Malnutrition and Growth

Malnutrition from any cause retards normal growth. Growth assessments are therefore the best way to monitor a person's nutritional status. While there are a variety of methods used to measure growth, the most common are known as anthropometric indices, which compare an individual's age, height, and weight, each of which is measured against the others. The values are expressed as percentages, or percentiles, of the normal distribution of these measurements. So, for example, a child with a given height and age might rank in the 90th percentile for height based on all children of that particular age, meaning that 90 percent of children that age are shorter than this particular child. Through anthropometric studies, researchers have found that particular measurements correlate with specific growth trends, based on how the body normally changes over time. Abnormal height-forage (stunting) usually measures long-term growth faltering. Low weight-for-height (wasting) correlates with an acute growth disturbance.

Malnutrition can have severe long-term consequences. Children who suffer from malnutrition are more likely to have slowed growth, delayed development, difficulty in school, and high rates of illness, and they may remain malnourished into adulthood.

Limited growth patterns are distributed unevenly across the globe. Eighty percent of children affected by stunting or wasting live in Asia, with 15 percent in Africa and 5 percent in Latin America. Low weight-for-age (underweight) is usually used as an overall measurement of growth status. More than 35 percent of all preschool-age children in developing countries are underweight. There are differences, however, across regions. "The risk of being underweight is 1.5 times higher in Asia than in Africa, and 2.3 times higher in Africa than Latin America" (Onis, p. 10). In some ways, these indices also enable an indirect understanding of the societal factors in these regions that contribute to malnutrition as mentioned above.

The Universal Declaration of Human Rights, established by the United Nations (UN) in 1948, identifies nutrition as a fundamental human right.

enteric: pertaining to the intestine; delivered via a tube into the intestine protein: complex molecule composed of amino acids that performs vital functions in the cell; necessary part of the diet calorie: unit of food energy vitamin D: nutrient needed for calcium uptake and therefore proper bone formation niacin: one of the B vitamins, required for energy production in the cell biotin: a portion of certain enzymes used in fat metabolism; essential for cell function folate: one of the B vitamins, also called folic acid antioxidant: substance that prevents oxidation, a damaging reaction with oxygen calcium: mineral essential for bones and teeth iron: nutrient needed for red blood cell formation zinc: mineral necessary for many enzyme processes marasmus: extreme malnutrition, characterized by loss of muscle and other tissue diet: the total daily food intake, or the types of foods eaten carbohydrate: food molecule made of carbon, hydrogen, and oxygen, including sugars and starches kwashiorkor: severe malnutrition characterized by swollen belly, hair loss, and loss of skin pigment anthropometric: related to measurement of characteristics of the human body wasting: loss of body tissue often as a result of cancer or other disease acute: rapid-onset and short-lived

An acutely malnourished Liberian boy is weighed at a therapeutic feeding center. Such centers, operated by international relief organizations, provide intensive care and a specialized diet to rehabilitate severely malnourished children. [AP/Wide World Photos. Reproduced by permission.]

enrichment: addition of vitamins and minerals to improve the nutritional content of a food hygiene: cleanliness prevalence: describing the number of cases in a population at any one time marasmus: extreme malnutrition, characterized by loss of muscle and other tissue protein: complex molecule composed of amino acids that performs vital functions in the cell; necessary part of the diet energy: technically, the ability to perform work; the content of a substance that allows it to be useful as a fuel malnutrition: chronic lack of sufficient nutrients to maintain health kwashiorkor: severe malnutrition characterized by swollen belly, hair loss, and loss of skin pigment calorie: unit of food energy wasting: loss of body tissue often as a result of cancer or other disease acute: rapid-onset and short-lived gastrointestinal: related to the stomach and intestines

Malnutrition remains one of the world's highest priority health issues, not only because its effects are so widespread and long lasting, but also because it can be eradicated. Given the multifactorial causes of malnutrition, interventions must be focused on both acute and broad goals. Current efforts are targeted at high-risk groups, particularly infants and pregnant women, for it is "in these populations and during these ages that nutritional interventions have the greatest potential for benefit" (Schroeder, p. 46). Even the simple supplementation of vitamin A or beta-carotene supplements during pregnancy can decrease maternal mortality by 40 percent. Interventions include direct food supplementation, food access, agricultural enrichment, nutritional education, and improved infrastructure related to hygiene, sanitation, and health care delivery. Each of these programs "must be tailored to the particular problems, cultural conditions, and resource constraints of the local context" (Schroeder, p. 417). Strategies for reducing the prevalence of malnutrition must effectively address its many causes. see also Kwashiorkor; Marasmus; Nutrients; Nutrition.

Seema P. Kumar

Bibliography

Gillespie, Stuart, and Lawrence Haddad (2001). Attacking the Double Burden of Malnutrition in Asia and the Pacific. Washington, DC: International Food Policy Research Institute.

Onis, M.; Monteiro, C.; Akre, J.; and Clugston, G. (1993). "The Worldwide Magnitude of Protein-Energy Malnutrition." In Bulletin of the World Health Organization 71(6).

Schroeder, Dirk G. (2001). "Malnutrition." In Nutrition and Health in Developing Countries, ed. Richard Semba and Martin Bloem. Totowa, NJ: Humana Press.

Shannon, Joyce Brennflck (2001). Worldwide Health Sourcebook. Detroit, MI: Omni-graphics.

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