Malnutrition

Definition


Malnutrition is a condition in which the body receives an insufficient, excessive or imbalanced amount of vitamins, minerals, and other nutrients needed to maintain healthy tissue and organ function.[1] [2] It may be the result of a single vitamin or nutrient deficiency, or it may be the result of inadequate caloric intake. All humans require a certain number of calories maintain metabolic functions and fuel activity requirements. However, the minimum number of calories required varies by age, sex, and individual.[3] The impacts of malnutrition on the body vary from mild, in which an individual may not experience any physical symptoms of being malnourished, to severe. Severe malnutrition may result in permanent, irreversible damage to the body. For instance, a severe iodine deficiency may result in irreversible brain damage even after an individual receives treatment. Starvation is another severe form of malnutrition that occurs when a person doesn't consume enough food to fuel their body.



History


lind_james.jpg
James Lind
The field of epidemiology has played a large role in the study of malnutrition as a disease. James Lind conducted the first epidemiological clinical trial of a nutritional deficiency in 1747. During Lind's time, scurvy, the result of a Vitamin C deficiency, represented a significant threat to sailors suffered as connective tissues began to breakdown. Lind gathered a pool of twelve sailors and concocted six different possible remedies. The sailors were divided into groups of two and each pair was assigned to take one remedy. The only pair of sailors that did not develop scurvy were those assigned to consume oranges and lemons. These citrus fruits contained the Vitamin C that the sailors lacked in their diet while at sea.[4]





Undernutritionmalnutrition.jpg

Malnutrition and dietary deficiencies cause specific metabolic and diet-related diseases, such as stunting, wasting, obesity, hypertension, and diabetes. However, in many cases malnutrition also increases the risk of infection and infectious disease. It is a vicious cycle in which the state of malnutrition makes individuals more susceptible to infectious diseases and those individuals suffering from infectious disease tend to become malnourished because their body requires an increased amount of nutrients to combat the disease. This is called the nutrition-infection-complex. Undernutrition is a medical and social disorder, commonly thought of as a disease intricately linked to environmental and socioeconomic factors. High rates of micronutrient deficiency disease affect more than 70% of children who live in Asia, 26% live in Africa, and 4% who live in Latin America and the Caribbean.[5] Globally, the United Nations Food and Agriculture Organization estimates that 1.02 billion (decreasing to 925 million in 2010) people are undernourished.[6]



Overnutrition

Recently, the concept of overnutrition has emerged as a form of malnutrition because overconsumption of resources has become a leading factor in the development of chronic diseases. The phenomenon of fast food (defined as food items that can be reproduced for the masses relatively inexpensively and are packed with calories and fat but lack other essential nutrients), combined with other environmental constraints such as lack economic or geographic access to healthy alternatives, contributes to overnutrition. While undernutrition may impact the spread of infectious diseases, overnutrition contributes to the development of chronic diseases such as obesity, cardiovascular disease, cancer, and diabetes.



Studies of Malnutrition in Anthropology


"Small but Healthy?"

Although undernutrition is a growing problem in the area of international public health, a universal Body Mass Index may provide a poor indicator for determining whether someone is suffering from malnutrition. In his “Small but Healthy?” hypothesis, David Seckler argues that those individuals who are considered “small” in comparison to their supposedly “healthy” counterparts are not in fact suffering from debilitating aspects of malnutrition. Seckler hypothesizes that small people who suffer a moderate to mild degree of chronic malnutrition should be considered healthy individuals because they “do not demonstrably have signs or symptoms of functional impairments caused by energy-protein deficiencies.”[7] These otherwise small individuals are healthy in every functional aspect. Seckler's hypothesis has been criticized by the anthropological and global health communities. Anthropologist Ellen Messer claims that Seckler's "Small but Healthy?" argument promotes malnutrition and decreases the magnitude of food shortages suffered by individuals by claiming chronic malnutrition is not severely debilitating and therefore, not a major global health problem. Messer counters Seckler's argument by claiming that any form of malnutrition is a health problem and one cannot define nutritional standards to be different from country to country.[8]



Globalization and Nutrition

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Overeating, or rather, overconsumption of some nutrients is not limited to countries where access to food is not an issue, it has also become a problem in countries that suffer from food shortages. Globalization has led to the spread of fast food establishments and products in many countries and the affordability and accessibility of high calorie items has made nutrition disorders due to overeating a worldwide problem. Although the impact of globalization and overnutrition was mentioned earlier as an underlying cause to the development of chronic diseases, David Himmelgreen and Nancy Romero Daza in their paper “Nutrition and Health” further address the effects of globalization and nutritional health on several different indigenous groups. They note that while globalization and the increasing amount of world travel has let communities economically benefit from a tourism-based economy, the introduction of highly processed carbohydrate-dense foods and western mainstreams such as Coca Cola are causing a change in food consumption and physical activity patterns to the detriment of the health of the local population. There has been an overall trend in the increase in obesity and other chronic diseases due to the overconsumption of highly processed foods. Due to globalization, the availability of these foods has become very accessible to cultures that once had a low prevalence of diseases due to over-nourishment, but, as cultures shift away from an agricultural economy and start catering towards tourism, individuals start to make their living from less labor intensive jobs and suffer from a westernization of their diet to the detriment of their overall health.[9]




The Role of Anthropometry

Anthropometric measurements such as height, weight, head and arm circumference, and skin fold measurements are commonly used in studies of malnutrition and its impact on growth and development. While weight is a good indicator of an individual's current nutritional status, it
is a sensitive measure and can change on a daily basis due to fluctuations in body composition or water levels. Height, on the other hand, is an indicator of prolonged incidences of malnutrition or recurrent cycles of malnutrition. For a more complete picture of malnutrition, weight-for-age, weight-for-height, and height-for-age measures can be collected. Incidences of stunting (lower height-for-age measures) and wasting (lower weight-for-height measures) have been linked to prenatal malnutrition and malnutrition in early life. They can also be used to combat "small but healthy" claims.[10]



See Also




Society for the Anthropology of Food and Nutrition

United Nations Food and Agriculture Organization

World Health Organization's Global Database on Child Health and Malnutrition

UNICEF- Nutrition

Works Cited


  1. ^
    Dorlands Medical Dictionary
    http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/dorlands/dorland/five/000062745.htm
    accessed September 24, 2010.
  2. ^ The Free Dictionary
    http://medical-dictionary.thefreedictionary.com/malnutrition accessed September 24, 2010
  3. ^ Wiley, Andrea S., and John S. Allen
    2009 Medical Anthropology: A Biocultural Approach. New York: Oxford University Press.
  4. ^
    Oleckno, William A.
    2002 Essential Epidemiology: Principles and Applications. Illinois: Waveland Press.
  5. ^
    World Health Organization
    http://www.who.int/water_sanitation_health/diseases/malnutrition/en/
    accessed September 24, 2010
  6. ^ World Hunger Education Services
    http://www.worldhunger.org/articles/Learn/world%20hunger%20facts%202002.htm
    accessed October 20, 2010
  7. ^
    Seckler, David. (1989) Small but Healthy? Are We Asking the Right Question? Human Organization. Volume 48, Number 1 /30 – 39
  8. ^ Messer, Ellen. (1986) The “small but healthy” hypothesis: Historical, political, and ecological influences on nutritional standards. HUMAN ECOLOGY 14, 57-75,
  9. ^
    Himmelgreen, David, and Nancy Romero Daza. In press. Nutrition. In M. Singer & PI Anderson, eds., Companion to Medical Anthropology.
  10. ^
    Cameron, Noel
    2006 Human Growth and Development. San Diego: Academic Press.