Antoinette Uwimpuhwe Research paper II: Malnutrition 1

Antoinette Uwimpuhwe.
HLTH-1020
11/17/2017

Malnutrition
Malnutrition is defined as a condition of impaired development or function caused by

either a chronic deficiency or excess in calorie and/or nutrient intake (Smith et al. 2018, p. 549).

The World Health Organization (WHO) defines malnutrition as deficiencies, excesses or

imbalances in a persons intake of energy and/or nutrients (WHO, 2016). These two definitions

combined imply that malnutrition occurs when an individual has insufficient or excessive

nutrient intake and when there is imbalance between nutrients intake and their use. This essay

will focus on these three main aspects of malnutrition, malnutrition by deficiency, malnutrition

by excess and malnutrition by imbalance.

Malnutrition by deficiency, also referred to as undernutrition, may involve one or many

nutrients at the same time. Proteins, lipids and carbohydrates, vitamins and minerals may all be

involved in deficiencies. According to the United Nations Food and Agriculture Organization

(FAO), the estimated number of undernourished people increased from 777 million in 2015 to

815 million in 2016 (FAO, 2017).

Undernutrition involving proteins, lipids and carbohydrates is called protein-calorie

malnutrition. It is also called protein-energy malnutrition. It has range of conditions according to

whether proteins or lipid and carbohydrates are more in deficiency. When the deficiency is more

of proteins, the resulting malnutrition condition is kwashiorkor. When the deficiency is more of

lipids and carbohydrates, the resulting condition is marasmus.

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Undernutrition can also involve macronutrients, vitamins and minerals. The most

prominent commonly found are deficiency of Vitamin A which causes xerophthalmia, risk of

blindness and slowed growth, deficiency of vitamin D which caused rickets, deficiency of

vitamin C which causes scurvy, deficiency of vitamin B1 which causes beriberi, deficiency of

vitamin B3 which causes pellagra, deficiency of vitamins B9 and B12 which cause anemia,

deficit of iodine which causes goiter, deficit of iron which causes anemia.

The causes of undernutrition includes poverty, poor eating habits and diseases. Poverty

limits access to nutritious foods. It stems from political, economic, social and demographic

causes that fall beyond the scope of this essay. Poor eating habits are caused by lack of

knowledge of basic nutritional principals and, despite the presence of enough food, the

individual does not take advantage of it to satisfy his nutritional needs. Diseases can limit food

intake especially by causing loss of appetite which reduces significantly the amount of food

intake. Overall, undernutrition weakens the bodys immune system and impairs multiple

functions which increases vulnerability to serious infections that can lead to death.

Malnutrition by excess is also referred to as overnutrition. Like undernutrition, it may

involve one or more nutrients at the same time. Most of the time, it involves excessive intake of

calories (lipids and carbohydrates) and shows up as overweight and obesity. According the

United Nations childrens funds 2016 Global Nutrition Report, in 2014, 41 million (6.1 % of the

world population) children under 5 years and 1.9 billion adults over 18 years (39 % of the world

population) were overweight. 600 million adults over 18 years (13 % of the world population)

were obese.
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Overweight and obesity are always are often associated with major health problems such

as high blood pressure, type II diabetes, heart coronary artery disease and strokes. Discussion on

how overweight and obesity cause these health problems goes beyond the scope of this essay.

Although overnutrition of macronutrients has not been as well researched and

documented as overnutrition involving calorie intake, it seems that excess intake of vitamins and

minerals may be associated with negative health outcomes. For example excessive intake of

vitamin A has been linked to decreased bone density and increase risk of hip fracture in older

men and women (Promislow et all, 2002). Excessive intake of niacin (vitamin B3) can cause

liver toxicity. (Rader, J. I., Calvert, R. J. & Hathcock, J. N., 1992).

Malnutrition by imbalance occurs when the nutrients supply cannot cope with a high rate

of nutrients consumption by the body. It may also occur when all the nutrients supplied cannot

be used by the body due to a too slow consumption rate. When consumption is higher than

supply, the condition leads to undernutrition just similar to when the supply is insufficient with a

normal consumption rate. When consumption is too slow, the condition leads to overnutrition,

just similar to when the supply is excessive with a normal consumption rate.

The causes of malnutrition are multiple but can be summarized in three, poverty, lack of

knowledge and diseases, which themselves stem from a range of factors, including political,

social, economic and demographic. Whatever the causes are, malnutrition in the world, where

some people suffer from starvation while others suffer from plenty, is a painful constant

reminder that the human kind still has to do better.

In summary, Malnutrition is a situation when nutrients intake is insufficient or excessive

compared to the body needs. Insufficient nutrient intake leads to undernutrition and excess intake

leads to overnutrition. Both, overnutrition and undernutrition, can arise from a situation of
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imbalance between intake and consumption of nutrients. Malnutrition is associated with negative

health outcomes. Undernutrition is associated with weakened immune system and vulnerability

to potentially lethal infectious diseases. Overnutrition leads to chronic diseases such as type II

diabetes, coronary heart disease, hypertension and strokes which can spoil the quality of live and

shorten the life span. Social, political, economic and demographic factors contribute to create

environments where poverty, lack of knowledge and diseases are the major causes of

malnutrition.

References:

Food and Agriculture organization of the United Nations. (2017). The State of Food Security and

Nutrition in the World 2017. Retrieved from: http://www.fao.org/state-of-food-security-

nutrition/en/. November 10, 2017.

Promislow, J. H., Goodman-Gruen, D., Slymen, D. J. & Barrett-Connor, E. Retinol Intake and

Bone Mineral Density in the Elderly: the Rancho Bernardo Study. (2002). Journal of

Bone minerals research. 17(8):1349-58.

Rader, J. I., Calvert, R. J. and Hathcock, J.N. (1992). Hepatic toxicity of Unmodified and Time-

Release Preparations of Niacin. American Journal of Medicine. 1992; 92:7781.

Smith, M. A., Collene, L. A., and Spess, K. C. (2018). Energy Balance and weight Control.

Wardlaws contemporary Nutrition: A Functional Approach. New York, 2 Penn Plaza:

Mc Graw-Hill Education

United Nations Childrens Fund (UNICEF). (2016). Global Nutrition Repot. From Promise to

Impact. Ending Malnutrition by 2030. Retrieved from https://data.unicef.org/wp-

content/uploads/2016/06/130565-1.pdf. November 11, 2017

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World Heal0th Organization. Online Q/A: What is Malnutrition? July 8, 2016. Retrieved from:

http://www.who.int/features/qa/malnutrition/en/