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2 Major Health Problems Resulting From Malnutrition

Many societies suffer from the health problems of malnutrition. When the word malnutrition is mentioned, most people think of it as a problem of under nutrition only while the fact is that over nutrition is also a problem. The correct definition of malnutrition is that it is a condition which arises from improper nutrition status of an individual.
There are a lot of disorders that result from under nutrition. Here are two major health problems resulting from under nutrition.

1. Protein Energy Malnutrition:
There are two types of this disorder.
a) Kwashiorkor where there is inadequate intake of protein only.
b) Marasmus where there is inadequate intake of both protein and energy.
• Kwashiorkor:
A. Mostly affect children from 1 to 3 years.
B. Diet is grossly deficient in protein.
C. It is seen during the weaning period when the child diet is changed from breast milk to diet high in starch and low protein.
D. The following points are the clinical features of the disease:
1) Edema which is constant in the face and more marked in the lower limbs.
2) Wasting of muscles.
3) Low body weight masked by edema.
4) Hair change: the kid’s hair becomes light and easily removed.
5) Skin: the kid will have patched and pigmentations.
6) Hepatomegaly.
7) Apathy and irritability.

• Marasmus:
A. Affect children under 1 year.
B. Inadequate caloric and protein intakes.
C. It happens due to the early cessation of breast feeding where breast milk is replaced by over diluted formula feeding with low calories and nutrient content.
D. The following points are the clinical features of the disease:
1) Senile faces.
2) Severe muscle wasting.
3) Very low weight for age.
4) Loss of subcutaneous fat.
5) There is no edema.
6) The liver is not affected.
7) There is no mental affection.
• How to prevent protein energy malnutrition?
A. General measures.
1. Raising socioeconomic standards.
2. Planning for increasing production of protective foods.
3. Environmental sanitation.
B. Specific measures:
1. Proper breast feeding for 2 years.
2. Proper weaning practices with complementary feeding.
3. Nutrition education of mothers.
4. Prevention and control of infectious diseases.
5. Growth monitoring for early detection and management of protein energy malnutrition.

2. Dental Caries (tooth decay):
Dental caries is a chronic widely prevalent disease. It forms a nutritional as well as public health problem all over the world.
• The Cause of dental caries:
dental caries results from the interaction of four undependable variables:
1. Susceptible host (teeth and surrounding saliva).
2. Carcinogenic diet like any soft carbohydrates.
3. Caries specific bacteria.
4. Decrease of fluoride.
• How to prevent dental caries?
a) Adequate nourishment especially for growing children.
b) Oral hygiene and proper cleaning of teeth.
c) Fluoridation of water (optimum content is 1 ppm).

These two health problems mainly affect our kids so they need to be understood completely in order to know how to protect our kids against them. Under nutrition problems in our kids will affect them now and for the rest of their lives.

Everything You Need to Know about Vitamin K, C and B Vitamins

Why do you need to know all the information about vitamins? Because they must be included in your diet and in your kids meals in order to maintain your body functions. Instead of searching everywhere for information, here is the best and simplest guide that will help you know everything about three very important vitamins; Vitamin K, C and B vitamins.

1. Vitamin K:
• Physiological role of Vitamin K:
It serves as essential co-factor needed for Pro-thrombin in liver which is responsible for normal clotting mechanism of blood.
• Sources of Vitamin K:
1. K1: Dietary sources as fresh dark green leafy vegetables.
2. K2: Synthesized by bacteria flora of the human intestine.
3. K3: Synthetic preparation for therapeutic uses.
• Clinical Effects:
A) Deficiency of Vitamin K:
1. Prolonged clotting time.
2. Defective coagulation.
3. Increased tendency for bleeding.

B) Excess Vitamin K:
It is dangerous in pregnant women who are taking large amounts of Vitamin K as they may deliver an infant with haemolytic anaemia.
• Therapeutic uses of Vitamin K:
1. bleeding of the new-born.
2. Premature new-born.
3. Biliary obstruction and mal-absorption.

2. Vitamin C:
• Physiological role:
1. Formation of the matrix of tissues as connective tissue, osteoid tissue, dentine of the teeth and capillary endothelium.
2. Vitamin C facilitates the intestinal absorption of iron.
3. It is involved in folic acid metabolism.
• Clinical effects:
a) Deficiency: vitamin C deficiency causes scurvy which is characterized by the following:
1. Weakness.
2. Irritability.
3. Weight loss.
4. Failure of wound healing.
5. Haemorrhagic manifestations.
b) Excess:
Large doses of ascorbic acid have been associated with hypoglycaemia and impaired bactericidal activity of white blood cells.
• Sources of Vitamin C:
1. Citrus fruits and juices.
2. Green vegetables (Raw or minimally cooked).
3. Guava and berries.
• Recommended daily intake of vitamin C:
1. Adult: 60 mg per day.
2. Pregnant women: 80 mg per day.
3. Lactating mother: 100 mg per day

3. B vitamins:
• Sources of B vitamins:
1. Dietary: Yeast, germ of cereals, nuts, beans, peas, meat, organ meat, green leafy vegetables and dairy products. The highly refined flour and polished white rice are deficient in B vitamins.
2. Biosynthesis of B vitamins by intestinal bacteria flora.
3. Biosynthesis of niacin (type of B vitamins) from tryptophan (niacin precursor) from animal protein foods.
• Types of B vitamins:
1. Thiamine (B1):
A. Deficiency of it causes Beriberi disease which has two types; wet type with cardiovascular manifestations and dry type with nervous manifestations.
B. Recommended daily intake of it is 1.2 mg for males and 0.9 mg for females.
C. It works as a co-enzyme that is essential for carbohydrate metabolism.
2. Riboflavin (B2):
A. Deficiency of it causes angular stomatitis, dermatitis and cornel vascularization.
B. Recommended daily intake is 1.8 mg for males and 1.3 mg for females.
C. It works as a co-enzyme.
3. Niacin:
A. Deficiency of it causes pellagra.
B. Recommended daily intake of it is 20 mg for males and 15 mg for females.
C. It works as a co-enzyme in oxidation and reduction reactions and in lowering low density lipoproteins and increasing high density lipoprotein.
4. Pyridoxine (B6):
A. Deficiency of it causes peripheral neuritis, skin lesions and stomatitis.
B. Recommended daily intake of it is 2 mg for males and 1.5 mg for females.
C. It works as a co-enzyme in amino acid metabolism.
5. Folic acid:
A. Deficiency of it causes anaemia. Deficiency during pregnancy may lead to congenital malformations.
B. Recommended daily intake of it is 200 UG for males and 400 UG for pregnant females.
C. It is essential for formation of nucleoprotein which is necessary for the normal maturation of RBCs in the bone marrow.
6. Cyano-Cobalamin (B12):
A. Deficiency of it causes pernicious anaemia and nervous manifestations.
B. Recommended daily intake of it is 3 UG for adults.
C. It is essential for carbohydrates, fat and amino acid metabolism.

The Relationship between Anaemia and Malnutrition

The causes of under nutrition are many. The socioeconomic causes like big families, low income, faulty nutritional habits, ignorance and illiteracy play a role. The personal causes like the improper food intake either because the food is forbidden by the doctor or the person is patient and he refuses to eat because he has anorexia nervosa or a chronic disease, improper digestion due to GIT problems, improper absorption due to mal-absorption syndrome, improper metabolism and excessive loss of food such in cases of diarrhoea, vomiting or parasitic infection. There are also food related causes such as insufficient food intake or the high prices of foods.
All these problems cause under nutrition which leads to serious diseases. One of the most serious complications is anaemia; let’s find everything you need to know about it.

1. Nutritional anaemia:
It is considered among the most common diseases in the whole world especially in rural areas.
• Nutrients that are essential for red cell formation:
A. Vitamins: Vitamin B12 and folic acid. Vitamin C is also important for iron absorption and folic acid metabolism.
B. Minerals: iron.
C. Protein: it is essential for the normal formation of red cells and haemoglobin.
• Iron deficiency anaemia:
1) underlying factors for iron deficiency:
a) inadequate intake of dietary iron.
b) Low bioavailability of iron in cases of plant origin iron, excess oxalate and phosphate, vitamin C deficiency and hypo-acidity of the stomach.
c) Increased requirement of iron as in pregnancy and lactation. The lost iron in a normal pregnancy, delivery and lactation for 6 months may be totally 1900 mg.
d) chronic blood loss such as parasitic diseases like malaria and bleeding disorders.

2) Clinical signs and symptoms of iron deficiency anaemia:
a) general weakness and easy fatigability.
b) Dyspnoea on exertion and headache.
c) Pallor and spoon shaped nails.
d) Blood picture: hypochromic microcytic anaemia which is characterized by low haemoglobin and diminished red blood cells count.

3) Prevention and control of iron deficiency anaemia:
a) community development.
b) Prevention and control of parasitic infections.
c) Improving bioavailability of iron diet through consumption of foods rich in vitamin C.
d) Enrichment of food deficient in iron with iron preparation like bread and biscuits for children.
e) Supplementation of the vulnerable groups as children, pre-terms and pregnant women with iron preparation.
f) Control of blood loss.
g) Periodic screening tests for early detection and management of anaemia.

2. B12 and folic acid deficiency anaemia:
B12 and folic acid deficiency lead to macrocytic anaemia where the development of red blood cells in the bone marrow stops at a certain phase.
• The main causes of deficiency of vitamin B12 and folic acid:
A. Pernicious anaemia where there is stop secretion of intrinsic factor which is necessary for absorption of vitamin B12.
B. A parasitic infection with a worm called “Diphyllobothrium latum”. This parasite absorbs large amount of vitamin B12 producing secondary macrocytic anaemia.
• Prevention and control:
A. Adequate nourishment with animal food.
B. Prevention and control of parasitic infections.
C. Parental vitamin B12 is useful in control of pernicious anaemia.

This is the complete guide to understand the relationship between anaemia and malnutrition; understand it well to protect yourself, your kids and your family.