CPH Lesson 6 Part 2

• Ecological Factors Affecting Nutrition

  
  

  6. Cultural factors

  
  

  • For most people food is cultural, not nutritional

  
  

  • A plant or animal may be considered edible in one society and inedible in another.

  
  

  • Culture is essential in understanding the local causes of malnutrition
• Ecological Factors Affecting Nutrition

  
  

  7. Political Factors

  
  

  • Essential to nutrition programs, advocacy, resources, and operations

  
  

  • Determines policy and budget

  
  

  • Political will, commitment, and leadership

  
  

  • Lack of political will is often cited as an obstacle to progress in nutrition
• Ecological Factors Affecting Nutrition

  
  

  Strengths of Ecological Data

  
  

  • Provides information on the basic causes of malnutrition.

  
  

  • Data on some ecological factors can easily be gathered (i.e. socioeconomic data, demographics, vital statistics).

  
  

  • May be obtained from secondary data most of the time.

  
  

  • Aids in decision-making of priority health & nutrition programs.

  
  

  • Provides an opportunity to address the diverse causes of malnutrition.

  
  

  • Effective basis for planning interventions on the national level
• Limitations of Ecological Data

  
  

  • Serves only as a supplement for other methods of nutritional assessment.

  
  

  • Should always be used in conjunction with other methods of nutritional assessment.

  
  

  • Need to only select/prioritize ecological variables to be included in a study
• Malnutrition

  
  

  • Refers to deficiencies, excess, or imbalance in a person’s intake or energy and/or nutrients

  
  

  • The double burden of malnutrition consists of both undernutrition and overweight and obesity, as well as diet-related noncommunicable diseases.

  
  

  • Poverty increases the risk of and consequences of malnutrition.

  
  

  • It raises healthcare expenses, lowers productivity, and hinders economic growth.
• 2 Broads Groups of Conditions of Malnutrition (Forms of Malnutrition)

  
  

  Undernutrition – which includes stunting, wasting, underweight, and micronutrient deficiencies.

  
  

  Overnutrition – which includes overweight, obesity, and diet-related noncommunicable diseases
• Forms of Malnutrition

  1. Undernutrition - Denotes insufficient intake of energy and nutrients to meet an individual needs to maintain good health
• Forms of Malnutrition

  
  

  1. Undernutrition

  
  

  A. Stunting

  
  

  • Is defined as low height for age.

  
  

  - It is the result of chronic or recurrent undernutrition, usually associated with poverty, poor maternal health and nutrition, frequent illness and inappropriate feeding and care in the early life.

  
  

  - Stunting prevents children from reaching their physical and cognitive potential
• Forms of Malnutrition

  
  

  1.Undernutrition

  
  

  B. Wasting

  
  

  • Is defined as low weight-for-height.
  • It often indicates recent and severe weight loss, though it can also persist for a long time.
  • It usually occurs when a person has not had food of adequate quality and quantity and/or they have
  • Had frequent or prolonged illnesses.
  • Wasting in children is associated with a higher risk of death if not treated properly
• Forms of Malnutrition

  
  

  1 .Undernutrition

  
  

  C. Underweight

  
  

  • Is any weight computed below the normal BMI. Common medical condition is anorexia nervosa. Anorexia is a psychological disorder whereby people become underweight due to deliberately limiting food intake
• Forms of Malnutrition

  
  

  1 .Undernutrition

  
  

  D. Micronutrient Deficiency

  o Refers to a deficiency of the essential vitamins and minerals that are needed for physiological function and development. The main micronutrient deficiencies in developing countries are iodine, vitamin A, and iron
• Severe Acute Malnutrition (SAM)

  
  

  • Severe acute malnutrition in children 6-59 months of age is defined as weight-for-height less than -3 z-scores, or the presence of edema of both feet, or a mid-upper arm

  
  

  • Children with SAM are at risk for hypoglycemia, hypothermia, serious infections, dehydration, and severe electrolyte disturbances
• Severe Acute Malnutrition (SAM)

  
  

  Marasmus

  • Characterized by severe wasting. It is a severe manifestation of protein-energy malnutrition. It occurs as a result of total calorie insufficiency. This leads to overt loss of adipose tissue and muscle. The child may have a weight-for-height value that is more than 3 standard deviations below the average for age or sex. Marasmic children are extremely thin
• Severe Acute Malnutrition (SAM)

  
  

  B. Kwashiorkor

  
  

  • Is a severe manifestation of protein-energy malnutrition. It is associated with a poor-quality diet high in carbohydrates but low in protein content such that the child may have a sufficient total energy intake. Severe protein insufficiency leads to characteristic bilateral pitting pedal edema and ascites.
• Severe Acute Malnutrition (SAM)

  
  

  C. Marasmic – Kwashiorkor

  
  

  • characterized by severe wasting with edema. Bi-lateral edema and weight-for-height of less than -2 SD
• Micronutrient Deficiencies

  
  

  Micronutrients

  
  

  • Also known as vitamins and minerals.

  
  

  • Essential components of a high-quality diet and have a profound impact on health.

  
  

  • Required only in tiny quantities, however, they are essential building blocks of healthy brains, bones, and bodies
• Micronutrient Deficiency

  
  

  • Often referred to as “hidden hunger” because they develop gradually over time, their devastating impact not seen until irreversible damages have been done
• Common Micronutrient Deficiencies

  
  

  Iodine Deficiency

  
  

  • Can lead to brain damage in children, particularly during fetal development and in the first few years of child’s life.

  
  

  • Leading causes of preventable mental retardation and brain damage.

  
  

  • Can also lead to hypothyroidism and cretinism and other Iodine deficiency disorders (IDD).

  
  

  • The normal requirements for iodine for humans averages 150ug per day
• Common Micronutrient Deficiencies

  
  

  Vitamin A Deficiency

  
  

  • Vitamin A consists of Retinol (pre-formed vitamin), Retinal, Retinoic acid, and Beta-carotene (pro-vitamin)

  
  

  • Normal function is for normal vision in dim light.

  
  

  • Maintains the integrity and normal function of glandular and epithelial tissues which lines intestinal, respiratory, and urinary tracts, as well as skin and eyes.
• Common Micronutrient Deficiencies

  
  

  Vitamin A Deficiency

  
  

  • Supports growth (skeletal growth).

  
  

  • Essential for the maintenance of proper immune system

  
  

  Ex. Follicular hyperkeratosis, Anorexia, and growth retardation, night blindness, conjunctival xerosis, bitot’sspots, corneal xerosis, keratomalacia
• Common Micronutrient Deficiencies

  
  

  Iron Deficiency

  
  

  • Iron is an essential mineral that is needed to form hemoglobin, an oxygen-carrying protein inside red blood cells.

  
  

  • A deficiency in iron can lead to several conditions such as anemia, risk of hemorrhage during childbirth that can lead to maternal deaths, vulnerability to infections, learning disabilities, and delayed development
• Common Micronutrient Deficiencies

  
  

  Overnutrition

  
  

  • Occurs when an individual has an excessive consumption of food, far more than their dietary needs

  
  

  • It can lead to heart disease, obesity, and other dietary disorders

  
  

  Ex. Bulimia,

  - obesity which is a risk factor for diabetes, hypertension, polycystic ovary syndrome (PCOS), coronary heart disease, obesity