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Certain people are more susceptible to malnutrition than others. For example, individuals in rapid periods of growth, such as infants, adolescents, nutritional requirements: the set of substances needed in the diet to maintain health 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 nutrition: the maintenance of health through proper eating, or the study of same undernutrition: food intake too low to maintain adequate energy expenditure without weight loss etiology: origin and development of a disease

In developing nations, more than half of all deaths among children under five years old are due to malnutrition. Malnourished children who survive may experience stunted growth, illness, and lifelong malnourishment. [Photograph by Bruce Brander. National Audubon Society Collection/Photo Researchers, Inc. Reproduced by permission.]

gastrointestinal: related to the stomach and intestines chronic: over a long period immune system: the set of organs and cells, including white blood cells, that protect the body from infection absorption: uptake by the digestive tract nutrient: dietary substance necessary for health malnourished: lack of adequate nutrients in the diet hookworm: parasitic nematode that attaches to the intestinal wall malaria: disease caused by infection with Plasmodium, a single-celled proto-zoon, transmitted by mosquitoes and pregnant women, have higher nutritional needs than others, and are therefore more susceptible to the effects of poor nutrition. Those living in deprived socioeconomic circumstances or that lack adequate sanitation, education, or the means to procure food are also at risk. Most importantly, individuals at risk for systemic infections (particularly gastrointestinal ) and those who suffer with a chronic disease are at greatly increased risk because they require additional energy to support their immune system and often have decreased absorption of nutrients.

In fact, the relationship between malnutrition and infection is cyclical— infection predisposes one to malnutrition, and malnutrition, which impairs all immune defenses, predisposes one to infection. The World Health Organization (WHO) identifies malnutrition as "the single most important risk factor for disease" (WHO). Some research has identified malnourished children as being more likely to suffer episodes of infectious disease, as well as episodes of longer duration and greater severity, than other children. In particular, hookworm, malaria, and chronic diarrhea have been linked with malnutrition. These conditions are more prevalent in the developing world than in the industrialized world, though malnutrition exists worldwide, par-

ticularly in areas of poverty and among patients with chronic disease or who are hospitalized and on enteric feeding.

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