Malnutrition means more than feeling hungry or not having enough food
to eat. Inadequate intake of protein (necessary to keep the body healthy and
build muscle), calories (a measure of energy the body needs), iron (for proper
blood cell function), and other nutrients make up different types of malnutrition.
Poor nutrition occurs in developing countries, as well as in more prosperous
areas of the world. As many as 800 million persons worldwide are affected
by malnutrition. More than half the childhood deaths in developing countries
are related to malnutrition. The August 4, 2004, issue ofJAMA includes an article about surveys that measure acute malnutrition
in residents of a developing country.
If the body does not receive the energy it needs in the form of food,
weight loss (mostly due to lack of muscle mass) will occur. Children with
malnutrition have inadequate fat stores and very little muscle. Their bones
are prominent and they often have disproportionately large abdomens. Brain
development can be impaired, and these children have a high incidence of disease
because their bodies cannot fight infection. Malnutrition contributes to the
high death rate among children in developing countries.
The body requires micronutrients (small amounts
of essential nutrients) from diet because the body does not make all the products
it needs for optimum function. Micronutrients include vitamins A, B, and C,
folate, zinc, calcium, iodine, and iron. The 3 major micronutrient deficiencies
in the developing world are iron (see below), iodine (deficiency can cause goiter [enlarged thyroid gland] and can lead to death or
mental retardation for a developing fetus), and vitamin A. Vitamin A deficiency
is a serious worldwide medical problem because it is the leading cause of
preventable blindness in children. Breastfeeding is recommended to prevent
vitamin A deficiency in infants because breast milk is rich in vitamin A.
Food fortification and increasing the amounts of fruit and vegetables in the
diet are also important ways to reduce vitamin A deficiency in adults. A pregnant
woman is especially vulnerable to vitamin A deficiency because her developing
fetus uses what vitamin A is available in her body.
Worldwide, iron deficiency is the most common form of malnutrition.
As many as 4 billion individuals may lack enough iron in their diet. Malaria
and parasitic infections are common contributing causes. Iron deficiency causes anemia (low red blood cell count). Anemia causes fatigue,
may cause heart failure in severe cases, and may also affect brain function.
Preventing iron deficiency requires an adequate diet including iron-rich foods
such as leafy green vegetables, beans, and red meats. Treatment of iron deficiency
may include increasing iron intake through fortified foods and iron supplements.
World Health Organizationhttp://www.who.int
National Institute of Child Health and Human Development 800/370-2943 http://www.nichd.nih.gov
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Sources: World Health Organization, National Institute of Child Health
and Human Development, Centers for Disease Control and Prevention
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TOPIC: CHILD HEALTH
Torpy JM, Lynm C, Glass RM. Malnutrition in Children. JAMA. 2004;292(5):648. doi:10.1001/jama.292.5.648