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DISORDERS
Dr. ANAMIKA DEV
NUTRITIONAL DISEASES
• An adequate diet should provide:–
• Sufficient energy in the form of carbohydrates, fats and
proteins.
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MALNUTRITION
The World Health Organization defines malnutrition as
"the cellular imbalance between supply of nutrients and
energy and the body's demand for them to ensure
growth, maintenance, and specific functions.“
Loss of appetite
3/8/2019
Atrophy of different Atrophy of different
tissues and organs but tissues and organs
subcutaneous fat including subcutaneous
NUTRITIONAL DISORDERS
preserved fat
Small bowel – mucosal Rarely seen
atrophy & loss of villi and
micro villi
Bone marrow hypoplastic
Hypoplastic
Cerebral atrophy
Seen
Thymic & lymphoid
Less marked
atrophy
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KWASHIORKOR AND MARASMUS
3/8/2019
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NUT
RITI
ONA
L
DIS
ORD
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MARASMUS
3/8/2019
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NUT
RITI
ONA
L
DIS
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PEM IN DEVELOPED WORLD
Secondary PEM
Develops in chronically ill, older and bed ridden
patients
Obvious Signs of secondary PEM include:
Depletion of subcutaneous fat in arms, chest wall,
shoulders or metacarpal regions
Etiology
Obesity results when calorie intake exceeds utilisation
like in
Over eating
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genetic predisposition to develop obesity
Loss of function mutation in leptin
25-30 overweight
>30 obese
A. Life-long obesity:
2. Hypertension
4. Cholelithiasis
7. Cancer
8. Osteoarthritis
OBESITY
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DISORDERS OF VITAMINS
VITAMINS
Fat soluble vitamins
a) vit A
b) vit D
c) vit E
d) vit K
water soluble vitamins
a) vit B complex
b) vit C
VITAMIN DEFICIENCY STATES
Water soluble Dietary sources Consequence of
Vitamin deficiency
B1 (Thiamine) Cereals , milk, eggs, fruits, yeast Beriberi, Neuropathy, Cardiac
extract failure, Kosakoff’s psychosis,
Wernicke’s encepahlopathy
B2 (Riboflavine) Cereals , milk, eggs, fruits, liver Ariboflavinosis (Mucosal fissuring,
Cheilosis and Glossitis, Angular
stomatitis)
B6 (Pyriodoxine) Cereals , milk, meat, fish Cheilosis, glossitits, Neuropathy,
Sideroblastic anemia
C (ascorbic acid) Citrus fruits, green vegetables Scurvy, Swollen bleeding gums,
Bruising and bleeding
PELLAGRA
Hypocalcemic tetany
E Cereals, eggs, vegetable oils Neuropathy,
(α- tocopherol) Anemia(reduced red
cell life span)
K Blood coagulation
Vegetables, liver
Defects
VITAMIN A
The major functions of vitamin A are
maintenance of normal vision, regulation of cell
growth and differentiation, and regulation of
lipid metabolism.
The most devastating changes occur in the eyes and are referred
to as xerophthalmia (dry eye).
First, there is dryness of the conjunctiva (xerosis conjunctivae)
as the normal lacrimal and mucus-secreting epithelium is replaced
by keratinized epithelium.
Blindness ultimately
Squamous metaplasia in respiratory and urinary
tract predisposing to infections and renal stones
respectively
Mechanism:
lack of vit D impairs mineralisaton of the growing skeleton
Signs of deficiency
• Rickets (children)
• Osteomalacia (adults)
• Hypocalcemic etany
SIGNS OF RICKETS
Skeletal deformities –
bow legs & lumbar
lordosis
THORACIC CHANGES IN RICKETS
Deformation of the chest results from overgrowth of
cartilage or osteoid tissue at the costochondral
junction, producing the “rachitic rosary.”