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Nutritional Status Assessment and Analysis
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Learning objectives
At the end of this lesson you will be able to:
define the concept of malnutrition;
identify the factors influencing nutritional status; and
be aware of the relationships between nutrition, food security,
health and mortality.
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Introduction
Understanding these factors is essential in order to:
assess malnutrition,
design programmes which tackle nutrition
problems, and
correctly inform programme management
and evaluation.
What are the factors affecting an individual’s nutritional status?
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What is malnutrition?
The term malnutrition indicates a bad nutritional status.
Nutritional status is the physiological state of an individual, which results from:
the relationship between nutrient intake and requirements, and
the body’s ability to digest, absorb and use these nutrients.
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What is malnutrition?
A distinction must be made between Malnutrition and Undernutrition:
It arises either:
from deficiencies or excesses of specific nutrients, or
from undiversified diets (wrong kinds or proportions of foods).
It is the outcome of insufficient food.
It is caused primarily by an inadequate intake of dietary or food
energy.
Malnutrition
Undernutrition
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In many developing countries, under and overnutrition are
occurring simultaneously among different population groups.
What is malnutrition?
This phenomenon is referred to as the “double burden” of malnutrition.
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Causes of malnutrition
However, overnutrition and dietary imbalances cut across many socio-economic boundaries.
Poverty is the root cause of malnutrition.
(The underlying causes are food security, health and care).
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The most important factors can be grouped under these broad categories:
Causes of malnutrition
FOOD HEALTH CARE
Nutritional status is influenced by multiple and interrelated factors.
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Food, health and care are interrelated:
actions affecting one area may have significant consequences on another.
Development policies usually are not included in the domain of nutrition as such.
However, they impact considerably on the nutritional well-being of the population.
Causes of malnutrition
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Conceptual frameworks
This is the most commonly used framework for understanding the causes of malnutrition.
(adapted from the UNICEF conceptual framework).
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Another conceptual framework for malnutrition:
the Food Insecurity and Vulnerability Mapping System (FIVIMS) framework for food security, livelihoods and nutrition.
Socio-economic and political environment
Performance of the food economy:
• availability
• access
• stability
Care practices
Health and sanitation
Nutritional status
Food consumption
Food utilization
Conceptual frameworks
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Nutritional status, health, mortality and low birth weight
It is important to consider the relationships between nutritional status and health status, mortality and low birth weight.
NUTRITIONAL STATUS
HEALTH STATUS
NUTRITIONAL STATUS
MORTALITY
NUTRITIONAL STATUS
LOW BIRTH WEIGHT
Let’s see these relationships more in detail...
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Nutritional and health status
NUTRITIONAL STATUS
HEALTH STATUS
This can eventually lead to severe malnutrition and death.
Nutrition and health are closely linked:
disease contributes to malnutrition
while malnutrition makes an individual more susceptible to disease.
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Nutritional and health status
INADEQUATE DIETARY INTAKE
Weight loss, growth faltering and reduced immunity, which lower the
body’s ability to resist infection.leads to
this causes
Longer, more severe and more frequent disease episodes.
Loss of appetite, malabsorption of nutrients,
altered metabolism and increased nutrient needs.
leads to
this results in
This ‘vicious cycle’ is known as the “malnutrition-infection cycle”:
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Certain diseases are particularly frequent causes of poor growth, for example:
diarrhoea,
respiratory infections,
HIV/AIDS and
malaria.
Nutritional and health status
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Nutritional and health status
The relationship between nutrition and disease can be observed in the seasonal changes in nutritional status.
Many communities experience periods in the year when malnutrition levels are higher. These are influenced by seasonal patterns such as:
cropping patterns,
food availability,
disease,
child care,
income sources,
price of foods,
labour demand.
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Many factors that impact mortality are often compromised in situations of conflict and displacement.
In emergencies there may be varying levels of mortality associated with the same level of malnutrition.
Nutritional status and mortality
NUTRITIONAL STATUS
MORTALITY
Mortality increases exponentially with declining nutritional status.
Consequently, mortality rates cannot be predicted from prevailing rates of malnutrition.
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It is estimated that each year 24 million babies are born with low birth weight (LBW)-less than 2.5 kg.Ninety five percent of these events occur in developing countries.
NUTRITIONAL STATUS
LOW BIRTH WEIGHT
Nutritional status and low birth weight
The most significant cause is poor maternal nutrition.
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The cycle of poor nutrition perpetuates itself across generations.
This diagram by the Standing Committee on Nutrition shows the intergenerational cycle of growth failure:
Child growth failure Low
weight and
height in teenagersSmall adult
woman
Early pregnancy
Low birth
weight baby
Nutritional status and low birth weight
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Summary
Malnutrition refers to all deviations from adequate nutrition, including undernutrition (and overnutrition) resulting from inadequacy (or excess) of food.
Malnutrition carries heavy human and economic costs on individuals and households, communities and nations. Malnutrition and undernutrition are often used as synonyms. However, a clear distinction needs to be made at all times.
The co-existence of undernutrition, micronutrient deficiencies, overweight/obesity and other nutrition-related chronic diseases occurs in the same countries, in the same communities and even in the same households throughout the world today, posing one of the greatest challenges to national policy makers. This phenomenon is referred to as the “double burden” of malnutrition.
Even if poverty is the root cause of undernutrition, malnutrition has multiple and interrelated causes. The direct causes of malnutrition can be grouped under the broad categories of: food, health and care.
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If you want to know more...
Nutrition and development: a global challenge - adapted from Nutrition and development - a global assessment, written by FAO and WHO for the International Conference on Nutrition, 1992.
United Nations Standing Committee on Nutrition/Administrative Committee on Coordination (ACC/SCN) Second report on the World Nutrition Situation: Vol.1: Global and Regional Results, ACC/SCN Geneva, 1992.
The double burden of malnutrition – Case studies from six developing countries. FAO Food and Nutrition Paper 84, Rome 2006. http://www.fao.org/docrep/009/a0442e/a0442e00.htm
Measurement and Assessment of Food Deprivation and Undernutrition - FIVIMS Proceedings, International Scientific Symposium held in FAO, Rome 26-28 June 2002. FAO 2003. http://www.fao.org/DOCREP/005/Y4249E/Y4249E00.HTM
Conducting small-scale nutrition surveys: A field manual. FAO, 1990, 186p, English, Spanish, French ISBN 202851. http://www.fao.org/docrep/009/a0442e/a0442e00.htm#Contents
Body mass index - A measure of chronic energy deficiency in adults. FAO Food and Nutrition Paper 56, 1994. http://www.fao.org/docrep/T1970E/T1970E00.htm
Nutritional Status Assessment and Analysis
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United Nations Standing Committee on Nutrition Issue No. 33 Diet-related Chronic Diseases and the Double Burden of Malnutrition in West Africa, 2006, pages 18-20.http://www.unsystem.org/scn/Publications/SCNNews/scnnews33.pdf.
Incorporating Nutrition Considerations into Development Policies and Programmes: Brief for Policy-Makers and Programme Planners in Developing Countries, FAO 2004. http://www.fao.org/docrep/007/y5343e/y5343e00.htm
The State of Food Insecurity in the World (SOFI): monitoring progress towards the World Food Summit and Millennium Development Goals (FAO-SOFI, 2004)http://www.fao.org/docrep/007/y5650e/y5650e00.htm
If you want to know more...