Malnutrition

Malnutrition in the World

Nutrition is the science that studies food and their relationship with health. Malnutrition, on the other hand, means a pathological condition that occurs when the body does not receive the various nutrients in adequate proportions. Based on this definition, cases of malnutrition can be divided into two broad categories: those due to a reduction in energy intake and those linked to caloric hyper-intake (which we will not discuss in this article).

Before describing the pathological side of malnutrition it is good to remember that undernourished people do not reside only in developing countries, but they are a common reality even in the most industrialized nations, especially among the lower classes and in hospitalized patients.

When fasting lasts for more than 24 hours, the body begins to massively use muscle proteins to extract energy. This leads to a reduction in muscle mass, resulting in weakness and apathy. Furthermore, there is a significant reduction in plasma proteins, with the consequent appearance of generalized edema (presence of excess fluid in the interstitial spaces of the organism).

CAUSES OF MALNUTRITION : Reduced nutritional intake; Increased energy expenditure; Loss or lack of nutrient absorption.

Malnutrition disorders: Kwashiorkor and Marasma

PROTEIN-ENERGY MALNUTRITION (PEM) : term coined in 1976 to indicate a pathological condition sustained by excessive reduction of protein and caloric intake. It occurs in two forms: the Kwashiorkor and the marasmus.

The Kwashiorkor is also known as the second child's disease, since it mainly affects the firstborn. In the poorest countries the period between pregnancy and the other is rather limited, as soon as the mother becomes pregnant with the second child she is no longer able to provide the right amount of nutrients to the firstborn, who is facing this serious malnutrition disease . In particular, the causative agent of kwashiorkor is represented by a diet rich in carbohydrates (starch) but extremely poor in proteins. The main characteristics of children affected by Kwashiorkor are the swollen abdomen, caused by edema (causative agent: hypoalbunemia), and fatty liver or fatty liver (causative agent: reduction of circulating lipoproteins). Other obvious signs of this malnutrition disease are skin depigmentation, growth retardation, muscle weakness and swelling of the face (face to moon). The mortality rate can reach 30-60%.

The other form of PEM malnutrition is marasmus (from the Greek maraimo = to consume, debilitate). Unlike Kwashiorkor, chaos is due to the body's adaptation to malnutrition and is supported by both protein and caloric deprivation. The organism reacts to the poor energy supply by exploiting all the energy reserves (lipid and protein) it has, including the essential or primary ones. The pathology is therefore characterized by an extreme loss of adipose and muscular tissue that leads to: dry skin (children with marasma have an aged appearance), hypothermia, muscular atrophy, irritability and stunted growth.

	Kwashiorkor	marasma
See also: arm circumference as a sign of malnutrition
APPEARANCE	late	Early, within the first year of life
DEFECTS OF GROWTH		Very pronounced
EDEMA	Yup	No
PLASMATIC PROTEINS	- - - - - -	-
SKIN CHANGES	Spots, red spots	Uncommon
LIVER	fat
HIRING PERIOD	short	Very long

Malnutrition can also be linked to a deficit in micronutrient intake (water, mineral salts and vitamins).

Vitamin deficiencies

We speak of hypovitaminosis in the presence of insufficient intake of vitamins with the diet. This deficiency can be linked to an absolute nutritional deficiency (avitaminosis) or relative (hypovitaminosis), to the increased need (pregnancy, stress, etc.) or to diseases affecting the digestive tract (ulcers, stomach cancer, etc.).