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Understanding Malnutrition: Factors, Causes, and Relationships

This lesson delves into the concept of malnutrition, examines the factors that influence nutritional status, and explores the relationships between nutrition, food security, health, and mortality. By the end of the lesson, learners will be able to define malnutrition, identify the factors affecting nutritional status, and understand the connections between nutrition and various outcomes.

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Understanding Malnutrition: Factors, Causes, and Relationships

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  1. Learning objectives • At the end of this lesson you will be able to: • define the concept of malnutrition; • identify the factors influencing nutritional status; and • be aware of the relationships between nutrition, food security, • health and mortality.

  2. Introduction What are the factors affecting an individual’s nutritional status? • Understanding these factors is essential in order to: • assess malnutrition, • design programmes which tackle nutrition • problems, and • correctly inform programme management • and evaluation.

  3. What is malnutrition? The term malnutrition indicates a bad nutritional status. • Nutritional status is the physiological state of an individual, which results from: • the relationship between nutrient intake and requirements, and • the body’s ability to digest, absorb and use these nutrients.

  4. What is malnutrition? A distinction must be made between Malnutrition and Undernutrition: • It arises either: • from deficiencies or excesses of specific nutrients, or • from undiversified diets (wrong kinds or proportions of foods). Malnutrition It is the outcome of insufficient food. It is caused primarily by an inadequate intake of dietary or food energy. Undernutrition

  5. What is malnutrition? In many developing countries, under and overnutrition are occurring simultaneously among different population groups. This phenomenon is referred to as the “double burden” of malnutrition.

  6. Causes of malnutrition Poverty is the root cause of malnutrition. (The underlying causes are food security, health and care). However, overnutrition and dietary imbalances cut across many socio-economic boundaries.

  7. Causes of malnutrition Nutritional status is influenced by multiple and interrelated factors. The most important factors can be grouped under these broad categories: FOOD HEALTH CARE

  8. Causes of malnutrition Food, health and care are interrelated: actions affecting one area may have significant consequences on another. Developmentpolicies usually are not included in the domain of nutrition as such. However, they impact considerably on the nutritional well-being of the population.

  9. Conceptual frameworks This is the most commonly used framework for understanding the causes of malnutrition. (adapted from the UNICEFconceptual framework).

  10. Conceptual frameworks Another conceptual framework for malnutrition: the Food Insecurity and Vulnerability Mapping System (FIVIMS) framework for food security, livelihoods and nutrition. Socio-economic and political environment Care practices Food consumption • Performance of the food economy: • availability • access • stability Nutritional status Food utilization Health and sanitation

  11. NUTRITIONAL STATUS NUTRITIONAL STATUS MORTALITY HEALTH STATUS Nutritional status, health, mortality and low birth weight It is important to consider the relationships between nutritional status and health status, mortality and low birth weight. NUTRITIONAL STATUS LOW BIRTH WEIGHT Let’s see these relationships more in detail...

  12. Nutritional and healthstatus Nutrition and health are closely linked: NUTRITIONAL STATUS disease contributes to malnutrition HEALTH STATUS while malnutrition makes an individual more susceptible to disease. This can eventually lead to severe malnutrition and death.

  13. Nutritional and healthstatus This ‘vicious cycle’ is known as the “malnutrition-infection cycle”: INADEQUATE DIETARY INTAKE Weight loss, growth faltering and reduced immunity, which lower the body’s ability to resist infection. leads to this causes this results in Loss of appetite, malabsorption of nutrients, altered metabolism and increased nutrient needs. Longer, more severe and more frequent disease episodes. leads to

  14. Nutritional and healthstatus • Certain diseases are particularly frequent causes of poor growth, for example: • diarrhoea, • respiratory infections, • HIV/AIDS and • malaria.

  15. Nutritional and healthstatus The relationship between nutrition and disease can be observed in the seasonal changes in nutritional status. • Many communities experience periods in the year when malnutrition levels are higher. These are influenced by seasonal patterns such as: • cropping patterns, • food availability, • disease, • child care, • income sources, • price of foods, • labour demand.

  16. Nutritional status and mortality Mortality increases exponentially with declining nutritional status. NUTRITIONAL STATUS Many factors that impact mortality are often compromised in situations of conflict and displacement. In emergencies there may be varying levels of mortality associated with the same level of malnutrition. MORTALITY Consequently, mortality rates cannot be predicted from prevailing rates of malnutrition.

  17. NUTRITIONAL STATUS LOW BIRTH WEIGHT Nutritional status and low birth weight It is estimated that each year 24 million babies are born with low birth weight (LBW)-less than 2.5 kg.Ninety five percent of these events occur in developing countries. The most significant cause is poor maternal nutrition.

  18. Nutritional status and low birth weight The cycle of poor nutrition perpetuates itself across generations. This diagram by the Standing Committee on Nutrition shows the intergenerational cycle of growth failure: Child growth failure Low weight and height in teenagers Low birth weight baby Early pregnancy Small adult woman

  19. Summary • Malnutrition refers to all deviations from adequate nutrition, including undernutrition (and overnutrition) resulting from inadequacy (or excess) of food. • Malnutrition carries heavy human and economic costs on individuals and households, communities and nations. Malnutrition and undernutrition are often used as synonyms. However, a clear distinction needs to be made at all times. • The co-existence of undernutrition, micronutrient deficiencies, overweight/obesity and other nutrition-related chronic diseases occurs in the same countries, in the same communities and even in the same households throughout the world today, posing one of the greatest challenges to national policy makers. This phenomenon is referred to as the “double burden” of malnutrition. • Even if poverty is the root cause of undernutrition, malnutrition has multiple and interrelated causes. The direct causes of malnutrition can be grouped under the broad categories of: food, health and care.

  20. If you want to know more... • Nutrition and development: a global challenge - adapted from Nutrition and development - a global assessment, written by FAO and WHO for the International Conference on Nutrition, 1992. • United Nations Standing Committee on Nutrition/Administrative Committee on Coordination(ACC/SCN) Second report on the World Nutrition Situation: Vol.1: Global and Regional Results, ACC/SCN Geneva, 1992. • The double burden of malnutrition – Case studies from six developing countries. FAO Food and Nutrition Paper 84, Rome 2006. http://www.fao.org/docrep/009/a0442e/a0442e00.htm • Measurement and Assessment of Food Deprivation and Undernutrition - FIVIMS Proceedings, International Scientific Symposium held in FAO, Rome 26-28 June 2002. FAO 2003. http://www.fao.org/DOCREP/005/Y4249E/Y4249E00.HTM • Conducting small-scale nutrition surveys: A field manual. FAO, 1990, 186p, English, Spanish, French ISBN 202851. http://www.fao.org/docrep/009/a0442e/a0442e00.htm#Contents • Body mass index - A measure of chronic energy deficiency in adults. FAO Food and Nutrition Paper 56, 1994. http://www.fao.org/docrep/T1970E/T1970E00.htm

  21. If you want to know more... • United Nations Standing Committee on Nutrition Issue No. 33 Diet-related Chronic Diseases and the Double Burden of Malnutrition in West Africa, 2006, pages 18-20. • http://www.unsystem.org/scn/Publications/SCNNews/scnnews33.pdf. • Incorporating Nutrition Considerations into Development Policies and Programmes: Brief for Policy-Makers and Programme Planners in Developing Countries, FAO 2004.http://www.fao.org/docrep/007/y5343e/y5343e00.htm • The State of Food Insecurity in the World (SOFI): monitoring progress towards the World Food Summit and Millennium Development Goals (FAO-SOFI, 2004) • http://www.fao.org/docrep/007/y5650e/y5650e00.htm

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