MALNUTRITION

Malnutrition or malnourishment is a condition that results from eating a diet in which nutrients are either not enough or are too much such that the diet causes health problems.^[1][2] It may involve calories, protein, carbohydrates, vitamins or minerals.^[2] Not enough nutrients is called undernutrition or undernourishment while too much is called overnutrition.^[3] Malnutrition is often used specifically to refer to undernutrition where there is not enough calories, protein, or micronutrients.^[3][4] If undernutrition occurs duringpregnancy, or before two years of age, it may result in permanent problems with physical and mental development.^[2] Extreme undernourishment, known as starvation, may have symptoms that include: a short height, thin body, very poor energy levels, and swollen legs and abdomen.^[2][3] People also often get infections and are frequently cold. The symptoms of micronutrient deficienciesdepend on the micronutrient that is lacking.^[3]

Undernourishment is most often due to not enough high-quality food being available to eat.^[5] This is often related to high food prices and poverty.^[2][5] A lack of breastfeeding may contribute, as may a number of infectious diseases such as: gastroenteritis, pneumonia,malaria, and measles, which increase nutrient requirements.^[5] There are two main types of undernutrition: protein-energy malnutritionand dietary deficiencies.^[4] Protein-energy malnutrition has two severe forms: marasmus (a lack of protein and calories) andkwashiorkor (a lack of just protein).^[3] Common micronutrient deficiencies include: a lack of iron, iodine, and vitamin A.^[3] Duringpregnancy, due to the body's increased need, deficiencies may become more common.^[6] In some developing countries, overnutrition in the form of obesity is beginning to present within the same communities as undernutrition.^[7] Other causes of malnutrition includeanorexia nervosa and bariatric surgery.^[8][9]

Efforts to improve nutrition are some of the most effective forms of development aid.^[10] Breastfeeding can reduce rates of malnutrition and death in children,^[2] and efforts to promote the practice increase the rates of breastfeeding.^[11] In young children, providing food (in addition to breastmilk) between six months and two years of age improves outcomes.^[11] There is also good evidence supporting the supplementation of a number of micronutrients to women during pregnancy and among young children in the developing world.^[11]To get food to people who need it most, both delivering food and providing money so people can buy food within local markets are effective.^[10][12] Simply feeding students at school is insufficient.^[10] Management of severe malnutrition within the person's home withready-to-use therapeutic foods is possible much of the time.^[11] In those who have severe malnutrition complicated by other health problems, treatment in a hospital setting is recommended.^[11] This often involves managing low blood sugar and body temperature, addressing dehydration, and gradual feeding.^[11][13] Routine antibiotics are usually recommended due to the high risk of infection.^[13] Longer-term measures include: improving agricultural practices,^[14] reducing poverty, improving sanitation, and the empowerment of women.^[10]

There were 793 million undernourished people in the world in 2015 (13% of the total population).^[15] This is a reduction of 216 million people since 1990 when 23% were undernourished.^[15][16] In 2012 it was estimated that another billion people had a lack of vitamins and minerals.^[10] In 2013, protein-energy malnutrition was estimated to have resulted in 469,000 deaths—down from 510,000 deaths in 1990.^[17] Other nutritional deficiencies, which include iodine deficiency and iron deficiency anemia, result in another 84,000 deaths.^[18] In 2010, malnutrition was the cause of 1.4% of all disability adjusted life years.^[10][19] About a third of deaths in children are believed to be due to undernutrition, although the deaths are rarely labelled as such.^[5] In 2010, it was estimated to have contributed to about 1.5 million deaths in women and children,^[20] though some estimate the number may be greater than 3 million.^[11] An additional 165 million children were estimated to have stunted growth from malnutrition in 2013.^[11] Undernutrition is more common indeveloping countries.^[21] Certain groups have higher rates of undernutrition, including women—in particular while pregnant or breastfeeding—children under five years of age, and the elderly. In the elderly, undernutrition becomes more common due to physical, psychological and social factormalnutrition image  click here to see images