NUTRITIONAL DISORDER IN CHILDREN ESSAY
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NUTRITIONAL DISORDER
Nutritional disorder is a pathological state due to a relative or absolute deficiency or excess of one or more essential nutrients; clinically manifested or detected only by biochemical, anthropometric or physiological tests. Nutritional disorder which is also known as malnutrition 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 (Young, 2012). It may involve calories, protein, carbohydrates, vitamins or minerals. Not enough nutrients is called undernutrition or undernourishment while too much is called overnutrition (Young, 2012). Malnutrition is often used specifically to refer to undernutrition where there is not enough calories, protein, or micronutrients. If undernutrition occurs during pregnancy, or before two years of age, it may result in permanent problems with physical and mental development in a child. When a child is exposed to extreme undernourishment, known as starvation, this may have symptoms that include: a short height, thin body, very poor energy levels, and swollen legs and abdomen in child. Children also often get infections and are frequently cold. Undernutrition is an important determinant of maternal and child health, accounting for more than a third of child deaths and more than 10 percent of the total global disease burden according to previous studies (Black et al., 2008) The World Health Organization estimates that malnutrition accounts for 54 percent of child mortality worldwide, (Walker et al., 2008) about 1 million children (Jean, 2008). Another estimate also by WHO states that childhood underweight is the cause for about 35% of all deaths of children under the age of five years worldwide (FAO, 2008). As underweight children are more vulnerable to almost all infectious diseases, the indirect disease burden of malnutrition is estimated to be an order of magnitude higher than the disease burden of the direct effects of malnutrition (FAO, 2008). The combination of direct and indirect deaths from malnutrition caused by unsafe water, sanitation and hygiene (WASH) practices is estimated to lead to 860,000 deaths per year in children under five years of age.
The symptoms of micronutrient deficiencies depend on the micronutrient that is lacking. Some of the well-known classification of nutritional disorders in children are: Under-nutrition (Marasmus), Over-nutrition (Obesity, Hypervitaminoses), Protein-energy malnutrition (PEM) (Kwashiorkor, Hypovitaminoses), Mineral Deficiencies, Imbalance (Electrolyte Imbalance).
1.1.1 Malnutrition (Undernutrition and Overnutrition)
Malnutrition is most often due to not enough high-quality food being available to eat. This is often related to high food prices and poverty. A lack of breast feeding may contribute, as may a number of infectious diseases such as: gastroenteritis, pneumonia, malaria, and measles, which increase nutrient requirements (WHO, 2005). There are two main types of undernutrition: protein-energy malnutrition and dietary deficiencies. Protein-energy malnutrition has two severe forms: marasmus (a lack of protein and calories) and kwashiorkor (a lack of just protein). Common micronutrient deficiencies include: a lack of iron, iodine, and vitamin A. During pregnancy, due to the body's increased need, deficiencies may become more common. In some developing countries, overnutrition in the form of obesity is beginning to present within the same communities as undernutrition. Other causes of malnutrition include anorexia nervosa and bariatric surgery (WHO, 2005).
Nutritional disorder is caused by eating a diet in which nutrients are not enough or are too much such that it causes health problems. It is a category of diseases that includes undernutrition and overnutrition. Overnutrition can result in obesity and being overweight (Murray, 2012). In some developing countries, overnutrition in the form of obesity is beginning to present within the same communities as undernutrition. However, malnutrition is commonly used to refer to undernutrition only. Undernutrition encompasses stunted growth (stunting), wasting, and deficiencies of essential vitamins and minerals (collectively referred to as micronutrients). The term hunger, which describes a feeling of discomfort from not eating, has been used to describe undernutrition, especially in reference to food insecurity (Lim et al, 2012).
1.1.2 Protein-energy malnutrition (PEM)
Undernutrition is sometimes used as a synonym of protein–energy malnutrition (PEM). While other include both micronutrient deficiencies and protein energy malnutrition in its definition. It differs from calorie restriction in that calorie restriction may not result in negative health effects (Black et al., 2008). The term hypoalimentation means underfeeding. Severe malnutrition or Severe undernutrition is often used to refer specifically to PEM. PEM is often associated with micronutrient deficiency. Two forms of PEM are kwashiorkor and marasmus, and they commonly coexist (Stevenson and Conaway, 2011). Chronic undernutrition manifests primarily as protein-energy malnutrition (PEM), which is the most common form of malnutrition worldwide. Also known as protein-calorie malnutrition, PEM is a continuum in which people—all too often children—consume too little protein, energy, or both (WHO, 2005). At one end of the continuum is kwashiorkor, characterized by a severe protein deficiency, and at the other is marasmus, an absolute food deprivation with grossly inadequate amounts of both energy and protein. Treatment of PEM has three components. (1) Life-threatening conditions—such as fluid and electrolyte imbalances and infections—must be resolved. (2) Nutritional status should be restored as quickly and safely as possible; rapid weight gain can occur in a starving child within one or two weeks. (3) The focus of treatment then shifts to ensuring long term nutritional rehabilitation of the child. The speed and ultimate success of recovery depend upon the severity of malnutrition, the timeliness of treatment, and the adequacy of ongoing support (WHO, 2005).
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