Do you also have nutritional problems? Let's talk about malnutrition!

Have you ever wondered if the food we eat is really good for our bodies? Sometimes, even though we eat a lot, our bodies may not get the nutrients they need. Or, we may get too much of something and have problems. That's what malnutrition is, in simple terms. This is not as simple as it seems, so let's talk about it in a little more detail .

What is malnutrition?

Simply put, malnutrition occurs when your body does not get the nutrients it needs, such as vitamins, minerals, proteins, carbohydrates, and fats , in the right amounts. This can be of two types. One is undernutrition . The other is overnutrition . Don't be surprised, even a deficiency of just one vitamin or mineral can cause serious health problems. Similarly, too much of some nutrients can cause problems.

What are the main types of malnutrition?

When we talk about malnutrition, we can mainly talk about four components. They are undernutrition, overnutrition, imbalance of macronutrients, and imbalance of micronutrients. Let's look at these one by one.

Undernutrition

This is what most people think of when they hear the word "malnutrition." It means not getting enough nutrients. This condition can occur if your diet is not balanced, or if your body is not absorbing nutrients from the foods you eat. The loss of fat and muscle due to malnutrition can sometimes be visible or invisible . Some people can have this nutritional deficiency even if they are overweight.

Macronutrient undernutrition

This is also called protein-energy undernutrition . Macronutrients, that is, proteins, carbohydrates, and fats, are the main building blocks of our body and the main things that provide energy. If any of these are lacking, the body's functioning begins to deteriorate. The body begins to break down its own tissues and stop non-essential activities to conserve low energy.

Micronutrient undernutrition

Micronutrients are vitamins and minerals. Our bodies need these in very small amounts. However, they are essential for all body processes. Because our diets are not varied, many people are deficient in certain vitamins and minerals. You may not notice a small vitamin deficiency, but if this micronutrient deficiency becomes severe, it can have serious and long-term effects.

Overnutrition

The World Health Organization (WHO) recently added overnutrition to its definition of malnutrition. This is because excessive consumption of nutrients can also have adverse health effects. This includes conditions such as overweight and obesity and the noncommunicable diseases (NCDs) that result from them. It also includes toxicity caused by excessive intake of certain micronutrients.

Macronutrient overnutrition

When your body consumes more calories from protein, carbohydrates, and fat, it stores them as fat cells. These are stored in our adipose tissue . However, when this storage space is exhausted, those fat cells start to grow. These enlarged fat cells are associated with chronic inflammation and the metabolic disorders that result from it. These can lead to non-communicable diseases like Diabetes Mellitus , Coronary Artery Disease, and Stroke .

Micronutrient overnutrition

In fact, taking too many vitamin and mineral supplements can be problematic. More research is needed to understand how this happens and how much is “too much.” In general, micronutrient overnutrition from food alone is rare. However, if you take mega doses of some supplements, it can have toxic effects. Therefore, do not take any supplements without medical advice.

Who is most affected by malnutrition?

In a broad sense, malnutrition can affect anyone. Lack of knowledge about nutrition, difficulty in obtaining a variety of foods, sedentary lifestyles, and economic hardship are the main factors contributing to malnutrition. However, some groups of people are at higher risk for specific types of malnutrition.

People at higher risk of malnutrition:

• Poor and low-income people: Whether in developed or developing countries, people with economic difficulties are less likely to have access to adequate nutrition. Look at Sri Lanka, where sometimes you can buy a packet of instant noodles, a packet of rice, or a "short eats" cheaper than a pack of nutritious vegetables and fruits.
• Children: Growing children have higher nutritional needs than adults. Children, especially from families with economic difficulties, are more likely to face malnutrition and its consequences. Some children may not like to eat, and this problem can also arise.
• People with long-term illnesses: Many long-term illnesses can cause a loss of appetite or reduce the absorption of nutrients from food. Some illnesses require more calories. There is also a risk of malnutrition during hospitalization.
• Elderly people: As people age, their nutritional status can deteriorate for a variety of reasons. This can include difficulty walking, being placed in nursing homes, decreased appetite, and reduced absorption of nutrients.

People at higher risk of overnutrition:

• Poor and low-income people: In developed countries, low-income communities have easier access to high-calorie but low-nutritional fast foods than to nutritious whole foods. This can lead to macronutrient overnutrition and micronutrient undernutrition.
• People who lead busy, inactive lifestyles: Working in an office chair, having no time to play due to children's educational activities, and having to stay in one place all day due to social reasons can lead to a significant increase in body weight. Imagine, where does a child who goes to tuition classes from morning to night have time to play?

What happens to the body when you are malnourished?

Protein-energy undernutrition causes the body to lose the energy it needs to maintain itself. To compensate, the body begins to break down its own tissues and stop functioning. This starts with stored fat. It then affects muscles, skin, hair, and nails. People with protein-energy undernutrition often appear thin and have brittle bones . Growth and development in children can be stunted.

The first system to start to malfunction is the immune system . As a result, people with poor nutrition are more likely to develop diseases and infections, and they take longer to recover. Wounds also take longer to heal. The heart's function also decreases. As a result , the heart rate decreases (Low heart rate) , blood pressure decreases (Low blood pressure) , and body temperature decreases (Low body temperature) . You may feel faint, weak, and have no interest in life. You may lose your appetite, and some parts of the digestive system may atrophy.

People who are malnourished with macronutrients are more likely to be malnourished with micronutrients. This is because when calories are reduced overall, it also affects vitamin and mineral levels. Some complications of severe malnutrition conditions such as marasmus and kwashiorkor are caused by specific vitamin deficiencies. For example, vitamin A deficiency can cause vision problems, and vitamin D deficiency can cause weak bones.

Some people eat a lot of calories but don't get enough vitamins and minerals. In these cases, the effects of malnutrition are not as obvious. Even if they are overweight due to macronutrient overnutrition, they may show signs of anemia – weakness, fatigue, and weakness – due to mineral or vitamin deficiencies. People who are overnourished may show signs of conditions like metabolic syndrome , such as insulin resistance and high blood pressure.

What are the symptoms of malnutrition?

Malnutrition is not a single condition, so the symptoms vary.

Symptoms of malnutrition may include:

• Weight loss, visible bones, fat and muscle loss.
• Edema (swelling) due to thinning of the limbs and fluid accumulation in the abdomen and face.
• Impaired growth and intellectual development of children.
• Weakness, dizziness, and fatigue.
• Irritability, lethargy, or difficulty concentrating.
• Dry skin, loss of skin elasticity, skin damage and sores.
• Hair loss, hair thinning, and hair color changes.
• Frequent and severe infections.
• Decreased body temperature, loss of feeling of warmth.
• Decreased heart rate and blood pressure.

Symptoms of overnutrition may include:

• Obesity.
• High blood pressure.
• Insulin resistance.
• Heart disease.

What are the causes of malnutrition?

Malnutrition can be caused by a variety of factors.

Causes of poor nutrition:

• Economic difficulties: Inability to buy nutritious food due to lack of money.
• Limited access to nutritious foods: In some areas, it is difficult to find good vegetables and fruits, and even if they are available, they are expensive.
• Conditions that make eating difficult: things like nausea, vomiting, difficulty swallowing.
• Conditions that deplete calories: Chronic diarrhea, diseases like cancer .
• Times when more calories are needed: Pregnancy , breastfeeding, and growing children.
• Mental health problems that discourage eating: Conditions like depression and dementia .
• Eating disorders: Things like Anorexia and Bulimia .
• Diseases that impair the absorption of nutrients: such as pancreatic insufficiency and inflammatory bowel disease .
• Long-term intravenous feeding.
• Following a very limited diet or eating an unappetizing diet chosen by someone else.

Causes of overnutrition:

• Lack of nutritious food options: When the easy way out is to eat high-calorie, low-quality food, people will turn to it.
• Lifestyle with little physical activity.
• Conditions that slow down metabolism: For example, hypothyroidism .
• Hormonal imbalances that interfere with hunger and fullness signals.
• Chronic stress.
• Anxiety or depression.
• Binge eating disorder.
• Long-term excessive use of dietary supplements.

How to identify malnutrition?

Typically, a doctor will diagnose protein-energy malnutrition or overnutrition by examining you physically and asking about your diet and health conditions . Doctors may look at your BMI , or they may measure a child's arm circumference to try to figure out the extent of the problem. If possible, they will take a blood sample to check for specific micronutrient imbalances . This is because macronutrient malnutrition often goes hand in hand with micronutrient malnutrition. Also, someone with macronutrient overnutrition can also have micronutrient malnutrition. If you have symptoms of micronutrient overnutrition, it can also be diagnosed with a blood test (although this is very rare).

How is malnutrition treated?

Malnutrition is treated with nutritional supplements . This can be individual micronutrients or a specialized, high-calorie nutritional formula designed to replenish what the body is lacking. Refeeding may take several weeks to correct severe malnutrition.

But remember! This refeeding can be a bit scary, especially in the first few days. Because the body goes through a lot of changes to get used to the reduced nutrition. When you refeed, the body has to function in the old way again. Sometimes the body may not be ready to handle the change. Therefore, it is best to start this treatment under medical supervision to prevent and manage serious, even life-threatening complications like refeeding syndrome .

Overweight is usually treated with weight loss, diet, and lifestyle changes . Losing excess weight can reduce the risk of developing secondary conditions such as diabetes and heart disease. Weight loss treatments may include diet and exercise plans, medications, or medical procedures. They may also include treatment for an underlying medical condition, such as a thyroid disorder, or a mental health disorder. Weight loss can happen quickly or can be gradual over a long period of time. However, once you lose weight, it is the lifestyle changes you make that will help you maintain that weight. This may require long-term support systems such as counseling, behavioral therapy , support groups, and nutrition education.

How to prevent malnutrition?

Malnutrition is a global problem. In both developed and developing countries, poverty and lack of awareness about nutrition are the main causes. We can help control malnutrition by providing better education and supporting the disadvantaged (with access to clean water, nutritious whole foods, and medicine) around the world. Children and the elderly, who may not be able to speak for themselves, are particularly vulnerable, so it is important to pay more attention to their diet and health status.

The best way to prevent malnutrition is to eat a balanced diet that includes a variety of nutritious whole foods . If you are getting enough of all the nutrients your body needs, you will be less likely to overeat to meet those needs. Even with a normal diet, some micronutrient deficiencies are common. One way to find out if you would benefit from micronutrient supplements is to have a blood test. Your doctor can help you decide the right dose for you.

What is the future for those with malnutrition? (Prognosis)

Malnutrition can be treated, but some effects may persist. The effects of severe undernutrition, such as blindness due to vitamin A deficiency, bone weakness due to vitamin D deficiency, and stunted growth due to protein-energy malnutrition in children, may not fully recover even after rehabilitation. The secondary effects of long-term overnutrition, such as insulin resistance and carotid artery disease , may persist even after weight loss. However, with early intervention and good follow-up support, people can make a full recovery.

When should you see a doctor about malnutrition?

See a doctor in the following cases:

• If you have recently lost or gained more than ten pounds, unintentionally.
• If you have symptoms of anemia, such as weakness, dizziness, lethargy, and fatigue.
• If you think you have an eating disorder.
• If you suspect that children or the elderly in your community are being abused or neglected.

When most people think of malnutrition, they think of undernutrition – either a lack of overall calories or a lack of certain nutrients. Undernutrition is only one aspect of malnutrition, but overnutrition can also be detrimental to your health. Nutritionists now define malnutrition as a mismatch between the nutrients you need and the nutrients you get . By this definition, malnutrition is very common. It is also a significant contributor to disease, disability and death worldwide. We need to fight malnutrition on many fronts, including education, infrastructure and policy measures. At home, you can help prevent malnutrition by eating a balanced diet.

Take-Home Message

• Malnutrition is not just a lack of nutrition, but also malnutrition.
• A balanced, varied diet is very important. Instead of fast food, prioritize nutritious, home-cooked meals.
• Take special care of the nutrition of children, pregnant mothers, and the elderly.
• Do not take vitamin pills or supplements haphazardly. Always seek medical advice.
• If you are experiencing symptoms of malnutrition, see a doctor immediately. The longer you wait, the more problems you may have.

Let's all take care of our nutrition and try to live a healthy life!

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