What is malnutrition?

Malnutrition is a condition encompassing both overnutrition and undernutrition. Individuals experiencing undernutrition may suffer from weight loss, fatigue, mood swings, or vitamin and mineral deficiencies. Conversely, overnutrition can lead to overweight, obesity, and micronutrient deficiencies. Both types can result in severe health problems if not addressed promptly.

1. What is Malnutrition?

Malnutrition is a serious condition that occurs when your diet lacks sufficient nutrients, or in other words, it is either a deficiency or an excessive consumption of nutrients. Types of malnutrition include:

• Undernutrition: This type of malnutrition results from the body not receiving enough protein, calories, or essential micronutrients. It leads to conditions such as low weight-for-height (wasting), low height-for-age (stunting), and low weight-for-age (underweight).
• Overnutrition: Consuming too much of certain nutrients, such as protein, calories, or fats, can also lead to malnutrition. This commonly results in overweight or obesity.

Generally, undernourished individuals tend to lack vitamins and minerals, especially iron, zinc, vitamin A, and iodine. However, micronutrient deficiencies can also occur in cases of overnutrition. Overweight or obesity can arise from consuming excessive calories without simultaneously receiving enough vitamins and minerals. Food choices are also a contributing factor to overnutrition; for instance, fried and high-sugar foods tend to be high in calories and fat but low in other essential nutrients.

2. Signs and Symptoms of Malnutrition

The signs and symptoms of malnutrition vary depending on the type. Early detection of malnutrition’s effects can help in identifying the appropriate treatment.

Undernutrition This is often a result of the body not receiving enough nutrients from your diet. It can cause the following problems:

• Weight loss
• Loss of fat and muscle mass
• Sunken cheeks and eyes
• Swollen abdomen
• Dry hair and skin
• Slow wound healing
• Fatigue
• Difficulty concentrating
• Irritability
• Depression and anxiety

Undernourished individuals may exhibit one or more of these symptoms.Kwashiorkor is a severe protein deficiency leading to fluid retention and abdominal swelling. Meanwhile, marasmus occurs due to severe calorie deficiency, resulting in emaciation, accompanied by significant loss of fat and muscle. Additionally, undernutrition can lead to micronutrient deficiencies. Some of the most common deficiencies and their accompanying symptoms typically include:

• Vitamin A: Causes dry eyes, night blindness, and increases the risk of infections.
• Iron: Impairs brain function, causes problems with body temperature regulation, and gastric issues.
• Zinc: Leads to loss of appetite, stunted growth, slow wound healing, hair loss, or diarrhea.
• Iodine: Causes enlarged thyroid gland (goiters), reduced thyroid hormone production, and problems with growth and development.

In reality, undernutrition can lead to serious physical and health problems, and it even increases the risk of mortality if not addressed promptly. It was estimated that stunting, wasting, zinc deficiency, and vitamin A deficiency caused approximately 45% of all child deaths in 2011.

Overnutrition (Excess Nutrition) The main signs of overnutrition are overweight and obesity, but it can also lead to nutrient deficiencies. Research has shown that overweight or obese individuals are more likely to have inadequate nutrient intake, and their blood levels of vitamins and minerals are often lower compared to those with normal weight. Another study conducted in adolescents also showed that vitamin A and E levels in the blood of obese individuals were 2–10% lower than in normal-weight participants. This is because overweight and obesity can result from excessive consumption of fast food and processed foods, which are high in calories and fat but very low in other essential nutrients for the body. Another study indicated that people who eat fast food generally absorb very little vitamin A and C, while significantly consuming larger amounts of calories, fat, and sodium compared to those who avoid these types of foods.

3. Assessing Malnutrition

Symptoms of malnutrition are assessed through health examinations at hospitals or clinics. The main tools used to identify malnutrition typically include weight loss charts and body mass index (BMI), blood tests for micronutrient status, and a general physical examination. If you have a history of weight loss and other symptoms related to undernutrition, your doctor may request additional tests to determine micronutrient deficiencies. On the other hand, identifying nutrient deficiencies due to overnutrition can be more challenging. If you are overweight or obese and primarily consume processed foods and fast food, your body may not be receiving enough essential vitamins or minerals. To find out if you are experiencing nutrient deficiencies, discuss your daily eating habits with your doctor.

4. How Does Malnutrition Affect Health?

Malnutrition can lead to the development of diseases and other chronic health conditions. Long-term effects of undernutrition often include a higher risk of obesity, heart disease, and diabetes. One study on adolescents showed that boys stunted by early malnutrition gained 5% more body fat within 3 years compared to their non-stunted peers. Additionally, about 21% of stunted adolescents had higher blood pressure than healthy adolescents. Researchers also found that childhood undernutrition can cause changes in metabolism, leading to a higher risk of chronic diseases later in life. Furthermore, overweight or obese children have a higher risk of developing heart disease and type 2 diabetes compared to other children. Specifically, a recent study showed that obese children have a four-fold higher risk of developing type 2 diabetes than children with a normal BMI. Since the long-term effects of malnutrition can increase the risk of several chronic diseases, early prevention and treatment of malnutrition can significantly reduce the incidence of these risks.

5. What Causes Malnutrition?

Malnutrition is a global issue that can arise from various factors, including environmental, economic, and health conditions. The World Health Organization (WHO) estimates that over 460 million adults and 150 million children are undernourished, while over two billion adults and children are overweight or obese. The most common causes of malnutrition typically include:

• Food insecurity, or lack of access to adequate and affordable food: Food insecurity in a country can lead to food shortages, resulting in hunger and increasing the risk of severe malnutrition.
• Digestive and nutrient absorption issues: Certain malabsorption conditions, such as Crohn’s disease, celiac disease, and bacterial overgrowth in the gut, can cause malnutrition.
• Excessive alcohol consumption: Heavy alcohol use can prevent the body from absorbing sufficient amounts of protein, calories, and essential micronutrients.
• Mental health disorders: Depression and other mental health conditions can increase the risk of malnutrition. One study showed that individuals with depression had a malnutrition rate approximately 4% higher than healthy individuals.
• Inability to obtain and prepare food: Researchers have indicated that frailty, immobility, and lack of muscle strength are risk factors for malnutrition. These issues also contribute to a reduced ability to prepare food.

6. People at High Risk of Malnutrition Malnutrition can affect people worldwide, but certain groups have a higher risk, including:

• People living in developing countries or areas with limited food access: Undernutrition and micronutrient deficiencies are particularly prevalent in Sub-Saharan Africa and South Asia.
• People with increased nutrient needs, especially children and pregnant or lactating women: In some developing countries, about 24-31% of pregnant and lactating mothers are malnourished.
• People living in poverty or with low incomes: Low socioeconomic status is closely linked to malnutrition.
• Older adults, especially those living alone or with disabilities: Research has shown that up to 22% of older adults are malnourished, and over 45% are at risk of malnutrition.
• Individuals with conditions affecting nutrient absorption: People with Crohn’s disease or ulcerative colitis may be up to four times more likely to be malnourished than those without these conditions.

7. Measures for Preventing and Treating Malnutrition To effectively prevent and treat malnutrition, we need to focus on addressing the underlying causes of the problem. Research has shown that the most effective ways to prevent malnutrition include providing iron, zinc, iodine supplements, food fortification, and nutrition education for those at risk of malnutrition. Additionally, children and adults at risk of overnutrition should choose healthy foods and regularly engage in physical activity to significantly prevent overweight and obesity. Moreover, you can prevent the risk of malnutrition by eating a well-balanced diet with a variety of foods, including sufficient carbs, protein, fats, vitamins, minerals, and water. On the other hand, the treatment of malnutrition often involves more individualized approaches. If you suspect that you or a loved one is malnourished, discuss this with a doctor as soon as possible. Healthcare professionals can help you assess the signs and symptoms of malnutrition, thereby determining appropriate interventions for you, such as dietary changes including supplements.

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