Malnutrition

Question 1

Define malnutrition

Answer 1

Having an inappropriate level of micro/macro nutrients in the diet.
Includes both under nutrition and over nutrition (obesity).

Question 2

Where is malnutrition most likely an issue?

Answer 2

low and middle income countries e.g., Asia

Question 3

Define food insecurity

Answer 3

Disruption of food intake or eating patterns/behaviours due to lack of income or other resources.
E.g., elderly struggling to get to shop
E.g., person from low economic background can’t afford food

Question 4

List some factors that are associated with food insecurity.

Answer 4

Income/employment
Climate
Race/ethnicity
Disability

Question 5

What % of childhood death does malnutrition contribute?

Answer 5

50%

Question 6

Describe some factors that contribute to malnutrition.

Answer 6

Climate
- affects agriculture and food availability

Conflict

• lack of resources
• need to quickly flee to escape conflict

Urbanization

• lack of income/purchasing power leads to household deficiencies
• mothers will often give their children food before themselves

Question 7

What are the 3 types of malnutrition?

Answer 7

Energy-protein malnutrition

• kwashiorkor
• marasmus

Micro-nutrient deficiency

Mild to moderate deficiency

• stunting
• wasting
• underweight

Question 8

Describe kwashiorkor.

Answer 8

Increased carbohydrate intake with decreased protein intake

usually occurs in response to emergency situations e.g., famine

Question 9

What are some clinical consequences of kwashiorkor?

Answer 9

fatty liver - due to increased influx of FFA’s resulting in production of triglycerides more than the liver can handle.

oedema

Question 10

What are some signs and symptoms of kwashiorkor?

Answer 10

sparse unnaturally blonde hair
swollen belly caused by oedema and fatty liver
infection prone skin 
apathy
decreased muscle mass

Question 11

Describe marasmus and the mechanism behind it

Answer 11

Low energy intake - deficit of calories leading to wasting

Gluconeogenesis utilises skeletal muscle to maintain plasma glucose level

Fatty acids are incompletely oxidised to produce ketone bodies that provide energy to the brain/muscle/organs.

Question 12

What are some signs and symptoms of marasmus?

Answer 12

severe weight loss - no subcutaneous fat and little muscle.

child hyper alert and hungry

Question 13

How is malnutrition measured?

Answer 13

stunting
wasting
underweight

Question 14

Describe stunting.

Answer 14

Height and age are disproportionate.

Height is lower the reference for that particular age.

Represents long term growth retardation.

Question 15

Describe wasting

Answer 15

Height and weight are disproportionate

weight is lower than reference value for same height

Question 16

Describe underweight

Answer 16

Weight and age are disproportionate

weight is lower than reference for same age group.