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Physiological Effects of Malnutrition during the Human LifeSpan…
Physiological Effects of Malnutrition during the Human LifeSpan
Malnutrition
2- imbalance btw body needs and the intake of nutrients
1- underconsump & overconsump.
3- 4 types
Protein-calorie mal* (undernut)
Secondary mal* (undernut)
Overnutrition
Dietary deficiency or micronutrient mal (undernut)
OVERNUTRITION - over consumption of nutrients due to;
excess intake of vitamins
overeating
excess intake of trace minerals
insufficient exercise
The Hunger-Obesity Paradox
1- paradoxical assoc btw hunger, F.I and excess wt: hunger-obesity paradox
2 - inc rate of overwt and obesity among low-income women who are FI
3- food depriv in youth>neg nutrition behaviors and maybe overwt later in life, even when an indiv is no longer FI or living in poverty
FI rate & O rates are high in low in come families. why? theories:
2 -affordable neighborhoods: proximity to food stores, fast-food, social services, etc.
3- effect women more: wt gain, loss, metabolic inefficiency leads to overwt.
1-FI homes opt for lower $ e-dense foods instead of higher $ more healthy foods
STUDY: JAND, 2009
1 -BRFSS, 66K adults, 12 states, obese had sig higher prevalence of FI, women, blacks, hispanics.
2- What happened?
Overcomp, overall intake bc avail-ie food stamps
cyclical foods-restrictions> inc in body fat, dec in lean body muscle mass, quicker wt gain
in body fat stores and e dense foods high in fat, sugar n less $
FI assoc w; low food expenditure, low F/V poor diet, leads to > e intake and O
psychological consequences: anxiety and depression - may link to obesity
5- Why women?
prevention of physiologic consequence of FI stress, depression - assoc w obesity (high)
sacrifice own nutrition for kids
Dietary Guidlines 2010
lower cost foods
added sugar, HFCS, high glycemic index, added fats, Trans FA, minimal nutritional intake
higher cost foods:
fiber, vitamins, minerals, antioxidants, phytochemical, low e density, high satiating power
Questions-
improve diet qual while maintaining lower diet $? reaction btw food prices and diet quality? what is the relation btw food prices, poverty, and obesity? are specific macronutrients (added sugar, fats) assoc w obesity? do liquid cals affect satiety/linked to obesity rates?
Undernutrition
Due to:
inadequate intake, malabsorp., systemic loss of nutrients: diarrhea, hemorrhage, renal failure, excessive sweating, infection, addiction to drugs
assoc w poverty and social deprivation
HI RISK: infancy, early childhood, adolescence, pregnancy/lactation, old age
UNICEF: types of undernut - growth failure
Acute Malnutrition
Marasmic-Kwashiorkor
combo of wasting and bi lateral edema
Classified as severe acute nutrition = SAM
Marasmus
characteristics
lack of tx = sever = death
severe wasting of fat and muscle which is broken down for e
skin and bones, thin old man face, ribs protrude, skin of arm and thigh are loose, flesh missing from buttocks
Childs body tries to conserve e by reducing PA and growth, red internal body processes and shutting down, no infection response.
red activity limits liver, kidney, heart, gut func
at risk for low blood sugar, body temp, fluid overload/heart fail, infection
rapid dec in nut status in short time, most common acute malnut in nutr emergencies
Kwashiorkor
characteristics
affecting both sides of body- bilateral pitting edema
edema is excessive accumu of fluids in body tissue = severe nutritional deficiencies; bloating from water reten.
starts in leg/feet , progresses to arms hands face
classified as severe acute nutrition
Clinical signs:
loss of appetite, apathy, irritable, changes in hair color (yellow/orange), dermatosis (abnorm skin discoloration, shedding, ulceration of skin, weeping lesions)
origin/theory: caused my inadequate protein intake (also cal def) but complicated
evil inf ofirst child bc of the 2nd
prev in overpop areas where diet is starchy veg like cassava and plantains
moderate acute malnutrition= MAM: WHZ <-2 but >-3
SAM: MUAV < 11.5 ; WHZ <-3 ; bilat pitting edema (MK)
Causes of Acute Malnutrition
undernut assoc w war, famines, inapp weaning, infection (BF up to 6mo)
high risk: children of inexp mothers, twins, female infants
WHO: 49% of 10.4 mil deaths/yr in children under 5 in DC assoc w PEM
Protein
Recs: 0.8 g/kg
if 50kg person x 0.8= 40g protein/day
enough cal meets protein needs
even if 75-80% cal intake protein intake is achieved
WASTING : thinness or nutritional edema
Chronic Mal: Stunting - growth failure/chronic malnutr. overtime
stunting: appear normal prop but shorter than normal age
before birth- poor maternal nut, feeding practices, food qual, frequent infections that slow growth
Acute/chronic mal --UNDERWT
Secondary Malnut
primary cond prevents proper digestion or absorption of food
accompanies other types of undernut
causes
diarrhea, respiratory illness, measles, loss of appetite/anorexia, diversion of nut to parasitic host
Other Micronutrients
Iodine Def (IDD)
common cause of preventable mental retardation and brain damage in world
lowers IQ by 10-15 in less severe cases
causes goiters
impair G AND D
miscarriages, stillbirth, preg. complications
2.2 bill38% pop w IDD
Causes of IDD
lack in diet, it does not stay stored in body
food grown in iodine poor soil
intervention
oil
supps.
food fortification: iodized salt programs
Vit A Def (VAD)
may raise risk of mother to child HIV transmission
mothers def
night blindness-xerophthalmia
in children
visual impairment, blindness, inc risk of death, common w infection like diarrheal, measles
in pregnancy, high risk areas
VAD esp during last trimester
intervention
VA supps.
BF
next phase for long term results
food fortification: sugar in Guatemala
GMO ie golden rice
home gardens
Iron Def Anemia (IDA)
inadequate arts of iron to meet body demands
dec in RBC w too little hemoglobin, O-carrying pigment in blood
iron normally obtained through food (or cooking vessel)
intervention
screen pop at risk
encourage BF, iron infant formula
causes
inadequate daily intake of iron
pregnancy
poor absorp. of iron
growth sports or blood loss
vitamin D
ricks, soft bone, in children
osteomalacia in adults
can be due to little exposure to sunlight
northern countries, dark skim, elderly/infant, excess sunblock, covering ones face
B Vitamins
Thiamin Def
BeriBeri 'I can't, I can't'
needed for chem rx that prod energy
natural in unrefined cereals fresh foods, white rice, thiamine w husk is removed
Asian, 19th century, staple food
Niacin Def
the lime in wood ash tx makes niacin nutr avail reduce pellagra
trad maize prep nixtamalization tx grain w lime Ca(OH)2 alkali
Zinc
inc growth in young, red diarrhea inc, help absorb other micronut.
Vitamin C
scurvy - hemorrhagic manifestations
Dietary Deficiency (Micronut malnut)
vit/min needed in small pmts but insufficient diet causes severe def diseases
3 most common def: VIT A, IRON, IODINE