Causes of malnutrition

NE-411
The conceptual model for undernutrition

Undernutrition

Immediate Inadequate food

Disease
causes intake

Poor social and Poor Public

Underlying Household food
care practices Health
causes insecurity

Basic causes Formal and informal infrastructure/

political ideology/resources
Immediate causes of undernutrition
• Undernutrition occurs when there is
– insufficient nutrient intake
– an increase of nutrient needs that prevents
effective utilization of nutrients (i.e. morbidity)

• Nutritional requirements are defined by

– Macronutrients: needed in large amounts and include
protein,carbohydrate and fat.
– Micronutrients: needed in much smaller amounts and include
vitamins and minerals
Infection and undernutrition in
emergencies
•Most mortality in the initial period of an emergency is
caused by four infectious diseases: diarrheal diseases,
acute respiratory infections, measles and malaria, as
well as undernutrition
–Malnutrition and infection often occur at the same time.
Malnutrition can increase the risk of infection while infection
can cause malnutrition
 Interactions between malnutrition and major diseases
Disease Impact of malnutrition on
Disease
Diarrhoea •Increased duration
• Increased severity
•Increased risk of dying
Acute Respiratory •Increased severity
Tract Infections •Increased risk of dying
Measles • Increased duration
•Increased severity
•Increased risk of dying
Malaria • Some evidence of increase
severity in deficiencies of
vitamin A and zinc
Impact of infectious disease on
nutritional status
•Malabsorption
•Appetite loss
•Appetite loss
•Increased metabolic rate resulting in
muscle breakdown
•Appetite loss
•Decreased levels of plasma vitamin A
•Prolonged immune suppression
resulting in increased ARI and
diarrhoea
•Increased metabolic rate resulting
in
muscle breakdown
•Loss of proteins into the gut
•Appetite loss
•Increased metabolic rate
•Destruction of red blood corpuscles
leading to anaemia
•Impaired foetal development, low
birth weight
Underlying causes of malnutrition:
Household food insecurity
• Household food security is defined as sustainable access to
safe food of sufficient quality and quantity to ensure
adequate intake and healthy nutrition for all family
members
• It depends on access to food as well as its availability and
proper utilization by each person
• Two examples:
– Disasters can destroy food stocks in the home, warehouses and where
crops are grown (land, water, forests and grazing ground), as well as
incomes
– Some of the major famines in the world have been caused by market
shocks which have resulted in an inability to buy food due to high food
prices
Underlying causes of malnutrition: Poor
social and care practices
• Caring practices are the way community members, including the vulnerable such
as children, the elderly and the sick, are fed, nurtured, taught and guided. Care
practices include:
– Caring for and supporting vulnerable groups
– Optimal infant and young child feeding practices
– Health protection behaviour
– Psycho-social support
– Caring for and supporting mothers

• Cultural factors and resources, like income, time and knowledge, determine caring
practices
• Societal values e.g., attitudes towards modern health services, water & sanitation,
women’s education, unequal division of labour
Underlying causes malnutrition: Poor
public health
• Health refers to access to affordable, good quality
curative and preventative health services and a
healthy environment
• Access to quality health services is essential and is
determined by physical distance, cost, transport,
poor quality or good quality
– A complete disruption of health services is frequent in emergencies
• Health environment Clean water and sanitation
facilities, shelter, cold
– In emergency situations the environment often
deteriorates rapidly and leads to ill-health
 Basic causes
• Political, legal and cultural factors may defeat the best efforts of
households to attain good nutrition, depending on how:
– the rights of women and girls are protected by law
– control that women have over resources
– political and economic systems that determine how income and assets
are distributed
– ideologies and policies that govern social sectors
• Political discrimination due to religion, ethnic can lead to systematic
marginalization from food and other relief services and add on top of
economic marginalization that is the basic cause of malnutrition in many
emergencies
– In emergencies, the injustices of the overall system are often
exacerbated and can lead to the nutritional status of minority groups
deteriorating rapidly
 Conti…
• Volatile food prices impact on the poorest means
difficult decisions have to be made – eating less food,
missing a meal and eating less diverse diet – which
have detrimental impact on nutritional status. High
food prices result in nutritional emergencies
• Climate change chronic emergencies often occur in
places with challenging physical environment –
frequent droughts, floods. Climate change negatively
impacts on food and nutrition security, quality of crops,
access to safe water and for agricultural purposes,
health.
 Causes of stunting
• Poor living conditions - low
parental education, poor
maternal nutrition during
pregnancy, etc

• Poverty

• Consequences include:
• Higher morbidity and
mortality
• Lower educational
achievement
• Reduced productivity in
adulthood.
Age: 2 years 9 months 2 years 6 months
Weight: 10.7 kg. 11.6 kg.
Height: 78.3 cm 86.4 cm
Causes of Obesity in Children
• Inadequate pre-natal care

• Suboptimal infant and young child

nutrition

• Poor diet

• Low levels of physical activity

• Consequences:
• Obesity in adulthood
• Disability in adulthood
• Cardiovascular disease
• Diabetes
• Premature death
Thank You!!!!
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