Nutrition-Malnutrition

Presented By:

Khan Tawhid Parvez

Nutrition is the foundation of Health

Health is the backbone of a nation

Magnitude of Malnutrition

Micronutrient related

- More than 80% < 2 year children have nutritional anaemia

- About 40% population have ID

- More than 2.5% PLW have VAD

- Zinc deficiency disorders are becoming more pronounced

Magnitude of Malnutrition

Macronutrient related

- More than 40% <2 children are LWA- About 40% children are stunted- More than 40% WCBA have low BMI- Colostrums rejection is > 50%- IYCF practices are unacceptable- mean pregnancy weight gain is <5kg

..Continued…

Magnitude of Malnutrition

Economic loss

- Direct yearly loss due to micro and macronutrient deficiency is >US$2.2 billion

- Indirect loss (health expenses due to malnutrition) is huge.

Malnutrition Malnutrition

There will be about 3,000 deaths globally, There will be about 3,000 deaths globally, mostly women, infants and children, mostly women, infants and children, during this during this presentation sessionpresentation session!!Globally, one in three people are Globally, one in three people are malnourishedmalnourished

7

Causes of under-five deaths in relation Causes of under-five deaths in relation to malnutrition in Bangladeshto malnutrition in Bangladesh

Neonatal 45%

Diarrhoea 20%

Pneumonia 18%

Injuries 3%

Measles 2%Malaria 1%

HIV/AIDS 0%

Other 11%

More than one More than one third of this third of this mortality is mortality is

attributable to attributable to UndernutritionUndernutrition

Causes of Deaths among U-5 Childrenin Developing Countries

Ref: World Health organization. The global burden of disease: 2004 update. Geneva, World Health organization, 2008

Nutrition

It is the process in which food is consumed, digest and absorb and use them for health and growth. In other words, nutrition can be defined as food or nourishment needed to keep an organism growing, healthy and viable. (Traditional)

This definition is no longer being used.

Definition of mal/nutrition

Nutrition or malnutrition is the physical impression of the interactions among the determinants of malnutrition.

Definition of mal/nutrition

Although ‘primarily’ it is the physical impression, but other indicators can also be used to determine the nutritional status.

• Clinical• Bio-chemical• Dietary• Anthropometric – Stunting, wasting, underweight• Ultrasonography - Thyroid• Radio Immuno-assay - Iodine

Determinants of Malnutrition (cont)

There are basically 03 determinants of malnutrition:

• Lack of Foods

• Lack of Caring Practices and

• Lack of Health Services (including

environmental and personal hygiene)

Determinants of Malnutrition (cont)

Lack of Foods

Causes: lack of landlack of technologylack of transportseasoncooking processlack of communicationlack of affordabilitylack of availabilitynatural and man made calamityfood culture etc.

Determinants of Malnutrition (cont)

Lack of Caring Practices

Causes: lack of care during pre, natal and post natal period

no / lack of breastfeeding (BF)no / lack of use of PHC / ESD lack of familial supportlack of knowledge on various issues related to pregnancy, child birth and child carevaccinationimportance of food and rest etc.

Determinants of Malnutrition (cont)

Lack of Health Services

Causes: no hospital (if yes, then)no doctor (if yes, then)no nurses (if yes, then)no paramedics (if yes, then)no medicineno / lack of communicationlack of confidenceremote etc.

Determinants of Malnutrition (cont)

All these three determinants are interdependent

They remain in a ‘chain like fashion’ or ‘three separate rings connected together’.

If any one of the determinants is lacking (‘-’), then it will have a trickle down effect on the other two determinants of nutrition

Then the overall outcome would be ‘-’ which means malnutrition.

Conceptual frame work of Malnutrition 

Human, Economic, and Institutional Resources

Nutritional Status

Health Diet

Household Food Security

Potential Resources

Ecological Conditions

Care of Mother and Child

Environ. Health,Hygiene & Sanitation

Political and Ideological Structure RootCauses

Manifestations

ImmediateCauses

UnderlyingCauses

Functional Consequences: Mortality, Morbidity, Lost Productivity, etc.

Consequences

Adapted from UNICEF

Unicef nutrition strategy

Thank You

Components of Optimal Nutrition

• Adequate and proper diet (food)– Calories, Carbohydrates, Proteins, Fats,

Minerals and Vitamins

• Good and loving care in a healthy environment

• Access to health care services

What are the Roles of Nutrition in Public Health?

Improving Population Health

21