Nutritional Disorders

Dr. Rimsha Ali

 Nutrition
• It is the selection of foods and preparation of foods, and their
ingestion to be assimilated by the body.

• By practicing a healthy diet, many of the known health issues can be

avoided

• The diet of an organism is what it eats, which is largely determined by

the perceived palatability of foods.
 Nutritional Disorders
• It occurs when the body doesn’t absorb or get from food the
necessary amount of a nutrient.

• Deficiencies can lead to variety of health problems.

• These can include digestion problems, skin disorders, stunted or

defective bone growth and even dementia.
Types Of Nutritional Problems

Under Nutrition
(Malnutrition)
Over Nutrition
 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.’

Primary: related to diet

Secondary: related to
• Nutrient malabsorption
• Impaired nutrient utilization or storage
• Excess nutrient loss
• Increased need for nutrients
 Protein Energy Malnutrition
• Inadequate intake of protein and calories
• Two main clinical syndromes:
Marasmus
• Starvation in infant with overall lack of calories
• Somatic protein compartment(skeletal muscles) affected
Kwashiorkor
• Protein deprivation more severe than deficit in calories
• Visceral compartment (protein stores in liver) affected
 Marasmus
• It is a consequence of protein energy deficiency characterized by:
wasting of muscles and fat tissues (‘skin and bone”) growth
retardation

• Serum protein is normal and there is no edema

• It can occur at any age and can be easily compensated by normalizing

nutritional supply of proteins and other nutrients.
 Clinical Features
• Weight is less than 60% of normal

• Loss of muscle mass and subcutaneous fat emaciation of

extremities and head appears too large for body

• Usually there is associated anemia, multivitamin deficiencies and

immune deficiency (T- cell mediated immunity) concurrent
infections
 Kwashiorkor
• It is a childhood protein energy deficiency that occurs when protein
deprivation is greater than reduction in total calories

• Typically occurs in children who have been weaned of the mother’s

breast when the second child was born

• There is hypoalbuminemia and generalized or dependent edema

• Loss of weight masked by edema

• Usually there is sparing of muscle and subcutaneous fat

• Weight is between 60-80% of normal

• Other clinical features include:

• Flaky Paint appearance of skin (alternating zones of hyperpigmentation, areas

of desquamation and hypopigmentation)

• Alternating bands of pale and dark hair--- Flag sign

• Enlarged fatty liver

• Atrophy and loss of small intestinal villi, leading to concurrent loss of
small intestinal enzymes disaccharidase deficiency

• Development of apathy and listlessness

• Loss of appetite

• Other vitamin deficiencies and defects in immunity

 Assessment of PEM
• Gomez Classification
Weight for age (%)= weight of child x 100
_________________
weight of normal child of same age

• Between 90 – 110% Normal Nutritional

• Between 75 – 89% Mild malnutritional
• Between 60 – 74 % Moderate Malnutritional
 Prevention
• Oral rehydration therapy: helps to prevent dehydration caused by
diarrhea
• Exclusive breast feeding for 6 months, thereafter supplementary
foods may be introduced along with breast feeds
• Immunization for infants and children
• Nutritional supplements
• Early diagnosis and treatment
• Promotion and correction of feeding practices
• Family planning and spacing of birth
 VITAMINS
DEFICIENCY
DISORDERS
Vitamins
VITAMIN DEFICIENCY STATES
Pellagra
Vitamin A Deficiency
Prevention and Control
• Administering large doses of vitamin A orally on periodic basis

• Regular and adequate intake of vitamin A

• Fortification of certain food with vitamin A – sugar, salt, tea and

skimmed milk
VITAMIN C DEFICIENCY
List of Deficiencies of Essential
Minerals
 Nutritional Anemia
• It is a condition where the hemoglobin content of blood is lower than

normal as a result of a deficiency of one or more essential nutrients,

regardless of the cause of such deficiency

 Causes/ Risk Factors
• Inadequate diet
• Insufficient intake of iron
• Iron malabsorption
• Pregnancy
• Excessive menstrual bleeding
• Hookworm infestation
• Malaria
• Close birth intervals
• GI bleed
• Infants and children
• Pregnant women
 Effects of Anemia
Pregnancy Infection Work capacity
• Increases risk of • Anemia can be • Most severe the
maternal and fetal aggravated by parasitic anemia, greater the
morbidity and mortality infections like malaria, reduction in work
• Abortions, premature intestinal parasites performance
births, PPH, low birth • Iron deficiency may
weight are associated repair cellular response
with anemia during and immune functions
pregnancy
 Prevention
• Estimation of Hb to assess degree of anemia
• Blood transfusion in severe cases of anemia (<8g/dl)
• Iron and folic acid supplements
• Food fortification with iron
• Changing dietary habits
• Control of parasites
• Nutritional education and awareness
Iodine Deficiency Disorders
• IDD leads to a much wider spectrum of disorders
commencing with the intrauterine life and extending through
childhood to adult life with serious health and social
implications
 Disorders
• Goiter
• Hypothyroidism
• Subnormal intelligence
• Delayed motor milestones
• Mental deficiency
• Hearing defects
• Speech defects
• Mental retardation
• Neuromuscular weakness
• Endemic cretinism