Malnutrition refers to an imbalance between the nutrients needed for a child to grow up healthy and those actually consumed. This imbalance impedes the proper functioning of tissues and organs resulting in poor growth and development. While traditionally malnutrition has been depicted as a condition where a child looks thin and wasted (what most health organisations and experts focus on), scientists define malnutrition in two ways:
Undernutrition: It refers to not consuming enough essential nutrients to support normal growth and development, excreting them or not being able to utilise them for one reason or another.
Overnutrition: It occurs when people eat too much of all the wrong foods or take too many dietary supplements. This category also includes obesity.
Factors leading to malnutrition
In developing countries, poverty, which can lead to poor access to a balanced diet or total hunger, continues to be the main culprit. In most developed countries, however, it is more of a lifestyle concern following increased cases of weight gain and obesity and little to no exercise, or overuse of supplements.
Acute or chronic illness can also lead to malnutrition; for instance, children suffering from cystic fibrosis may have trouble absorbing nutrients because the disease affects the pancreas, the organ responsible for manufacturing some digestive enzymes. Children suffering from celiac disease may also suffer the same fate because it affects the intestines leading to stunted growth. Acute illness often leads to poor weight gain while chronic illness may stunt normal growth and development.
Evolving trends and lifestyle preferences such as being vegan and cultural and religious norms may also lead to malnutrition if alternatives to fill in nutritional gaps are not included. Infants whose mothers also had poor access to a balanced diet during pregnancy may suffer from prenatal malnutrition, which may adversely affect their baby’s immunity and immune system.
Symptoms of malnutrition
Malnutrition can be difficult to recognise in some cases, especially where over-nutrition is concerned, but in children who are undernourished, it can be easily diagnosed. Symptoms include:
Tiredness and loss of energy
Appetite and weight loss
Mood swings such as depression, anxiety and irritability
Poor concentration and impaired intellectual development
Failure to grow at the expected rate, both in terms of weight and height
Changes in hair and skin colour and developing of rashes
Soft and tender bones which ache and bruise easily
Night blindness and increased sensitivity to light and glare
To diagnose malnutrition, even mildly, a couple of tests need to be done and they include:
Hand grip strength: This involves measuring muscle strength, which is among the most easily and fastest adversely affected part of the body when malnutrition sets in. In this case, a child’s grip power is measured by a machine to determine if it is sufficient or not.
Growth velocity: This refers to the rate at which a child grows in height and weight and can be compared to those of his or her age mates. Over time, the results can reflect a child’s nutritional status.
Circumference: In this case, the circumference of the child’s mid upper arm is measured to detect muscle and fat mass.
A child’s overall development such as fat distribution, appearance and organ function can also be good indicators of malnutrition. Blood and urine tests can also point out a child’s level of vitamins, minerals, and waste products. The doctor can also take a child’s body mass index.
In the event a child is suffering from under nutrition (due to poor access to food), then the first course of treatment is obviously ensuring access to a balanced diet. A nutritionist should advise on the best foods to eat (refer to this month’s Child Nutrition column) and supplements if needed. In the event of acute or chronic diseases, then a doctor and a nutritionist should be able to come up with a regimen on the best way forward in terms of diet, supplements and overall disease management to reduce chances of malnutrition.
In the event of over-nutrition, a nutritionist will advise on which foods to cut out and the amount the child should consume, while suggesting which foods should be incorporated to achieve a balanced diet. Exercise may also be incorporated. To get a clean bill of health, visit your doctor regularly for a progress report.
Published June 2016