICEF conceptual framework, which the nutrition community has been using for programming for the
past 25 years, identifies three levels of causes of undernutrition.
1. Immediate causes:The immediate cause of undernutrition is a result of a lack of dietary intake, or
disease. This can be caused by consuming too few nutrients or an infection which can increase
requirements and prevent the body from absorbing those consumed.
A. Inadequate dietary intake: 1.Decreaseddietary intake: Dysphagia (altered taste),Anorexia,
Abdominal pain/nausea, Bowel obstruction.
2. Increased nutrient losses: Bleeding, fistulas, diarrhea, protein losing enteropathy, bacterial
overgrowth.
3. Increased nutrient requirements: Fever/sepsis/increased mucosal turnover.
B. Disease: The table below highlights the impact of major diseases on nutritional status.
Disease Impact Of Under nutrition Impact of infection for nutrition
Diarrhoea Increased duration, severity, mortality Malabsorption, Appetite loss
Respiratory
Infection
Increased severity, mortality Appetite loss, Metabolic effects
due to muscle breakdown

2. Measles Increased duration, severity, mortality Appetite loss, fever, muscle
breakdown, immune function
Malaria Some evidence of increased severity in deficiencies of
Vitamin A and Zinc
Iron deficiency leading to
anaemia, Impaired foetal
development, low birth weight
and growth faltering
Under nutrition and infection often occur at the same time because one can lead to another.
 The level of interaction depends on the infection and the extent of undernutrition but in general, poor
nutrition can result in reduced immunity to infection.
 This can increase the likelihood of an individual getting an infection or increase its duration and/or
severity.
 Infection can result in loss of appetite, increased nutrient requirements and/or decreased absorption of
nutrients consumed.
2. Underlying causes:
UNICEF framework just described these are classified as underlying causes. They can be grouped into three
broad categories:
 Household food insecurity: Household food security is defined as sustainable access to safe
food of sufficient quality and quantity to ensure adequate intake and a healthy life for all
members of the family Therefore people are only food secure when food is both available and
accessible- food must not only be in the market but people must be able to afford it.
Additionally, for an active and healthy life, people need enough food as well as the right balance
of fat, protein, carbohydrates and micronutrients. Food security encompasses both quantity and
quality of food accessed. In emergencies, the ways in which people access food is often
disrupted, especially if they have to leave their homes due to conflict or sudden flooding or an
earthquake. Additionally, crops and food stocks are often destroyed in emergencies such as
floods or drought.
 Inadequate care: Caring practices such as breastfeeding, appropriate complementary feeding,
as well as hygiene and health seeking behaviours support good nutrition. These practices can be
severely disrupted in an emergency which can lead to poor dietary intake and increased
infection, both of which are underlying causes of undernutrition.
 Unhealthy household environment and lack of health services (poor public health):
The third category of the underlying causes of undernutrition refers to those related to poor
public health. This includes factors relating to the health environment, exposure to disease and
access to basic health services. The health environment is affected by access to clean, safe water
and sanitation, the presence of malarial breeding sites, the quality of shelter and consequent level

3. of cold, stress, overcrowding. Access to basic health services determines the extent to which
infection and disease can be prevented or treated. In emergency situations the health environment
often deteriorates rapidly. Access to adequate clean water and sanitation may be severely limited.
Population displacement can result in people living in camps or overcrowded living quarters
which can facilitate the spread of disease.
3. Basic causes: The third level of factors contributing to undernutrition identified by the conceptual
framework is considered basic causes. These refer to what resources are available (human, structural,
financial) and how they are used (the political, legal and cultural factors). These can be thought of as the
real reasons behind the underlying causes. Political, legal and cultural factors may defeat the best efforts
of households to attain good nutrition. These include the degree to which the rights of women and girls
are protected by law and custom; the political and economic system that determines how income and
assets are distributed; and the ideologies and policies that govern the social sectors.
Overcoming entrenched poverty and underdevelopment requires resources and inputs. If the basic
causes of under nutrition are to be addressed, greater and better-targeted resources and better
collaboration are needed.