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Malnutrition

Malnutrition. Supervision Prof. Dr.Mervat Salah. Malnutrition of Children Eradication of poverty and hunger . Intended Learning Outcomes. By the end of this lecture, students will have a general overview on malnutrition in children. Definition of malnutrition.

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Malnutrition

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  1. Malnutrition Supervision Prof. Dr.Mervat Salah

  2. Malnutrition of Children Eradication of poverty and hunger

  3. Intended Learning Outcomes • By the end of this lecture, students will have a general overview on malnutrition in children.

  4. Definition of malnutrition ”People are malnourished if their diet does not provide adequate calories and protein for growth and maintenance or they are unable to fully utilize the food they eat due to illness (undernutrition). They are also malnourished if they consume too many calories (overnutrition).” (Unicef)

  5. Malnutrition ”Malnutrition is a contributing factor in over 50% of deaths in children under five”WorldBank

  6. Population Density of Underweight Children(UN)

  7. MUAC Mid Upper Arm Circumferance SAM <110mm Children 6m-5yrs Measures Acute malnutrtion

  8. Measure of acute malnutrition W/H WASTING SAM <70% W/H (<-3 Z-scores) MAM 70-79% W/H (<-2 and >= -3 Z-scores)

  9. Measuring Chronic Malnutrition H/A STUNTING <90% of median

  10. Growth of Children <5 years ”all children, regardless of ethnic background or regional origin, grow similarly when their needs are met.”(MGRS) WHO

  11. NCHS 1978 Child Growth References • Measures made 1960-75 • American Children- geographically restricted area. • With formula milk • High socioeconomic background

  12. WHO 2006 Child Growth Standards 1997-2003 de Onis et al. 2004 MDGR

  13. Causes of Malnutrition Malnutrition/Death MANIFESTATIONS IMMEDIATE CAUSES Inadequate dietary intake Disesase Inadequate Maternal Childcare Insufficient Health Services/Unhealthy Environment Insufficient Household food UNDERLYING CAUSES Political and Economical powers BASIC CAUSES Modified from UNICEF 1998

  14. Severe Malnutrition W/H <70% or bilateral oedema Impaired immune system and electrolyte inbalance Marasmus Kwashiorkor

  15. Kwashiorkor • 2-4yrs • Comes suddenly after some time of Moderate Malnutrition • Low protein intake • HÖG MORTALITET! • Symtoms: • Bilateral Oedema • Apathy • Depigmented corse hair, easy to pull. • Skin lesions • Poor aptetite • Diarrhoea http://www.asnom.org/image/510_nutrition/116_327_kwashiorkor.jpg

  16. Marasmus • 1st year of life, often failure to breastfeed. • Lack of proteins and calories. • Body creates energy by dissolving its own tissues Loss of subcutanous fat and muscles. • Symtoms: • Wasting W/H <70% • Face o an old person • Pot belly due to lack of abd. muscles. • Anorexia, irritability. • Hunger

  17. The evil cycle of Malnutrition Weight loss Immunity lowered Growth faltering Mucosa damaged Inadequate Dietary Intake Disease: Incidence Severity Duration Apetite loss Nutrient Loss Malabsorbtion Altered metabolism Adapted from Andrew Tomkins and Fiona Watson, Malnutrition and Infection, ACC/SCN, Geneva, 1989 , State of the World’s Children 1998

  18. Fever as a main cause of child death in developing countries : ----------------------------------------------- Fever incease in body energy use ,if the body doent get the need energy from diet the body protein and fat will be used for energy these incease the serum fatty acids and amino acids lead to increase in blood acidity which cause loss of appetite ,dehydration ,fatigue seizures soetimes retardation and finaly DEATH

  19. Iodine Deficiency-Most important cause of brain damage and mental retardation, 760milj have goitre • Deficiency gives hypothyreosis and goitre. • Stillbirth and miscarriage • Cretinism: mental retardation, stunted, hypothyroidis, deaf-mutism. • Lower IQ by 10-15% • Iodising salt 5cents/person/year Source: Sea fish, sea weed, Iodized salt SOURCE: UNICEF

  20. Vit A Deficiency- Most important cause of blindness in developing countries Bitot spots • Protects skin and mucosa. Increases leucocyte activity. • Vit A protects against death in measles with 50% and diarrhoea with 30%. • Vit A to newly delivered mothers protects infants <6m against infection. • Vision: Scars on conjunctivatotal blindness. Night blindness • Treatment lowers the child’s risk of dying by 23%! 10 cents/child/year http://www.milesresearch.com/ • Source: • Egg, • Liver • Butter, cow’s milk • Breast milk. • Carotene. SOURCE: UNICEF

  21. Vitamin A is a generic term for many related compounds.Retinol (alcohol), Retinal (aldehyde) are often called preformed vitamin A. Retinal can be converted by the body to retinoic acid which is known to affect gene transcription. • Body can convert b-carotene to retinol, thus called provitamin A.

  22. FUNCTIONS • Vision:integrity of eye & formation of rodopsin necessary for dark adaptation. Regulation of gene expression: vital to cell differentiation & physiologic processes • Immunity: important for activation of T lymphocyte, maturation of WBC & integrity of physiological barrier. • Growth & developmen

  23. Deficiency of vitamin A leads to: • Night blindness & xerophthalmia • Growth retardation • Acquired immune deficiency • Keritinization of epithelia in RT, GIT & UT with increased risk of RTI, malabsorption & UTI.

  24. Assignment • Hadeerkamal abo bakr

  25. Recommended text book • Manual dietetic book

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