4. Epidemiology of malnutrition and nutritional deficiencies

Micronutrient deficiency?

Widespread in developing countries

- 2 billion people worldwide is affected

Deficiency affects the most vulnerable groups most commonly

Most common deficiencies?

- Iron

- Iodine

- Vitamin A

Malnutrition?

Inadequate or excess intake of a nutrient, leading to infections and disorders

- Large problem in developing world

- Affects mainly children and women

- Increase risk of dying from malaria, meningitis, pneumonia etc.

Epidemiology of malnutrition?

Descriptive studies:

- Describes nutritional state of a population

- National surveys are often used

Ecological studies:

- Measure incidence of a disease in the population

- Can compare how the incidence of a disease in a population changes over time

Case-control studies

- Retrospective study - compares people with a disease and without a disease & looks for possible risk factors

Cohort studies

- Compare two groups, one group with a risk factor and another without RF - compares their incidence of disease

Growth failure?

Kwashiorkor

Marasmus

These are acute malnutritions

Iron deficiency?

Most common nutritional disorder in the world

- 2 billion people worldwide

- Very prevalent in pregnant women and preschool children in developing countries

- Aggravated by parasite infections, malaria

Vitamin A deficiency?

Major cause of blindness in Africa, and south-east Asia

- Affects mostly children and pregnant women

Prevention:

- Fortification of rice - golden rice is fortified with vitA

- Promote breastfeeding

- Supplementation

Iodine deficiency?

Results in goiter/ hypothyroidism

Prevention:

- Fortification of table salt

Cachexia?

Complex metabolic syndrome characterized by wasting of muscles with or without fat loss, due to an underlying disease

- Seen in cancer, COPD, kidney disease

- Anorexia, inflammation, insulin resistance is associated with cachexia

- Not the same as starvation!

Intervention of malnutrition and nutritional deficiencies?

Determine etiology of malnutrition:

- Parasite?

- Infection?

- Increased demand?

- Poor diet?

Effective measures:

- Improve water supply, sanitation and hygiene

- Supplementation - when deficiency is severe

- Improve access to adequate amounts if healthy food

Fortification of foods:

- Not appropriate in severe deficiencies

- Requires participation of the food industry