Children and the elderly are those who suffer from more chronic malnutrition.
Malnutrition is a disease in which the anthropometric parameters (weight, size, muscle, fat and bone to the body) and biochemists are below seen suitable for the characteristics of a person. Malnutrition, as well as overweight or obesity, in the contrary case, occurs when there is no balance between the energy we take through food and energy we spend on various activities of life, both daily and sports.
One in five children under age five are malnourished
Situations of malnutrition may occur when a person’s energy needs increase with respect to the common, and this excess is not covered with the diet. For example, in cases of growth and development, as in early childhood, where energy needs are very high or adolescence where rapid and important body development makes many more calories are spent. Also in situations of pregnancy and breast-feeding increases the energy need and have to cover it adequately.
In the opposite end of the scale there are situations where the intake of calories, is reduced by form voluntary or involuntary, for example, cases of prolonged, very low energy and diets without dietary supervision or pathologies that cause a decrease in appetite. They are also prone to suffer from malnutrition people with an intestine where the nutrients do not take advantage, as in celiac without diagnose or treat disease.
Malnutrition, a problem also in modern societies
The world today is full of contradictions, and the incidence of malnutrition is a clear example of this. While in many countries it is wasted and pulled food tons, in many corners of the planet to food shortages, due to lack of water, natural disasters, large migrations, lack of equitable distribution, etc, it makes many people power deficit and does not reach to cover minimum recommendations.
In some American countries the prevalence of malnutrition reaches data of up to 52% general population at clear risk of malnutrition. This in particular is in Haiti. In other countries of the continent the figures move between 25% and 8%. In Africa the values are between 5-35%.
But today, in developed countries, where there is an excess of food supply and obesity is considered pandemic this century, it is also correct to talk about high numbers of malnutrition among the population. In these areas, the medium hospital, geriatric and most humble areas suffering from the economic crisis of recent years, with greater acuity are levels most likely to suffer it.
The children are, along with the elderly, the group suffering more chronic malnutrition. Data around the world talk about one of every five children under age five are malnourished. And global malnutrition makes us reflect with data that have descended from earlier decades, but which are still above 10%.
Malnutrition occurs not only in development but also in industrialized countries.
The origin of a problem of malnutrition can be caloric needs increase, decrease of intake or both simultaneously. If the supply of food in the area is not suitable and there is a shortage of means, transport, distribution, health, knowledge, etc, the problem worsens significantly.
Some of the most frequent causes of malnutrition are:
- Shortages of food and drinking water in order to maintain adequate food.
- Little socio-sanitary conditions to maintain a healthy nutritional status.
- Economic sharing unbalanced according to regions and little investment in farming, water extraction technologies, etc.
- Difficulty in mobility due to deficient means of transport and infrastructure at the time of collection or get products.
- Little variety in the diet with available food that often do not provide the necessary nutrients. Meat, eggs, milk or fish.
- Unbalanced, very-low-calorie diets held in time and without nutritional supervision.
- Anorexia or loss of appetite caused by multiple causes: treatments chemo or radiation, drugs, surgical procedures, and so on.
- Psychiatric disorders: anorexia nervosa, depression, bulimia…
- Not diagnosed or treated food intolerances: intolerance lactose, intolerance gluten and fructose intolerance.
- Pathological situations that increase the calorie consumption: cancer, cystic fibrosis, fever, Burns, infections, trauma, etc.
- Elderly people pluripatologicas and with criteria of fragility that is not valid for themselves for certain activities related to food.
- Pregnancies or pathological situations with increase in prolonged vomiting or diarrhea.
Weakness, fatigue and extreme thinness are some of the notable manifestations of this disorder.
In addition to be able to classify malnutrition according to their severity from mild to moderate and severe or serious, it is common to set the difference of malnutrition according to the main nutrient that is most scarce in the power. With this in mind, we have two types:
- Caloric malnutrition or morass. In this case there is a decrease in the total energy of the diet, i.e., the person does not eat, especially in quantities of most products, everything it should be. It is usually a long evolution malnutrition and the person looks very gaunt where are marked forms of bones on the skin. It is so thin that we say it: “is just skin and bones”.
The more obvious symptoms, in addition to extreme thinness, also known as cachexia, are: little force and energy to carry out activities, generalized fatigue, weakness, pallor and poor resistance to any type of infection, delayed growth in children age, low school performance, dizziness, sadness and lack of interest by the world that surrounds them.
- Protein malnutrition or kwashiorkor. The most deficit nutrient are proteins. In these diets, the energy content can be covered by caloric foods such as cereals, but foods with protein: meat, fish, dairy, eggs, legumes, nuts, etc, are present in the correct amount.
In these cases, produced edema generalized in the person with the accumulation of water in the lower limbs, stomach and other organs. Before the protein deficiency, the risk to life is important, since damaged tissues and growth and development are not replaceable is paralyzed.
Other symptoms are the trend to infections, fractures, muscle absence, extreme small effort any weakness, falling hair, delayed healing of wounds…
The weight itself does not determine the malnutrition, what if the BMI or a blood test.
For diagnosing malnutrition, not valued only the weight, since this data depends on many personal circumstances. So he is one of the tools most basic and simple to assess malnutrition through a measured index call BMI (BMI) or Quetelet index, and that relates the weight with the likes of this mode: weight in kilograms between height in meters squared.
This measure, devised by the Spanish society for the study of obesity (SEEDO) applies only in adults and classifies the result of this division in:
|30-34.5||Obese class I|
|35-39.9||Obese class II|
|40-49.9||Type III obesity or morbid obesity|
|>50||Obesity type IV or extreme obesity|
Growth curves are used to assess malnutrition in children’s stages. Professionals who interpret these tables, mostly pediatricians and nutritionists, appreciate the situation of each child in relation to your height and your weight. Growth tables are collections of data for age, weight and height of children and different countries. In principle, values below 3 may give us a clue as a nutritional status to review, and this means that that child has a weight or height less than 3% of the child population. As I have said, analyze and appreciate this are professionals, so it is important to go to health exams.
It is also necessary to know if there have been involuntary weight loss and how long it has taken place. It is referred to as the percentage of weight loss.
There are also other parameters that may accompany and substantiate the diagnosis of malnutrition. For example, the folds of skin taken in different parts of the body:
- In the arm. the triceps and the bicipital.
- On the back; the subscapular.
- In the abdomen; the abdominal and the suprailiaco.
Measures of fat should compare with reference tables. Likewise, you can use arm, waist and hip circumference measures, mainly, to determine if its fat and muscle has normal values for age and sex.
There are more tools that contribute to the diagnosis of malnutrition, as the use of bioimpedance where, through a device that emits electric current at low intensity, determines the amount of water, fat, bone and muscle of an individual.
Also through analytical data on blood plasma proteins: albumin, prealbumin, transferrin binding protein of retinol or immunologic values: total number of lymphocytes, which are sensitive to nutritional status. If this is deficit, the values will fall and can be compared with those considered normal.
On a practical level, there are several quizzes where you ask the patient suspected of malnutrition… on various issues related to food, nutritional habits, current and normal weight, and may be complemented with anthropometric or analytical values. Through all the above determines the risk of malnutrition of a person. These questionnaires for risk of malnutrition should be used as a screening, in different centers where malnutrition may be very present.
We recommend a varied diet and make mealtimes a pleasant time to spend in the company.
The most obvious malnutrition prevention measure refers to a diet more varied, comprehensive, balanced, and rewarding as possible. It is essential to focus on the time of food as something satisfying that gives us the necessary nutrients, but also the perfect excuse to get together and spend pleasant moments enjoying the food.
Before any suspicion of doubt about the diet, calorie needs and, especially, unjustified changes in weight or malnutrition, should consult with a specialist in Dietetics and nutrition. In cases where there is a very high risk of malnutrition, we must not spend the time to remedy. It is always easier to overcome a slight malnutrition that a serious. These recommendations and advice will help you prevent a possible malnutrition and even treat:
- Be very strict hygiene in the preparation of food. In many cases, the infections come from a poor preparation. Habits as simple as frequent washing of hands, the boiling of food and proper maintenance can avoid many problems.
- Encourage exclusive breastfeeding. Globally, who recommends this type of power up to six months of life. This will prevent the use of other foods that may be contaminated or the absence of protein in the diet of infants and children.
- Prioritize the adequate food in mothers. Both before pregnancy, during lactation and the same to ensure the nutritional quality of Breastmilk and curb the low weight at birth.
- Use of drinking water.
- Try to bring certain amounts of high biological value proteins: meat, fish, dairy and eggs on a daily basis. It is possible to use mixtures of cereals with legumes and nuts.
- Insisting on the need for cereals, fats, vegetables as a source of calories. Thus small amounts of protein foods can be used for the purpose of create and recover tissue and use it in child growth.
- Adapt the diet to the characteristics of each person: tastes, habits, physiological condition, etc. In this way, perhaps on occasion we must crush the food if they cannot chew or swallow. We can also recommend, sometimes, begin to eat by the second plate so that it is the most commonly consumed, and adapt meals to greater appetite schedules
- Check the condition of the teeth also is interesting as well as verify that swallowing is done correctly.
- Enriching foods with natural methods: Add cheese, milk, egg, cream, olive oil, butter, nuts… caloric and protein products and does not occupy much space by which do not produce large feeling of satiety.
- If it is not sufficient with natural enrichment, rating the need to add artificial supplementation to the diet: are products which are presented in various formats and flavors to add extra protein or calories to the diet. However, should never replace meals, save in very exceptional cases.
- If the above doesn’t work, we will then think about artificial feeding, scheduled and directed by responsible for optional equipment. As we see, before coming to this last point, there is a long way to go in the prevention or treatment of malnutrition in our midst many resources and tools to implement.