Marasmus is often the result of early weaning to a diet low in both protein and energy. Sufferers are extremely underweight, experience muscle wastage and their skin is wrinkled and they appear old in the face.
Kwashiorkhor is linked to a more severe protein shortage, and often appears in slightly older children. This is a difficult condition from which to recover because, not only is there liver damage, but the children become apathetic and lose their appetite. Sufferers are under-weight, have dry, brittle hair, a swollen abdomen due to an enlarged liver and oedema, which is swelling caused by the accumulation of fluid in tissues.
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Over-consumption – This is caused by taking in more calories than the body requires, it is often accompanied by a deficiency in vitamins and minerals. Many food companies exploit the human inclination towards fatty and sugary foods by offering consumers cheap and often nutritionally empty products. Compounded with their reduced physical activity and greater meat consumption, these people, the overweight and obese, are a fast -growing segment in the world’s population. Ironically they often live, as the middle and upper class, in those countries where hunger is prevalent.
Dietary survey data for poor communities in developing nations has shown energy intake to be much lower than the DRV (the nutrient and energy requirements for a particular group with reference to age, gender, fitness etc.). The significance of this is that protein that should be used for growth and repair of cells has to be used as a source of energy.
Most aid programmes that supply food to famine stricken areas aim to increase the energy intake of the population. Staple foods such as wheat and rice will satisfy energy intake and also provide energy protein.
The body adapts to progressive starvation by:
- Quickly using up glycogen stored in the liver
- Drawing upon the body’s fat stores
- Using protein as an energy source, which results in the wasting of the muscles and other tissues
It is estimated that 174 million children under the age of 5 in the developing world are malnourished. A child who is undernourished grows less and may end up being short and thin and has less energy to learn and do normal things, they also have a weak immunity system and therefore are less resistant to infections and diseases. Anthropometrics from the World health organization (WHO) show that over 30% of the world’s children under the age of five are malnourished in terms of being underweight. Of these around 79% live in developing countries.
Anorexia nervosa is a wasting disease and its symptoms are very similar to that of marasmus. In contrast though, it is usually found in developed countries and can be brought on from psychological distress. Anorexia is most common in teenage girls from middle to high-income families.
Sufferers of anorexia nervosa lose their appetite, eat little food and become dangerously thin. The symptoms include:
- Wasting, as muscle tissue is used as a source of energy once the body’s fat reserves have been used up
- A decrease in body temperature, metabolism and heart rate, slowing of growth and sexual development (the normal menstrual cycle stops)
- A greater susceptibility to infections
- Depression, so that the affected person’s thoughts are dominated by food and eating less and less
The causes of anorexia nervosa are complex, but tend to involve low self-esteem and anxiety about growing up and sexuality. If often develops from a desire to diet, but anorexics who have lost a great deal of weight still see themselves as being too fat.
People with anorexia often fail to see that they are starving themselves. Treatment focuses on building up self-esteem and if this is achieved, then normal eating patterns and weight gain usually follow.
In Britain and other wealthy countries, more people suffer from over nutrition than from under nutrition. If a person takes in more energy in food than required, then the surplus respiratory substances are converted to storage fat. This particular form of malnutrition is caused by a combination of factors:
- High intake of fatty foods and refined foods containing a lot of added sugar
- Too little exercise
- Social and emotional stress, leading to ‘comfort eating’
- Physiological problems such as an under active thyroid gland although these tend to be rare
Worldwide malnutrition continues to be a significant problem, especially among children who cannot fend adequately for themselves. Poverty, natural disaster, political problems and war in developing countries have demonstrated that hunger and malnutrition are not strangers to this world.
Malnutrition continues to exist in virtually all countries of the world whether due to over-consumption, hunger or protein-energy malnutrition in spite of a general improvement in food supplies and health conditions. The world’s population is at present more successful as a whole than it has ever been. People all over the world have greater resources than ever before, although this has come with an inevitable environmental cost. As a result of a substantial increase in agricultural input, humanity has never had as many choices or access to such a wide variety of foods. The world’s food production can easily meet the required nutritional needs of the planets growing population. However, ignorance, inadequate government programs and mismanagement, as well as other man-made disruptions such as war have produced huge imbalances of how food is distributed and made available to people.
