Effects of Chronic undernutrition (MT2)

subclinical deficiency and child mortality

1. 1/3 of deaths due to chronic malnutrition a. diarrhea b. pneumonia c. measles d. malaria

indicators of childhood malnutrition

1. IMR: infant mortality rate a. rate of death < 12 months per 1000 live births b. high LBW prevalence, high IMR c. associated with conflict zones: health care not in place 2. < 5 mortality rate

malnutrition infection cycle

1. Poverty (top) 2a. inadequate diet 3a. malnutrition 4a. immunosuppression 2b. poor environment 3b. infection - infection and malnutrition connected

Reproductive health (Menarche) in NA affected by what factors?

1. anorexia 2. athletics 3. low bone density

undernutrition productivity cycle

1. decreased food productivity 2. decreased food availability less at house hold level 3. decreased food intake/individual 4. decreased nutrient utilization 5. decreased nutritional status 6. decreased physiological function 7. decreased work capacity 8. decreased food producitivity

Vietnam (economics+stunting)

1. economically developing world 2. survey every 5 years shows that people are getting taller

undernutrition, intellect and learning

1. if a mother suffers from malnutrition during pregnancy her baby cam suffer from reduced intellectual capacity and cognitive functioning: don't do as well in schools 2. chronic malnutrition during the first 2-3 years of life can also permanently impair mental development 3. deficiencies in several micronutrients are associated with impaired intellectual abilities 4. Cognitive impairment a. Iodine deficiency = reduced IQ or cretinism b. iron deficiency

delayed menarche indicates

1. linked to nutritional status and stress a. US 13 vs rwanda 17 2. physiological and psychological health: can affect women's reproductive status (menarch)

undernutrition and menopause

1. menopause earlier 2. shorter reproductive life (starts later, ends earlier) e.g. India a. menopause at 30 to 40

undernutrition and reproductive health

1. puberty is dependant on sex hormones 2. undernourished girls produce less estrogen, essential for reproduction 3. delayed menarche 4. male puberty: sexual maturation delayed by 3 yrs (Female 2 years) 5. undernutrition and menopause . undernourished women (or girls ) are at greater risk of death or complications during birth: iron deficiency, infections, impacts child 6. fetal growth depends on 1) nutritional status prior to pregnancy and 2) wt gain during pregnancy (~10 kg): Who recommendations; need to take in more calories, more nutrient density foods 7. expectant mothers need a nutritious diet, a reduced workload care and rest (but, in Africa, preg. women carry firewood) 8. women undernourished during pregnancy are more likely to give birth to low birth weight babies (LBW) 9 indicators of childhood malnutrition: IMR, <5 mortality rate 10. organs, tissues, blood, brain, and bones are formed, and physical potential shaped from conception to about age 2 (the first '1000 days'): intervention is crucial)

Physical growth and size

1. stunting: low height for age (children) a. consequence of undernutrition during growth years b. critical period from conception to 2 years: the '1000' days c. 40% of children in developing world are stunted d. irreversible e. proportioned normally, but are shorter

undernutrition and productivity

1. time lost due to illness; inability to work hard (or long) 2. impacts individuals and economies of communities a. earn less money and produce less food 3. country level: a. productivity of country is reduced: reason why iron and salt fortification are supported by gov't

LBW

a. < 2500 g b. risk factor for babies c. increased morbidity, impaired cognitive development, higher risk of malnutrition, increase sickness d. LBW prevalence: indicates maternal nutritional status (high LBW, high undernourished women)

effects of chronic undernutrition (general)

a. malnutrition is implicated in more than 50% of all child deaths b. Millions of its survivors are left crippled, vulnerable to illness and intellectually disabled. A child who eats enough to satisfy immediate hunger can still be malnourished c. Three quarters of the children who die worldwide of malnutrition-related causes are mildly to moderately malnourished and betray no outward symptoms 1. Physical growth and size 2. Infection 3. Reproductive health 4. intellect and learning 5. productivity

undernutrition and infection

a. relationship are cyclic and closely linked b. infection exacerbates malnutrition i. Don't absorb nutrients they need (diahrrea or parasites) 1. malnutrition increases infection: increases severity, probability, and duration of infection a. lowered immunity: protein for antibodies+ Vit. A (synth of mucous secreting cells) b. lowered resistance to colonization and invasion by pathogens 2. infection increases the potential and severity of malnutrition a. loss of appetite or food intolerances i. when sick loss of apetite = anorexia b. altered metabolism 3. malabsorption

underlying causes of female malnutrition

social factors