Malnutrition

What is malnutrition?

Malnutrition refers to deficiencies, excesses, or imbalances in a person’s intake of energy and/or nutrients.

What are the three broad groups of conditions that the term malnutrition addresses?

Undernutrition

Micronutrient-related malnutrition

Overweight, obesity and diet-related non-communicable diseases

What does undernutrition include?

Wasting (low weight-for-height), stunting (low height-for-age) and underweight (low weight-for-age).

What does micronutrient-related malnutrition include?

Micronutrient deficiencies (a lack of important vitamins and minerals) or micronutrient excess.

What are some diet-related non-communicable diseases?

Heart disease, stroke, diabetes and some cancers.

Name two Sustainable Development Goals (SDGs) related to nutrition.

SDG 2 (end hunger, achieve food security and improved nutrition and promote sustainable agriculture)

SDG 3 (ensure healthy lives and promote wellbeing for all at all ages)

What are the six key action areas in the UN Decade of Action on Nutrition?

* Creating sustainable, resilient food systems for healthy diets

* Providing social protection and nutrition-related education for all

* Aligning health systems to nutrition needs, and providing universal coverage of essential nutrition interventions

* Ensuring that trade and investment policies improve nutrition

* Building safe and supportive environments for nutrition at all ages

* Strengthening and promoting nutrition governance and accountability, everywhere.

What are the 10 general principles for the inpatient management of severely malnourished children according to WHO guidelines?

* Treat/prevent hypoglycemia

* Treat/prevent hypothermia

* Treat/prevent dehydration

* Correct electrolyte imbalance

* Treat/prevent infection

* Correct micronutrient deficiencies

* Start cautious feeding

* Achieve catch-up growth

* Provide sensory stimulation and emotional support

* Prepare for follow-up after recovery.

What is hypoglycemia?

Low blood glucose, also called low blood sugar, occurs when the level of glucose in your blood drops below what is healthy for you.

Give three symptoms of hypoglycemia

Irregular or fast heartbeat, fatigue, pale skin, shakiness, anxiety, sweating, hunger, irritability.

What are ready-to-use therapeutic foods (RUTFs)?

RUTFs and F-75 and F-100 milks were created to provide appropriate nutrition and caloric intake to those experiencing malnutrition.

When would F-75 milk be ideal?

When trying to reintroduce food into a malnourished person

When would F-100 milk be used?

To aid in weight gain in a malnourished person.

What is the primary method used for screening malnutrition due to the difficulty in measuring weight-for-height Z scores (WHZ) frequently?

Mid-upper arm circumference (MUAC) < 115 mm

What is Kwashiorkor?

A subtype of severe acute malnutrition (SAM) characterized by bilateral peripheral pitting oedema.

What are some of the signs and symptoms of Kwashiorkor?

Pitting edema, distended abdomen, thinning of hair, loss of teeth, skin or hair depigmentation, dermatitis, irritability, and anorexia.

What are some of the proposed causes of Kwashiorkor?

Protein deficiency causing hypoalbuminemia, amino acid deficiency, oxidative stress, and gut microbiome changes.

What are the SAM diagnosis parameters according to the World Health Organization?

A "mid-upper arm circumference (MUAC) of < 115 mm, weight-for-height/length Z-score (WHZ) of < -3Z and nutritional oedema or any combination of these parameters.

What is the difference between Marasmus and Kwashiorkor?

Kwashiorkor is characterized by edema and occurs in children with a weight for age of 60-80% of the reference standard.

* Marasmus occurs in children with a weight for age of <60% of the reference standard and does not involve edema.

What percentage of deaths among children under 5 years of age are linked to undernutrition?

Around 45% of deaths among children under 5 years of age are linked to undernutrition.

Who introduced the term "Kwashiorkor" and what was their profession?

Jamaican Pediatrician Cicely Williams