Malnutrition:

Definition, Symptoms
and Treatment.
 INTRODUCTION
Malnutrition refers to getting too little or too much of certain
nutrients.
It can lead to serious health issues, including stunted growth,
eye problems, diabetes and heart disease.
Malnutrition affects billions of people worldwide. Some
populations have a high risk of developing certain types of
malnutrition depending on their environment, lifestyle and
resources.
This article discusses the types, symptoms and causes of
malnutrition and provides information about prevention and
treatment.
What Is Malnutrition?

Malnutrition is a condition that results from nutrient deficiency or overconsumption.

Types of malnutrition include:
•Undernutrition: This type of malnutrition results from not getting enough protein, calories or
micronutrients. It leads to low weight-for-height (wasting), height-for-age (stunting) and weight-
for-age (underweight).
•Overnutrition: Overconsumption of certain nutrients, such as protein, calories or fat, can also
lead to malnutrition. This usually results in overweight or obesity.
People who are undernourished often have deficiencies in vitamins and minerals, especially iron,
zinc, vitamin A and iodine.
However, micronutrient deficiencies can also occur with overnutrition.
It’s possible to be overweight or obese from excessive calorie consumption but not get enough
vitamins and minerals at the same time.
That’s because foods that contribute to overnutrition, such as fried and sugary foods, tend to be
high in calories and fat but low in other nutrients.
Signs and Symptoms
The signs and symptoms of malnutrition
depend on the type.
Being able to recognize the effects of
malnutrition can help people and healthcare
providers identify and treat issues related to
under- or overnutrition.
Undernutrition
Undernutrition typically results from not getting enough nutrients in your diet.
This can cause:
•Weight loss
•Loss of fat and muscle mass
•Hollow cheeks and sunken eyes
•A swollen stomach
•Dry hair and skin
•Delayed wound healing
•Fatigue
•Difficulty concentrating
•Irritability
•Depression and anxiety
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.
Undernutrition can also result in micronutrient deficiencies. Some of the most
common deficiencies and their symptoms include.
•Vitamin A: Dry eyes, night blindness, increased risk of infection.
•Zinc: Loss of appetite, stunted growth, delayed healing of wounds, hair loss,
diarrhea.
•Iron: Impaired brain function, issues with regulating body temperature,
stomach problems.
•Iodine: Enlarged thyroid glands (goiters), decreased production of thyroid
hormone, growth and development issues.
Overnutrition
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.
One study in 285 adolescents found that blood levels of vitamins A and E in obese
people were 2–10% lower than those of normal-weight participants.
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.
A study in over 17,000 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.
Assessing Malnutrition
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.
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.
If you’re overweight or obese and eat mostly processed and fast foods, you may
not get enough vitamins or minerals. To find out if you have nutrients deficiencies,
consider discussing your dietary habits with your doctor.
Common Causes of Malnutrition
Malnutrition is a worldwide problem that can
result from environmental, economic and
medical conditions.
The WHO estimates that over 460 million adults
and 150 million children are undernourished,
while more than two billion adults and children
are overweight or obese.
Common causes of malnutrition include:
•Food insecurity or a lack of access to sufficient and affordable food: Studies
link food insecurity in both developing and developed nations to malnutrition.
•Digestive problems and issues with nutrient absorption: Conditions that cause
malabsorption, such as Crohn’s disease, celiac disease and bacterial overgrowth in
the intestines, can cause malnutrition.
•Excessive alcohol consumption: Heavy alcohol use can lead to inadequate intake
of protein, calories and micronutrients.
•Mental health disorders: Depression and other mental health conditions can
increase malnutrition risk. One study found that the prevalence of malnutrition was
4% higher in people with depression compared to healthy individuals.
•Inability to obtain and prepare foods: Studies have identified being frail, having
poor mobility and lacking muscle strength as risk factors for malnutrition. These
issues impair food preparation skills.
Populations at Risk
Malnutrition affects people in
all parts of the world, but some
populations are at a higher risk.
Populations that are prone to malnutrition include:
•People living in developing countries or areas with limited access to food:
Undernutrition and micronutrient deficiencies are especially common in Sub-
Saharan Africa and Southern Asia.
•Individuals with increased nutrient needs, especially children and pregnant or
breastfeeding women: In some developing countries, 24–31% of pregnant and 
breastfeeding mothers are malnourished.
•People that live in poverty or have low incomes: Low socioeconomic status is
associated with malnutrition.
•Older adults, particularly those who live alone or have disabilities: Research
shows that up to 22% of older adults are malnourished and over 45% are at risk of
malnutrition.
•People with issues that affect nutrient absorption: People with Crohn’s disease
or ulcerative colitis may be up to four times more likely to have malnutrition than
those without these conditions.
Prevention and Treatment
Preventing and treating malnutrition involves addressing the underlying causes.
Government agencies, independent organizations and schools can play a role in preventing
malnutrition.
Research suggests that some of the most effective ways to prevent malnutrition include providing
iron, zinc and iodine pills, food supplements and nutrition education to populations at risk of
undernutrition.
In addition, interventions that encourage healthy food choices and physical activity for children
and adults at risk of overnutrition may help prevent overweight and obesity.
You can also help prevent malnutrition by eating a diet with a variety of foods that include
enough carbs, proteins, fats, vitamins, minerals and water.
Treating malnutrition, on the other hand, often involves more individualized approaches.
If you suspect that you or someone you know is undernourished, talk to a doctor as soon as
possible.
A healthcare provider can assess the signs and symptoms of undernutrition and recommend
interventions, such as working with a dietitian to develop a feeding schedule that may include
supplements.
FOUR MAJOR COMMON
NUTRITIONAL DISORDERS
PROTEIN- ENERGY MALNUTRITION
(PEM)
VITAMIN A DEFICIENCY (VAD)
IRON DEFICIENCY ANEMIA (IDA)
IODINE DEFICIENCY DISORDER (IDD)
PROTEIN-ENERGY MALNUTRITION (PEM)
 Protein-energy undernutrition (PEU), previously called
protein-energy malnutrition, is an energy deficit due to
deficiency of all macronutrients. It commonly includes
deficiencies of many micronutrients. PEU can be sudden
and total (starvation) or gradual. Severity ranges from
subclinical deficiencies to obvious wasting (with edema,
hair loss, and skin atrophy) to starvation. Multiple organ
systems are often impaired. Diagnosis usually involves
laboratory testing, including serum albumin. Treatment
consists of correcting fluid and electrolyte deficits with IV
solutions, then gradually replenishing nutrients, orally if
possible.
PROTEIN – ENERGY MALNUTRITION (PEM) MARASMUS
PROTEIN – ENERGY MALNUTRITION (PEM) KWASHIORKOR
VITAMIN A DEFICIENCY (VAD) hypovitaminosis A 
Vitamin A deficiency can result from inadequate
intake, fat malabsorption, or liver disorders.
Deficiency impairs immunity and hematopoiesis
and causes rashes and typical ocular effects (eg,
xerophthalmia, night blindness). Diagnosis is
based on typical ocular findings and low vitamin
A levels. Treatment consists of vitamin A given
orally or, if symptoms are severe or
malabsorption is the cause, parenterally.
VITAMIN A DEFICIENCY (VAD) NIGHTBLINDNESS
Night blindness (nyctalopia) is the inability
to see well at night or in poor light. It is not
a disease in itself, but rather a symptom of
an underlying problem, usually a retina
problem. It is common for patients who are
myopic to have some difficulties with night
vision, but this is not due to retinal disease,
but rather to optical issues.
VITAMIN A DEFICIENCY (VAD) BITOT’S SPOT
Bitot's spots are the buildup of keratin
located superficially in the conjunctiva of
human´s eyes. They can be oval, triangular
or irregular in shape. The spots are a sign
of vitamin A deficiency and associated with
drying of the cornea. In 1863, the French
physician Pierre Bitot (1822-1888) first
described these spots
IRON DEFICIENCY ANEMIA
Iron deficiency anemia is a common type of anemia —
a condition in which blood lacks adequate healthy red
blood cells. Red blood cells carry oxygen to the body's
tissues.
As the name implies, iron deficiency anemia is due to
insufficient iron. Without enough iron, your body can't
produce enough of a substance in red blood cells that
enables them to carry oxygen (hemoglobin). As a
result, iron deficiency anemia may leave you tired and
short of breath
IODINE DEFICIENCY DISORDER
Iodine deficiency is a lack of the trace
element iodine, an essential nutrient in
the diet. It may result in a goiter,
sometimes as an endemic goiter as well
as cretinism due to untreated congenital
hypothyroidism, which results in
developmental delays and other health
problems.
Both insufficient and excessive iodine
intake can result in thyroid disease
GOITER OR GOITRE
A goitre, or goiter, is a swelling in the neck resulting from an enlarged thyroid gland.[1]
[2]
 A goitre can be associated with a thyroid that is not functioning properly.
CLASS II CLASS III
ENDEMIC GOITER
Endemic goiter is a type of
goitre that is associated with
dietary iodine deficiency.[1][2]
Some inland areas where soil
and water lacks in iodine
compounds and consumption of
marine foods is low are known
for higher incidence of goitre. In
such areas goitre is said to be
"endemic".
CONGENITAL IODINE DEFICIENCY SYNDROME
Congenital iodine deficiency
syndrome, previously known
as cretinism, is a condition of
severely stunted physical and
mental growth owing to
untreated congenital
deficiency of thyroid hormone
(congenital hypothyroidism)
usually owing to maternal
hypothyroidism.