Malnutrition is a significant public health issue facing the world today. It is seen in every country. Worldwide, nearly 2 billion people are overweight and nearly half a million are underweight (WHO, 2016). Generally defined as “deficiencies, excesses or imbalances in energy intake or nutrients” (WHO, 2016). If malnutrition occurs during pregnancy or pre-two years of age – negative physical and mental development patterns can become permanent (Burchi et al, 2011).
Malnutrition exists in two main groups – undernutrition: historically associated by stunted growth, wasting, and micronutrient deficiencies and insufficiencies. Many diseases arise from undernutrition such as Kwashiorkor (severe protein deficiency) and Marasmus (significantly low body weight for age bracket). The other is overweight, obesity and diet-related noncommunicable diseases such as heart disease, diabetes, and cancer. In the UK, 26% of adults are classified as obese, up from 15% in 1993 (NHS,2016).
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Personal choice and willpower can have the strongest influence on what we consume but others do exist - conditions such as dementia can result in people forgetting to eat or have forgotten that they have already eaten. Sounding paradoxical, malnutrition can occur even when large amounts of food are consumed – especially when the foods have little or nutritional value. It is not uncommon to find both conditions in the same area. It is possible to be both overweight and micronutrient deficient. Symptoms of malnutrition depend on what nutrient is lacking, for instance, a lack of iron includes lethargy. Malnutrition and Social Issues Stating that malnutrition only arises due to insufficiency or too much intake is an oversimplification. Social situations such as living alone, social isolation, lack of knowledge about nutrition, impaired mobility, pressure on teenagers, low income/poverty all increase malnutrition.
Many factors can contribute to this; for instance, magazine covers show images of the “ideal women” thus increasing pressure on teenage girls which can result in them developing eating conditions such as anorexia or bulimia. Quick population growth resulting in insufficient food supply – as seen in WW2 with rations. It is a commonly held belief that obesity runs in the family – but what also runs in the family is diet. If a child grows up with poor nutritional practices, then they will be more likely to carry these on into adult life and possibly to their children. Malnutrition and Economical problems Malnutrition is seen in all nations, not just developed. Poor socio-economic positions result in malnutrition. Increasing food costs coupled with the lack of food availability results in many families being “priced out” of access to enough nutritious food such as meat and milk. Whilst the food high in sugar and salt become cheaper and more readily available resulting in the rapid rise of numbers of overweight and obese children and adults. However, this is a misnomer as generally fruits and vegetables when brought in wholesale tend to be cheaper than some high fat/sugar items. Nations which obtain their nutrition from a single source, such as rice can result in malnutrition.
Multiple reasons exist for this – ie: lack of education or only having access to a single food source. Malnutrition and food choice Certain people choose to be vegetarians or vegans. This choice can result in deficiencies of certain vitamins such as Vitamin B12. How to reduce Malnutrition Short-term solution – multivitamin tablets Long term solution – improving farming practices, increasing education Prevention is the best cure when it comes to malnutrition and the best way to ensure you get all the correct amounts of nutrients is to eat a healthy, balanced diet. The underlying cause of malnutrition was always be identified first, then individual treatment can be given. Effects of childhood undernutrition on later life Prenatal nutrition is important. Early life growth patterns alter metabolism and physiological patterns have lifelong effects on the risk of developing cardiovascular disease (Victora, 2008). Undernutrition in the early stages of life cause a multitude of issues in later life; those who are undernourished before the age of two and then gain weight quickly later in childhood/adolescence at a higher risk to developing chronic diseases related to nutrition (Victoria, 2008).
Also, a relationship between educational achievement and economic status was identified. If not treated quickly, those who suffer from stunted growth will remain stunted for the rest of their lives (Walker et al, 2008). A multi-generational effect was noted by Victoria et al (2008). They discovered that girls who were undernourished and grow into stunted growth adults tend to have smaller children. Conclusion The double burden of malnutrition is a complex issue which many factors. However, it is a preventable issue. Education is going to be one of the ways in which pressure from this issue can be released. Informing practitioners, educators, parents, and policymakers on all levels of the educational chain to pass on the correct information on to future generations is of paramount importance.
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