level Inadequate or faulty dietary intake Disease or infections Immediate causes at individual level Outcomes Malnutrition, disability and death Fig. . : Factors Related to Undernutrition A person is said to be underweight when his/her body weight is less than adequate for his/her age. Stunting (short stature) is said to be present when the height is less than adequate for age.
When weight is not adequate relative to height, it is termed ‘wasting’. Severe undernutrition due to deficiency of food and energy is termed as ‘marasmus’ and that caused by protein deficiency is termed ‘kwashiorkor’. b) Micronutrient deficiencies : If the diet is deficient in energy and protein content it is also likely to contain inadequate amounts of other nutrients especially micronutrients viz. minerals and vitamins.
The term “hidden hunger” is used to refer to micronutrient deficiency. The deficiencies of iron, vitamin A, iodine, zinc are of major public health concern. In addition, there is growing concern about deficiency of vitamin B12, folic acid, calcium, vitamin D and riboflavin. Some micronutrient deficiencies of public health concern are described below: Victims of (a) Protein Energy Malnutrition and (b) Micronutrient Deficiency Source: SIGHT and LIFE, Basel, Switzerland (a) (b) (i) Iron-deficiency anemia (IDA) : It is the most common nutritional disorder in the world and is prevalent in both developed and developing countries.
The vulnerable groups are women in child–bearing age, adolescent girls, pregnant women and school age children. IDA occurs when hemoglobin production is considerably reduced and it results in low levels of hemoglobin in blood. Symptoms depend on the rate of fall in hemoglobin. Since hemoglobin is required for carrying oxygen in the body, any physical exertion leads to shortness of breath (breathlessness on slight exertion) and the person complains of fatigue and may feel lethargic.
Manifestations of IDA include general pallor, paleness of conjunctiva of eyes, tongue and nail beds and soft palate. In children, cognitive functions (attention span, memory, concentration) are adversely affected. (ii) Vitamin A deficiency (VAD): Vitamin A is necessary for mainten- ance of healthy epithelium, normal vision, growth and immunity. Deficiency of vitamin A results in night blindness which progresses to complete blindness if corrective measures are not taken.
Also, there is less resistance to infection and growth may be adversely affected. There is a vicious cycle between vitamin A deficiency and infection. Vitamin A deficiency is the most common cause of childhood blindness.