Pathophysiology of Malnutrition!(Marasmus VS Kwashiorkor)

Exercise daily – Malnutrition is an imbalance between your body’s nutrients and the nutrients it gets from food. There are two types of malnutrition overnutrition and undernutrition. The prevalence of undernutrition is dominant in developing countries. We will tell you the pathophysiology of Malnutrition.

In this article, we will tell you why Malnutrition is prevalent worldwide, the types of Malnutrition, and what you can do to treat Malnutrition.

So, if you want to know about Malnutrition, you are at the right place. We will give you all information regarding Malnutrition in one article. So without further ado, let’s get started.

Malnutrition:

Malnutrition is not just a food problem; the concept of the importance of considering health, food, and care is of more recent origin.

This thinking continues to develop and to move forward steadily in the place of unpredictable leaps in search of fashion or funding.

Malnutrition or undesirable physical or disease conditions related to nutrition can be caused by eating too little or too much or an unbalanced diet that does not contain all nutrients necessary for good nutritional status.

Types of Malnutrition:

There are many types of Malnutrition. Some types are as follows:

Overnutrition:

There is an excess intake of one or more nutrients in Overnutrition. Examples are Overweight and obesity. People with overnutrition have a greater risk of chronic diseases like diabetes, Cardiovascular disease, cancer or hypertension, etc.

Macro-nutrient Overnutrition:

Macronutrients include proteins, carbohydrates, and fats. When you consume a large number of proteins, carbs, or fats, they get stored in your body tissues and cells, but when the amount of macronutrients increases in your body, there is no place to store them, so they start to accumulate in your body. And then leads to other metabolic disorders like diabetes and CVDs, etc.

Micro-Nutrient Overnutrition:

The micro-nutrient overnutrition is not common because you cannot eat a high amount of micronutrients from your diet alone. It can happen if you take several vitamin supplements at once.

Undernutrition:

Undernourishment definition is an inadequate intake of one or more nutrients. Following are the conditions that can occur due to undernutrition:

PEM( Protein-energy Malnutrition), Anemia, Goiter, Rickets, night blindness, etc.

Macro-nutrients Undernutrition:

Macro-nutrients include protein, carbohydrates, and fats. If your protein intake is very low in your diet then there are high chances of occurring macro-nutrient undernutrition. Macro-nutrients undernutrition includes Kwashiorkor and marasmus. What are marasmus and kwashiorkor? I will tell you later in this article. If you are not eating one of the macronutrients your body will not be able to work properly.

Micro-nutrients Undernutrition:

Micro-nutrients are minerals and vitamins. Its deficiency is mild and can also become severe if your diet lacks nutrients. Micronutrients help the body to produce enzymes, hormones, and other essential substances for growth.

Iodine, Vitamin A, and iron are the most important in global public health terms; their deficiency represents a threat to the health and development of populations worldwide, mainly pregnant women and children.

Causes of Malnutrition:

 

The following are the causes of Malnutrition:

• Inadequate dietary intake and infections are immediate causes of Malnutrition. One must eat an adequate amount of good-quality and safe food to meet all nutritional needs for the body and development of children.
• The food given to a child must be digestible and absorbable. Poor nutrition is often a result of food insecurity, improper care, and feeding practices.
• If you have an issue like dysphagia, in which you can’t swallow food easily. In this condition, Malnutrition is prevalent.
• Cancer is also a cause of Malnutrition because chemotherapy makes eating difficult due to nausea.

Factors on which good nutrition depends:

Good nutrition depends on three of these factors.

• The proper use of resources is the primary factor, and it is affected by social, economic, political, ecological, cultural, and other constraints. This is due to a lack of training to use resources and limited knowledge.
• The cultural context has a remarkable influence on the use of resources and the establishment and maintenance of institutions, especially at the local level.
• Malnutrition may be a health problem, and health professionals can provide some answers, but they alone cannot solve the problem. Agriculturists, and often agricultural professionals, are required to ensure that enough foods, and the right kinds of food, are produced. Tackling Malnutrition usually requires the contributions of professionals in social development, economics, politics, government, and many other institutions.

What are the most vulnerable groups to Malnutrition:

Vulnerable groups for undernutrition:

• Pre-school children:

Pre-school children are at significant risk of Malnutrition, which may be due to food insecurity( food is not available at home often), poverty, or household environment.

 

• Teenage boys and girls:

Teenage boys and girls are also included in the vulnerable group. It is because they don’t eat healthy food and mainly depend on fast food, so their nutritional needs are not met, and they develop Malnutrition.

• Pregnant and Lactating women:

Pregnant and lactating women’s nutrient needs become very high, so if they are not eating enough food, they will develop Malnutrition.

Vulnerable groups for overnutrition:

• Sedentary people:

People who sit all the time, don’t do any physical activity, and whose intake of nutrients is very high have high chances of overnutrition.

Pathophysiology of Malnutrition:

Let’s look at the pathophysiology of malnutrition. Malnutrition occurs due to starvation. If you don’t have enough nutrients for a more extended period, it will cause Malnutrition. And it is characterized by muscle wasting, loss of subcutaneous fat, edema, etc. In Malnutrition, especially in PEM, the person’s body doesn’t have enough nutrients to perform routine functions.

So the body starts to get energy from muscles, skin, and fats. In this way body’s immune system shutdowns and the children become prone to infections. They begin to feel weak and lazy and cannot do routine work.

PEM (Protein Energy Malnutrition):

After the physiology of malnutrition, now we will talk about one type of Malnutrition which is PEM. It is a type of undernutrition with inadequate protein and energy intake and it is very common worldwide in adults and children; annually, 6 million people die due to PEM. It is most common in children.

Types of PEM:

There are two types of PEM:

• Kwashiorkor
• Marasmus

 

Kwashiorkor:

Now we will look at the kwashiorkor symptoms and its pathophysiology is a type of Malnutrition caused by a deficient intake of protein. Their caloric intake is sufficient, but their protein intake is insufficient.

Symptoms:

Mild symptoms include the child’s moon face becoming irritable, anorexia, ulcerating dermatoses, and fatty liver.

Mild to severe kwashiorkor symptoms are anemia, change in skin and hair color (reddish-orange color), diarrhea, and fatigue.

And the loss of muscle mass, failure to grow or gain weight, flashy rash, and damaged immune system can further cause infections.

How is Kwashiorkor Diagnosed?

The doctor first notices enlarged liver and swelling (edema), and they also perform an albumin test on them.

Complications:

Even with treatment, children who were suffering from Kwashiorkor may never reach total growth and height. A child may develop permanent physical and mental problems if the treatment starts late. Or if it is left untreated, the condition may lead to coma or death.

How to treat Kwashiorkor?

We can treat it by eating more proteins and calories. First, we have to give more calories in the form of CHO, fats, and sugar than, in the end, provide them with a diet rich in protein. We can prevent this disease by eating enough calories and proteins. CDC recommends 10 to 35% of protein daily.

Marasmus:

Now we will look at the pathophysiology of malnutrition type (marasmus) and its symptoms. It is also a type of protein energy malnutrition. In this condition, a child looks like he is wearing baggy pants. And children will have low weight for height.

Causes:

Its pathophysiology or causes are severe deficiency of all nutrients, especially proteins, carbohydrates, and lipids.

To look for severe wasting:

Firstly we have to remove the child’s clothes. And then we have to look at the front view.

Front view:

• First, we must see if the outline of the child’s ribs is easily seen.
• Does the skin of the upper arm look loose?
• Does the thigh look lose?

Back view:

• Are the ribs and shoulder bones easily seen?
• Is flesh missing from the buttocks?

Signs and symptoms of marasmus:

The child appears like skin and bones. They have sunken cheeks and wide eyes, and hair becomes sparse and easily pluckable. 

The child becomes hypoglycemic and hypothermic. The child is underweight and has less than 60% of his expected body weight. They have dry skin folds hanging over the buttocks and armpits.

Conclusion:

This article concludes that Malnutrition is common worldwide, especially in developing countries. So we should work together to eradicate Malnutrition from this world. In this article, we talked about the pathophysiology of Malnutrition and one type of Malnutrition, PEM, that is also very common in developing countries among children.