Contents
What is malnutrition?
Malnutrition is the lack of nutrients in the body. These nutrients can be specific, like iron or zinc, or nonspecific, like a lack of calories. This disease is responsible for ⅓ of infant deaths each year.
Among the most common lack of nutrients are glucose, protein , iron, iodine and vitamin A deficiency. Some of these are common during pregnancy.
Malnutrition can cause several growth problems, neurological, psychological and even lead to death. It is especially common in underdeveloped countries, but anyone anywhere can become malnourished. Even people who look chubby can suffer from a lack of nutrients in their body.
Types
Malnutrition can be divided into mild, moderate or severe and has three different types, with the division being based on the type of nutrient that is lacking in the body. Are they:
Marasmus
Also known as dry malnutrition , this type of malnutrition is characterized by a lack of energy sources. Without glucose, the body does not function properly.
If there is a lack of carbohydrates and lipids – which are used for the production of glucose – in the diet and there is no fat reserve, the body goes into dry malnutrition, feeling severe energy shortages, even if other types of food are eaten.
When marasmus reaches its extremes, the patient is said to be in starvation .
Kwashiorkor
Known as wet malnutrition , this disease occurs when there is a lack of proteins and vitamins in the body.
The name came from a Ghanaian language, and means “older son’s disease”, because when another baby was born, the first child was weaned and fed mainly with carbohydrates. Thus, there was energy, but there was a lack of nutrients and vitamins.
Marasmo-Kwashiorkor
Also called mixed malnutrition , this type of malnutrition is a version in which both proteins and vitamins as well as energy sources such as carbohydrates and lipids are lacking in the body, leaving it completely without nutrients.
It is very common in situations of extreme hunger, since no nutrients can be received by the body if there is no food.
Classifications
It is possible to divide malnutrition into two classifications.
Primary malnutrition
Primary malnutrition is caused by an inadequate diet, being a malnutrition whose only cause is the lack of nutrients in the diet.
Secondary malnutrition
The secondary version is caused by something external to food, such as parasites and diseases that leave the body with difficulty in absorbing nutrients.
Malnutrition and obesity
Although it seems that malnutrition and being overweight are opposite, this is not true. It is possible to have malnutrition and obesity at the same time. In that case, doldrums are not possible, but kwashiorkor is.
Eating habits that involve high caloric amounts but without adequate nutrients can lead to this condition. If a person drinks a lot of soda, eats only fried food, pasta, bread, all of this in great quantity and without any exercise, the weight increases because the caloric intake is enormous.
Along with this, the person, not eating necessary foods such as fruits and vegetables, healthy and nutritious food, will have a nutritional shortage. It will be obese, but malnourished.
Food is a serious matter and must be observed to improve and maintain health. Nutrition should be observed in any weight range.
Causes
Several situations can cause malnutrition. Are they:
Eating disorders
Anorexia nervosa, bulimia nervosa and orthorexia are some of the eating disorders that can cause malnutrition. They cause the person to reduce their diet and sometimes even stop it altogether, causing a severe lack of nutrients.
Nutrient-free diet
It is not just people who eat little that can become malnourished. A diet completely focused on carbohydrates such as bread, pasta, soft drinks, snacks, can make a person fat and malnourished at the same time .
Kwashiorkor affects these people, who even with large energy reserves, are without proteins and vitamins.
Parasites
Worms like Taenia solium , the solitary, can cause anemia and malnutrition. Another worm that has this ability is Ascaris lumbricoides , known as roundworm.
These parasites decrease the host’s nutritional absorption and can cause them to become malnourished depending on the size of the infection and the person’s nutrition.
Gastroenteritis
Gastroenteritis is an inflammation and infection of the gastrointestinal tract. The disease can hamper absorption of nutrients and cause secondary malnutrition, even if there is food on the part of the patient. Treatment is needed for nutritional problems to be resolved.
Allergies
Allergies to certain foods can cause gastrointestinal problems and prevent the absorption of nutrients.
Diarrhea
The diarrhea causes the body can not absorb nutrients. If its cause is not treated, it can cause the patient to lose too many nutrients and become malnourished.
Cancer
Several types of cancer , especially in the terminal stage, cause a severe type of malnutrition called cachexia. The body’s metabolism is modified by the tumor and the muscles and fat stores are quickly consumed.
In addition, cancer treatments can cause diarrhea and vomiting, as well as canker sores that make feeding difficult.
Unfortunately, cachexia cannot be reversed through food and can reach the point where the patient needs to receive nutrients directly into the vein. Cachexia is responsible for more than 20% of cancer deaths.
Risk factors
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Some factors can facilitate the development of malnutrition and people who fit it must take care of themselves. Are they:
Socioeconomic difficulties
Countries with great socioeconomic differences or extremely poor countries have large malnourished populations.
The Democratic Republic of Congo, for example, suffers from this problem. Currently, 400,000 children with severe malnutrition are at risk of death from the disease.
In all, 750,000 children under the age of 5 in the country are malnourished according to a statement from the United Nations Children’s Fund (Unicef).
Several other countries suffer from the problem and, even in countries like Brazil, hunger is a persistent problem that can kill thousands of children due to malnutrition.
Advanced age
Elderly people are at greater risk of developing malnutrition than adults. They tend to be satisfied with less food, the taste and smell can be reduced with age, which cuts the pleasure of eating, in addition to several diseases, more common in old age, can lead to malnutrition, such as dementia, cancer, strokes , depression , arthritis and others. All of these illnesses can severely hinder eating.
Bad eating habits
An unbalanced diet can cause malnutrition of any type. Even with access to food, eating habits make room for diets that are poor in both quantity and nutritional quality.
Chronic diseases
Patient HIV , cancer and autoimmune disease are at risk of malnutrition group.
Diseases can cause malnutrition on their own, as is the case with HIV and cancer with cachexia and Chron’s disease, which does not allow efficient absorption of nutrients by the intestine. as well as diabetes , which hinders this absorption of nutrients.
Others may also hamper nutrition, such as multiple sclerosis, which can make it difficult or even prevent the person from feeding without assistance.
Alcoholism
The alcohol causes difficulty absorbing nutrients, and may be victims of kwashiorkor malnutrition, since, even though the alcohol is very calorie, lack of other nutrients does not allow the proper nutrition of the body, which comes into malnutrition.
Excessive weight loss in a short time
Losing weight does not necessarily mean that there is malnutrition, but if that loss happens too quickly, it may be that the body is missing certain nutrients and is using its reserves. This can lead to malnutrition.
Parenteral nutrition
Parenteral nutrition is nutrition directly in the bloodstream, used in hospitals for patients who are prevented from eating in the conventional way. It is a possible treatment for malnutrition, but it can also cause it if the patient’s nutritional needs are not precisely identified.
Symptoms
The various symptoms of malnutrition are as follows:
Weakness
When malnutrition exists, the body does not have enough energy to perform tasks and becomes weak.
Irritability
Hunger and lack of nutrients have the ability to make a person irritable.
Lack of concentration
Due to a lack of glucose in the brain, it may be difficult to concentrate in malnourished patients.
Fainting
Without enough energy to keep your brain fully functional at all times, you may pass out.
Accelerated weight loss
When there is no food, the body starts to use its energy reserves. They are the layer of fat that is below the skin, lipids in reserves in the muscles and liver and, finally, the muscles themselves. This process causes accelerated weight loss.
Thick skin
With malnutrition, the skin becomes thicker after the loss of the subcutaneous fat layer.
Loss of muscle mass
Muscles are consumed by energy. This affects all the muscles in the body, which get weaker. The heart loses muscle mass and may not be able to send blood properly to the entire body of the malnourished person.
Slow healing
Due to the lack of nutrients, the healing process is slowed down.
Slow infection recovery
The production of white blood cells is reduced by the lack of nutrients and the immune system becomes weaker. Recovery from infections is impaired and slow.
Persistent diarrhea
Some patients may experience persistent diarrhea or constipation.
Difficulty in warming up
Without the subcutaneous layer of fat, the body may face difficulties in maintaining its temperature. The difficulty to warm up becomes a problem for the patient.
Lethargy
Lethargy, in this case, is the state of suspension of sensitivity and body movements. Vital signs are extremely low and the person may appear dead.
The patient may be completely lucid during the lethargic state, but is unable to react. The almost total depletion of nutrients leads to this state, which, by making the breathing and pulse almost imperceptible, can be confused with death.
Swelling
Swelling can arise in the legs and other parts of the body due to a lack of protein in the blood.
Anemia
Anemia is a symptom of a lack of iron in the body and arises in malnutrition patients.
Kids
Children may experience some extra symptoms such as:
Growth below expectations for age
The lack of nutrients for children hinders their growth and it may not develop properly. A child who is too thin and too short may suffer from malnutrition.
Behavior changes
As in adults, children’s behavior is affected by hunger and lack of nutrition. She may be listless or irritated.
Changes in skin, hair and eye color
The missing nutrients can cause physical changes in the child. Your eyes can be grayed out, as well as your hair, which can turn gray, reddish or blond.
How is malnutrition diagnosed?
The diagnosis of the disease is made through some methods by the general practitioner, nutritionist or nutritionist. The methods are:
IMC
Measurement is made of the BMI (body mass index) which indicates the amount of body fat of the person. The count is simple: weight in kilograms divided by height in centimeters squared. The result is the patient’s BMI.
The BMI is considered healthy if it is between 18.5 and 25. When the BMI is between 17 and 18.5, the patient can be considered slightly malnourished. Between 16 and 17, he is malnourished and, when the BMI is below 16, malnutrition is severe.
Bloodtests
Through blood tests, it is possible to know what nutrients are missing in the person’s body and make the diagnosis of malnutrition. It serves to define the type of malnutrition present and, when it is severe, to find out what nutrients must be replenished in the patient’s body.
Kids
In children, the diagnosis can be made by measuring the patient’s height and weight, comparing the numbers with the expectation for age. Some children are genetically smaller, which is normal, but slow growth can mean malnutrition, as well as sudden and rapid weight loss.
Arm measurement
It is also possible to use, for the diagnosis in children, the measurement of the patient’s biceps at rest. Measurements of less than 110mm (11 centimeters) can indicate severe malnutrition. It is also used to measure skin folds, which can be thin because of the lack of subcutaneous fat, which is consumed during malnutrition.
Malnutrition in pregnancy
Malnutrition in pregnancy is a big loss for the baby. The mother needs more calories as the fetus grows and the lack of them can cause growth problems for the child. However, this does not mean that the mother must literally eat for two, as this can lead to an excess of calories and a lack of essential nutrients.
Pregnant women may need nutritional supplementation, as a regular diet cannot always provide all the necessary nutrients.
Can malnutrition be cured?
Yes, malnutrition can be cured . However, it is not in all cases that it can be cured. It is necessary to deal with two situations: the lack of nutrients per se and the cause of malnutrition.
When malnutrition is primary, the healing process is more intuitive, but not necessarily easier. Changing the diet to one that has all the necessary nutrients for the body is the solution, but this is not always possible in a bad economic situation, for example.
In addition, there are cases of malnutrition such as cachexia, which is caused by cancer and other terminal illnesses. Putting more nutrients into the person’s body will not do any good and cancer, in the stages in which it causes cachexia, has no cure.
What is the treatment for malnutrition?
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The treatment for malnutrition consists of re-nourishing the person and treating the cause. The causes can range from lack of food and inadequate nutrition to worm infections and cancer.
Each type of cause of malnutrition requires its own specific treatment. However, renutrition tends to follow the same processes in all cases and only varies according to the severity of the patient’s malnutrition.
Nutritional education
Through dietary re – education , it is possible to introduce the nutrients that are missing in the body of the person suffering from malnutrition. In most cases, dietary changes are made slowly, giving the body time to get used to the new diet. Mild and moderate cases of malnutrition are treated in this way. A nutritionist can help. Dietary and vitamin supplements may be indicated by the doctor to assist in nutrition.
In cases where there is moderate to severe malnutrition due to lack of food, too much food cannot be made available at once, or the body will suffer as the gastrointestinal system will not be prepared for this. Food should be reintroduced slowly, in several small meals a day.
Hospital treatment
In cases of severe malnutrition, hospital treatment may be mandatory. The patient may be unable to feed through the mouth or to eat solid food, so three options for eating can be used. Are they:
Nasogastric tube
The nasogastric tube is a tube inserted through the patient’s nose and that goes to the stomach. It takes the nutrients in liquid form so that the patient does not need to eat, but is nourished in any way.
Percutaneous endoscopic gastrostomy
In this procedure, a tube is placed in the stomach through surgery. The tube connects to the outside of the body through the abdomen and nutrients are inserted there in liquid form. This type of food is used when the patient cannot use the esophagus to nourish himself.
Parenteral nutrition
In extremely severe cases of malnutrition, the stomach may not be able to digest nutrients, so a different approach can be taken.
In this type of nutrition, carbohydrates, proteins, vitamins, minerals and all nutrients are administered directly into the vein. The nutrients are already broken so that the absorption is done directly by the blood, without having to go through the digestion process.
Other situations in which this type of food can be used are cases in which food cannot pass through the stomach (for example in patients with ulcerative colitis) or when some disturbance prevents digestion.
This procedure can be performed at home, but this situation is extremely rare since, if the person needs parenteral nutrition, his health condition will probably not be good enough for that.
Some problems may arise, such as:
- Excess water, which requires precise calculations and is variable;
- Reduction in bone density, a problem of unknown origin but which disappears with the interruption of parenteral nutrition;
- High risk of infections in the catheter region;
- Possibility of developing gallstones and liver problems.
Back to routine
When treatment takes the patient to a more stable nutritional state and the cause of malnutrition is found and treated, he can return to normal nutrition.
In the most severe cases, when the disease stabilizes, food re-education becomes a step towards healing. In all cases, a nutritionist may be necessary to make an adequate menu for the body to remain nourished.
Malnutrition medications
Some medications can be used by people with malnutrition to increase their appetite. Are they:
- Megestrol (Femigestrol);
- Dronabinol.
Growth hormones or anabolic steroids can also be used to increase muscle mass.
- Nandrolone ( Deca-Durabolin );
- Testosterona (Androgel).
Attention!
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
Prognosis
If left untreated, malnutrition can lead to starvation and death. Nutrients and food are essential for the functioning of the body. However, when there is treatment, malnutrition can be cured with some ease and, in mild or moderate cases, there should be no sequelae in the body. Even severe cases can be cured without any complications.
Complications
Several complications can arise as a result of untreated malnutrition. Are they:
Anemia
Among the nutrients that may be lacking in the human body is iron, which, when not present in sufficient quantity, leads to anemia.
Bone changes
The lack of nutrients can lead to osteoporosis and other bone changes, decreasing its density and even causing deformations.
Muscle loss
Muscles are reduced by malnutrition, causing weakness and can lead to heart failure, since the heart is a muscle that can also be affected.
Depression
Lack of nutrients can cause depression in malnourished patients.
Neurological losses
Chemical differences in the brain can also cause problems in all areas of the brain, from the central nervous system to behavior, leaving the person aggressive. Reasoning can also be affected by being slow.
Infections
Without nutrients, the body’s immune system is weakened, facilitating the penetration of bacteria, viruses and infections in general.
Difficulty in weight loss
In children with Kwashiorkor, the version of the disease that is represented by the presence of calories but a lack of nutrients, malnutrition can lead to difficulties for weight loss.
Effects on growth
Growing children may have their development slowed down and even stopped altogether. This includes the development of height, muscles and even brain development.
How to prevent malnutrition?
The prevention of malnutrition occurs in food. It is necessary to have a healthy diet with all the necessary nutrients for the body.
Track your BMI
Try to keep your BMI between 18.5 and 25. Although it is not an indicator of extreme accuracy, it is a good estimate for your nutrition.
Breastfeeding newborns
In the first six months of life, the baby needs only breast milk and nothing more. That’s enough to keep you nourished. However, it is important for the mother to eat properly as well.
food
The Ministry of Health recommends three meals and two snacks a day. Meals must have all food groups in the following order. The higher in the list, the greater the daily amount needed:
Breads, Rice, Potatoes – Sources of Carbohydrates
These foods are sources of energy for the body and should make up most of the diet.
Milk and Dairy Products
Important for the uptake of calcium by the body, dairy products are part of a healthy diet.
Fruits and vegetables
Sources of vitamins and minerals, as well as fibers important for digestive health.
Meats, beans, fish, eggs – Protein sources
Protein is part of what makes our body and a necessary nutrient.
More recommendations
The Ministry of Health also recommends reducing salt in the diet, drinking 2 liters of water a day, exercising and avoiding addictions such as cigarettes and alcohol, while maintaining a healthy diet.
Subsistence allowance
Some radical diets can bring risks, reducing nutrient consumption too much, leading to malnutrition.
Tips to make better use of nutrients
Some things can be done to make the best use of nutrients from vegetables and greens, for example. Heat and hot water can remove some of the nutrients from the food, so minimizing this loss helps to have a more nutritious diet.
Close the pot
Water is capable of taking nutrients from food. Steam does the same thing. Keeping the pan closed does not prevent the food from losing its nutrients to the water, but so it stays in the pan and the food has a chance to reabsorb them.
Cut large pieces
Large pieces reduce the area of the food in contact with water, so nutritional loss is reduced.
Keep the shell for cooking
Potatoes and carrots, among other foods, can be cooked with the peel still on, which can be removed after the food is ready. The peel acts as a barrier that keeps nutrients inside.
Reuse the water
After cooking vegetables, the water is left with several of the nutrients in them. You can reuse the water for a soup, keeping the nutrients in the meal.
Steam cook
You can steam cook to reduce the loss of nutrients to the water. As in this type of cooking there is no direct contact between vegetables and water, they lose much less nutrients, since only steam can remove them. With the pan closed, these nutrients return more easily to the food.
Malnutrition makes thousands of victims every year and it is necessary to be careful with your diet and what you eat. It can affect anyone, but it can be prevented and treated.
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