Adolescent still-growing girls who become pregnant are at high risk of undernutrition. Women of reproductive age are at greater risk of undernutrition than other adults in Southern Sudan because:. Maternal undernutrition increases the risk of morbidity and death and of having undernourished babies. Higher energy needs 2 , poor appetite and sometimes lack of food means any adult who is HIV positive is at risk of undernutrition.
When food is scarce all adults may become thin and undernourished and so have lowered immunity and lack energy. It is often thought that undernutrition among old people is rare. Old people are at risk of undernutrition if they:. We all know that to improve nutrition-related behaviours it is best to share and discuss information rather than tell people what to do.
Then people feel free to discuss their problems, needs and ideas, and together you can identify behaviour changes that are practical, easy and acceptable.
Counsel mothers to exclusively breastfeed for the first six months d. Breastmilk alone provides all the water and nutrients babies need.
Counsel parents on why and how to avoid pregnancy during lactation. Advise families to supervise mealtimes and encourage young children to eat, especially when sick — but never to force-feed.
Explain why it is important to bring children for immunisations and weighing and check-ups. Give appropriate advice, without blaming the parents, if a child is not gaining weight at the healthy rate.
Advise how to prevent infections such as malaria and diarrhoea, and make sure families know what to do if a child becomes sick, and how to feed during recovery 4. Give vitamin A supplements from the age of six months and continue until the child is 5 years old 5. When the time comes to stop breastfeeding, counsel mothers to stop slowly unless advised otherwise c , and check that they know to continue giving energy and nutrient rich meals at least three times a day with healthy snacks if needed.
If you are malnourished, your body will slow down and it will not work as well as usual. If you are malnourished, there is also an increased chance that you will develop post-operative complications should you need to have surgery for another medical condition. In some cases, malnutrition can also lead to feelings of apathy indifference , tiredness, and depression. Malnutrition is caused by a lack of essential nutrients, resulting in the inability of the body to function as efficiently as normal.
A lack of nutrients in the body can be caused by a number of circumstances and conditions. For example, in developing countries, such as in many African countries, chronic long-term malnutrition is a large scale and ongoing problem, which is the result of people not having enough food to eat on a daily basis. Not eating enough food to maintain proper body function, or eating an imbalanced diet that does not provide you with the nutrients needed to maintain a good, all round level of health, will cause you to become malnourished.
An inadequate diet can occur for a number of reasons. For example, if you are unwell, or you are recovering from an illness, such as a stroke, throat or mouth cancer, or gastro-oesophageal reflux disease GORD , you may develop dysphagia. Dysphagia can arise as a complication of these conditions and, for some people, it makes it difficult to swallow certain foods, or liquids.
Some people with dysphagia are completely unable to swallow. Mental health conditions, such as depression, can sometimes make you feel like not eating and can lead to malnutrition. Similarly, eating disorders, such as anorexia nervosa and bulimia, can also result in malnutrition because the amount of food that is consumed by someone with an eating disorder is often very low. Mobility problems, which are particularly common among the elderly, are another potential cause of malnutrition, as they can prevent people getting to the shops to buy food, or from preparing food for themselves.
If the food that you eat is not digested properly, your body will be unable to absorb the nutrients that it needs to function effectively. An ileostomy involves removing part of the small intestine. In some cases, the colon large intestine and rectum back passage may also need to be removed.
If you have an ileostomy, you will need to have a low fibre diet for the first few months after the procedure, and you may need to take vitamin supplements until you are able to resume a normal diet. Coeliac disease is a bowel condition that is caused by intolerance to a protein called gluten. In coeliac disease, the immune system mistakes gluten as being harmful and attacks it, damaging the lining of the intestines gut so that it is unable to absorb food properly.
If you have coeliac disease, you will need to exclude gluten from your diet, and you may also need to take vitamin and mineral supplements. Diarrhoea and vomiting can also lead to the body losing vital nutrients and, in severe cases, can cause symptoms of malnutrition. People who misuse alcohol can sometimes become malnourished because alcohol contains enough calories to stop you feeling hungry, but it does not contain the necessary nutrients that are required to stay healthy. It is very important that malnutrition is detected as early as possible in order to prevent the condition getting worse, and to devise an appropriate nutritional treatment programme for the patient.
MUST is a five-step tool that can be used by health professional in hospitals, or in the community, to accurately identify those who are at risk from malnutrition. The tool also includes guidelines for introducing an effective treatment plan that is appropriate for the patient. MUST can only be used to identify malnutrition in adults, or adults who are at risk of becoming malnourished.
The tool is also not designed to identify deficiencies or excesses in the intake of vitamins and minerals. Treatment for malnutrition will depend on its severity, and whether you have any underlying illnesses, or conditions, that are causing you to be malnourished.
Any underlying causes will need to be addressed. NICE also recommend that patients who are having nutritional support and their carers should be:. Once malnutrition has been identified, or if there is a risk that you will become malnourished, the healthcare professional who is responsible for your care will devise an appropriate care plan for you. This healthcare professional may be a doctor or a dietician a nutritional specialist. The care plan will set out the aims and objectives of your treatment, and will include treating any underlying conditions that are causing, or contributing to, your malnutrition.
Treatment will involve a programme of feeding using a specially devised diet, which may include additional nutritional supplements. If you are severely malnourished, or unable to obtain enough nutrition orally to meet your nutritional requirements, artificial nutritional support may be needed. Your care plan will also involve carefully monitoring your progress, and periodically reviewing your treatment, in order to ensure that your nutritional needs are being met.
The healthcare professional responsible for your care will discuss eating and drinking with you, and will give you advice about making healthy food choices. People who are undernourished often have deficiencies in vitamins and minerals, especially iron, zinc, vitamin A and iodine 3. Malnutrition includes undernutrition and overnutrition, both of which can lead to health problems and nutrient deficiencies if not addressed. Being able to recognize the effects of malnutrition can help people and healthcare providers identify and treat issues related to under- or overnutrition.
This can cause 5 :. People with undernutrition may have one or several of these symptoms. Some types of undernutrition have signature effects. Kwashiorkor, a severe protein deficiency, causes fluid retention and a protruding abdomen. On the other hand, the condition marasmus, which results from severe calorie deficiency, leads to wasting and significant fat and muscle loss 5.
Undernutrition can also result in micronutrient deficiencies. Some of the most common deficiencies and their symptoms include 3 :. Since undernutrition leads to serious physical issues and health problems, it can increase your risk of death.
The main signs of overnutrition are overweight and obesity , but it can also lead to nutrient deficiencies. Research shows that people who are overweight or obese are more likely to have inadequate intakes and low blood levels of certain vitamins and minerals compared to those who are at a normal weight 11 , This is likely because overweight and obesity can result from an overconsumption of fast and processed foods that are high in calories and fat but low in other nutrients 14 , A study in over 17, adults and children found that those who ate fast food had significantly lower intakes of vitamins A and C and higher calorie, fat and sodium consumption than those who abstained from this type of food Symptoms of malnutrition are assessed by healthcare providers when they screen for the condition.
Tools that are used to identify malnutrition include weight loss and body mass index BMI charts, blood tests for micronutrient status and physical exams 17 , 18 , If you have a history of weight loss and other symptoms associated with undernutrition, your doctor may order additional tests to identify micronutrient deficiencies. Identifying nutrient deficiencies that result from overnutrition, on the other hand, can be more difficult. To find out if you have nutrients deficiencies, consider discussing your dietary habits with your doctor.
Symptoms of undernutrition include weight loss, fatigue, irritability and micronutrient deficiencies. Overnutrition can result in overweight, obesity and a lower intake of certain vitamins and minerals. Long-term effects of undernutrition include a higher risk of obesity, heart disease and diabetes 20 ,
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