Epidemiology of malnutrition

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Nutritional deficiencies world map - DALY - WHO2002.svg
Percentage population undernourished world map.PNG
U.S. Census Bureau, 2012 American Community Survey
Bill Mead, a volunteer with Feeding America, paints food pallets at the new Feeding America warehouse in San Diego 25 March. The new facility can support 16 million pounds of food, including a new cold storage unit for dairy, eggs and meat.

Epidemiology of Malnutrition

The epidemiology of malnutrition involves the study of the distribution and determinants of nutritional disorders in populations and the application of this study to control health problems. Malnutrition encompasses both undernutrition, including wasting, stunting, and underweight, and overnutrition, which includes obesity and overweight. The global burden of malnutrition is vast, affecting millions of people across all age groups and geographies, with significant impacts on health, economic development, and social well-being.

Definition and Types

Malnutrition refers to deficiencies, excesses, or imbalances in a person's intake of energy and/or nutrients. The term includes two broad groups of conditions:

  • Undernutrition: This includes wasting (low weight-for-height), stunting (low height-for-age), underweight (low weight-for-age), and micronutrient deficiencies (lack of important vitamins and minerals).
  • Overnutrition: This involves overweight, obesity, and diet-related noncommunicable diseases (such as heart disease, stroke, diabetes, and cancer).

Causes

The causes of malnutrition are complex and multifactorial, involving an interplay of socio-economic, political, environmental, and individual factors. Key determinants include:

  • Food insecurity: Lack of access to sufficient, safe, and nutritious food.
  • Poor dietary choices: Consumption of nutrient-poor foods.
  • Infectious diseases: Illnesses that exacerbate nutritional deficiencies by reducing nutrient intake, absorption, and increasing nutrient loss.
  • Socio-economic factors: Poverty, lack of education, and inadequate healthcare access.
  • Environmental factors: Including contamination of water and food supplies.

Global Impact

Malnutrition is a global issue that affects both developed and developing countries. According to the World Health Organization (WHO), undernutrition is more prevalent in low-income countries, particularly in sub-Saharan Africa and South Asia, while overnutrition is rising globally, especially in urban settings and developed countries.

Undernutrition

Undernutrition contributes to about 45% of deaths among children under five, primarily in low- and middle-income countries. Stunting and wasting remain critical public health issues, impairing cognitive development and increasing mortality risk.

Overnutrition

Overnutrition, particularly obesity, has seen a dramatic increase worldwide. It is a major risk factor for noncommunicable diseases, which are leading causes of death globally. The economic impact of obesity is significant, affecting healthcare systems and national productivity.

Prevention and Control

Efforts to combat malnutrition require a multi-sectoral approach, addressing its underlying causes:

  • Improving food security: Through sustainable agricultural practices, improved food distribution systems, and social protection schemes.
  • Promoting healthy diets: Education campaigns and policies to encourage the consumption of nutritious foods and discourage unhealthy foods.
  • Strengthening healthcare systems: To provide comprehensive care, including nutrition interventions and treatment of infectious diseases.
  • Addressing socio-economic determinants: Through poverty reduction, education, and gender equality initiatives.

Conclusion

The epidemiology of malnutrition highlights the critical need for global and local actions to address this pervasive issue. Through coordinated efforts involving governments, international organizations, civil society, and communities, it is possible to reduce the burden of malnutrition and improve health outcomes for populations worldwide.


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Contributors: Prab R. Tumpati, MD