Malnutrition in MNCH

Where is the prevalence of malnutrition highest?

southern asia and sub-saharan africa

What two conditions can diets frequently deficient in macronutrients/micronutrients lead to?

1. protein-energy malnutrition (PEM)

2. micronutrient deficiencies (MND)

What age group is most affected by undernutrition?

children under 5

stunting

• low height for age

• product of chronic weight loss

wasting

• low weight for height

• indicates recent weight loss

What impacts does eliminating malnutrition have for young children?

• improved school attainment by at least a year

• reduced poverty

• empowerment of women and breaking the intergeneration cycle of poverty

_______ (stunting, wasting, or overweight rates) have declined steadily since 2000, _________ persist at alarming rates, and _______ will require reversal if the 2030 target is to be achieved.

stunting, wasting, overweight

What are the most important MNDs?

• deficiencies in iron (leading to anemia)

• deficiencies in iodine (iodine deficiency disorder)

• deficiencies in vitamin A (VADD leads to anemia)

• deficiencies in zinc (immune system)

• deficiencies in folic acid in pregnant women

What is the main underlying cause of under-nutrition?

poverty

What impacts does vitamin A deficiency have?

• leading cause of preventable childhood blindness

• increases risk of death from common childhood illnesses (ex: diarrhea and measles)

What is the intervention for vitamin A deficiency?

periodic, high-dose vitamin A supplementation

What can iodine deficiency cause?

• mental retardation/learning disabilities (especially during pregnancy and early childhood)

• in severe cases, can cause stillbirth or miscarriage

What is the most important risk factor for the burden of disease globally?

malnutrition

What are the causes of PEM in children?

• insufficient supply of macronutrients as a result of early weaning, inappropriate introduction of complementary food, and low-protein diet

• severe and chronic infectious diseases

marasmus

• severe wasting

• weight loss, dehydration, stomach shrinkage, diarrhea

kwashiorkor

• edema (swelling of hands and feet/stomach bulging)

• children who develop it are often older than children who develop marasmus

• can be caused by a mainly carb diet

• can cause an inability to grow or gain weight

marasmic kwashiorkor

severe wasting in the presence of edema

Kwashiorkor and marasmic kwashiorkor have a _________ (higher or lower) case fatality rate than marasmus.

higher

PEM definition

BMI below 18.5-20

Anemia is a risk factor for ______ during or after birth.

hemorrhaging

Maternal malnutrition can cause intrauterine growth restriction which leads to _________.

LBW babies increasing the risk of perinatal and neonatal mortality and ultimately contributes to stunting

What is the management strategy for severe PEM?

• community based therapeutic care

• combined nutritional and disease interventions

severe acute malnutrition

a life-threatening condition requiring urgent treatment

What impact did the invention of ready to use therapeutic foods (RUTF) have on the treatment of severe acute malnutrition?

• allows for the treatment children who are severely malnourished above the age of 6 months in outpatient settings instead of in hospitals

What is RUTF made of?

peanut butter, milk powder, and a combo of vitamins and minerals

• it’s a ready-made paste (no water necessary)

What are the interventions for MNDs?

• sprinkles and fat-based spreads (peanut butter)

• iron-fortified weaning foods

• low-dose iron supplements

• vit A supplementation

• iodized salt

• multivitamin, iron, and folic acid supplements during pregnancy