Strategies to combat malnutrition in India
Introduction:
Malnutrition is a
condition that is caused by a deficiency of nutrients or excess of nutrients.
It can be mild or severe. The damage caused by malnutrition may have a
permanent effect. Political problems, natural calamities, poverty, and war can
cause malnutrition.
In children, it
can affect brain development and overall growth. They will have lifelong
problems. Some problems related to malnutrition are malabsorption, hunger,
beriberi, kwashiorkor, megaloblastic anemia, pellagra, rickets, scurvy, spina
bifida, etc.
The government and
non-government organizations have adopted different strategies to combat malnutrition.
Table of
contents:
1. Definition
2. Causes
3. Symptoms
4. Specific
nutritional requirements
5. Statistics of
malnutrition in India and other countries
6. Adverse effects
of malnutrition
7. Strategies
adopted by the government
8. Conclusion
9. References
Definition:
Malnutrition refers to deficiencies, excesses, or imbalances in a person’s intake of energy and nutrients. It covers two broad categories. One is “undergrowth” which includes stunted growth, wasting, underweight, and micronutrient deficiencies. The other is “overweight” which includes obesity, heart disease, stroke, diabetes, cancer, etc.
Causes:
· Starvation
· Eating disorders
· Poor diet
· Deficiency of vitamins
· Decreased absorption of macronutrients and micronutrients
· Reduced dietary intake
Symptoms:
· Lack of appetite
· Inability to concentrate
· Depression
· Loss of fat, muscle mass, body tissue
· Delay in wound healing
· Tiredness and irritability
· Slow behavioural and intellectual development
Adverse effects of malnutrition
Malnutrition
affects the function of every organ system.
Muscle function:
The most obvious sign
of malnutrition is weight loss due to depletion of fat and muscle mass. Muscle
function declines before changes in muscle mass occur.
The downregulation of energy-dependent cellular membrane pumping is an explanation for these findings. This occurs followed by a short period of starvation. The direct consequences include loss of functional capacity and a brittle, but stable, metabolic state. Rapid decompensation occurs with infection and trauma. Unbalanced or sudden excessive increases in energy intake put malnourished patients at risk of decompensation and refeeding syndrome.
Cardio-respiratory
function:
Cardiac muscle mass reduction is recognized in malnourished individuals. The resulting decrease in cardiac output impairs renal function by reducing renal perfusion and glomerular filtration rate. Micronutrient and electrolyte deficiencies affect cardiac function, particularly during refeeding. Poor diaphragmatic and respiratory muscle function decreases cough pressure and expectoration of secretions, delaying recovery from respiratory tract infections
Gastrointestinal
function:
Chronic malnutrition
affects pancreatic exocrine function, intestinal blood flow, villous
architecture, and intestinal permeability. Reabsorption of water and
electrolytes by the colon is reduced. The secretion of ions occurs in the small
and large bowels. This leads to diarrhea, which is associated with a high
mortality rate in severely malnourished patients.
Strategies to
combat malnutrition:
Two major
approaches to addressing malnutrition are:
· Nutritional planning
· Direct nutrition and health development
Nutritional planning:
This includes a political commitment by
the government. A well-executed long-term project can fasten the developmental
process. The benefits can be rewarding and permanent.
Nutritional planning involves the implementation
of a nutrition policy. It involves an overall long-term planning to improve
production and supplies of food. To increase the purchasing power of people,
equitable distribution of food should be ensured. This includes land reforms
and proper guidance in agriculture that help in the marketing of farm produce.
Some of the strategies include:
·
To help people to buy nutritious food in adequate
quantity.
·
Execution of income-generating activities for the
weaker sections of the community.
·
Ensuring the distribution of good-quality food
Direct nutrition and health intervention:
Improved health care system:
Infections like Malaria,
measles, and diarrhea are certain infections that are prevalent in our society.
They precipitate acute malnutrition among children and infants. Proper
immunization, oral rehydration, periodic deworming, early diagnosis, and proper
treatment of common illnesses can prevent malnutrition to a certain extent.
Nutritional education:
People can be made aware
on:
- The
nutritional quality of foods
- Importance
and nutritional quality of culturally accepted low-cost foods.
- Importance
of exclusive breastfeeding for six months and continuation for up to 2
years or beyond.
- Trauma
caused by irrational beliefs and cultural practices of feeding
- Recipes
for preparing good supplementary food from locally available low-cost
foods.
Inclusion of milk, eggs, meat, or pulses in
sufficient quantities in the diet to enhance the net dietary protein value.
- Importance
of feeding children and adults during illness
- Importance
of growing a kitchen garden.
- Importance of immunization and following proper sanitation.
Early detection of malnutrition
and intervention:
Intervention must occur during the pregnancy and the first three years of life. If there is a delay, the chances of the occurrence of
permanent effects are greater.
A well-recorded growth chart can detect
malnutrition easily. The velocity of growth is more important than the actual weight.
If the growth of the child is slowed, any hidden
infection or any nutritional deficiency must be inspected.
Anthropometric indices like height, weight, mid arm
circumference, and chest circumference can be measured if growth chart is not
available.
Nutrition supplementation:
The government conducts various welfare measures for
biologically vulnerable groups like pregnant women, infants, preschool going,
and school-going children. Calories, proteins, and micronutrients like Vitamin A,
zinc, and Iron can be supplemented.
Objectives of nutrition
supplementation of infants and children:
· To treat and rehabilitate malnourished subjects.
· To improve the general health and well-being of children.
· To increase the resistance of infectious diseases.
· To accelerate the physical growth and mental development of children.
· To improve the academic performance of children.
Objectives of nutrition
supplementation of pregnant and lactating women:
·
Supplementation
of calcium to prevent osteoporosis
·
Preventing
anemia and improving pregnancy outcomes.
Conclusion:
The prevalence of malnutrition under five year old children is high and varied depending on the assessment, and methodology. The distribution of risk factors and their influence on malnutrition among children should be analyzed in planning diverse control measures.
1. World Bank. India, Undernourished children: A call for reform and
action. [Last accessed on 2014 Apr 05]. Available from:
2. Schroeder DG, Brown KH. Nutritional status as a predictor of child
survival: Summarizing the association and quantifying its global impact. Bull World Health Organ. 1994;72:569–79.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2486600/
3.
Rao S, Joshi SB,
Kelkar RS. Changes in nutritional status and morbidity over time among
preschool children from slums in Pune, India. Indian
Pediatr. 2000;37:1060–71.
Comments
Post a Comment