Wednesday, November 29, 2023

Malnutrition: definition, causes, prevention, treatment.

Published on 09/16/2023 at 16:38, updated on 09/16/2023 at 16:38

In collaboration with

Florence Foucaut (dietician-nutritionist)

Eating too fatty or too sweet, having vitamin or mineral deficiencies… Malnutrition, the result of a dietary imbalance, is a condition that can have serious consequences for health. What is malnutrition? Who are the people at risk? What are the symptoms? And the consequences on the body? Explanations.

The state of malnutrition is defined by inadequate and unbalanced food intake, which has consequences on health and the proper functioning of the body. But contrary to popular belief, malnutrition does not just refer to malnutrition and should not be confused with famine. The World Health Organization (WHO) defines malnutrition as “Deficiencies, excesses or imbalances in a person’s energy and/or nutrient intake.1. That is, we speak of malnutrition when the intake of calories, macronutrients (proteins, lipids and carbohydrates) and nutrients (vitamins and minerals) is excessive or deficient.

What are the disorders related to malnutrition?

This state encompasses different issues:

Malnutrition

We speak of malnutrition when caloric intake does not cover the needs of the individual: they do not eat until they are satisfied and do not cover their needs for essential nutrients. According to the WHO, this can lead to stunted growth (low height for age) in children, wasting, i.e. low weight for height, low weight, low weight for age.

Dietary deficiencies.

We speak of deficiencies in proteins, lipids, carbohydrates, vitamins and minerals when food intake does not cover essential needs, causing serious deficits of these essential elements. This hinders the proper functioning of the body, alters the functioning of organs and creates the basis for various diseases., explains Florence Foucaut, dietitian-nutritionist. These deficiency states can be caused by an insufficient or poorly diversified diet.

Eat excessively

It occurs when the person consumes more calories than necessary for their age, size and physical activity. This leads to weight gain. “Ultimately, overeating can lead to overweight, obesity, and the development of diet-related non-communicable diseases such as heart disease, diabetes, and even cancer.says Florence Foucaut.

Who are the people affected by malnutrition?

Malnutrition can affect everyone, both adults and children, adolescents and the elderly, as well as residents of favored or developing countries.

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According to the WHO, 1.9 billion adults worldwide are overweight, while 462 million are underweight, 41 million children under 5 years of age are overweight or obese, while 159 million are stunted and 50 million have no enough to eat.1.

In France, according to Inserm figures, 47.3% of French adults are obese or overweight.2 while malnutrition would affect 2 million people, of which 400,000 are elderly in their homes and 270,000 in nursing homes. Malnutrition can also affect people with chronic diseases. Thus, 30% of hospitalized people and 40% of cancer patients3 They are victims of malnutrition.

What are the symptoms of malnutrition?

It is important to quickly identify symptoms to remedy them before malnutrition causes health problems. These may affect you directly or affect someone close to you.

Food intake

The affected person eats less than usual, excludes foods from their diet or even skips meals/eats much more than usual during and outside of meals.

Weight

The affected person has involuntarily lost weight during the last three months. This weight loss is accompanied by muscle atrophy. / The affected person has gained a lot of weight unintentionally in the last three months.

Overall status

The interested party claims to be very tired, both physically and intellectually. He has trouble sleeping. “He tolerates periods of stress less, gets easily irritated and has problems concentrating and memorizing. explains Florencia Foucaut. Their vigilance is also reduced. In addition, you may feel pain (muscle and/or joint).”. Finally, malnutrition is characterized by a drop in immune defenses: the weakened body is less resistant to external attacks. It can also slow recovery and healing of wounds. “All of these symptoms are due to the body not receiving enough calories and/or nutrients to function properly. It may be a deficiency of iron, in particular because its deficiency causes anemia, as well as vitamin C, the deficiency of which can lead to the development of scurvy.explains Raphaël Gruman, dietitian-nutritionist.

What are the causes of malnutrition?

The factors of malnutrition are multiple. In the world, the main causes of malnutrition are found in “conflicts, climate change, lack of access to drinking water, poverty linked to economic crises and inequalities” lists the association Action Against Hunger. While overeating, mainly in developed countries, is due to overexposure to fatty, sugary and processed foods.

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But certain situations can promote malnutrition. “In the case of malnutrition, there may be digestive disorders and a history of digestive surgery, diseases such as cancer, depressive syndrome, cognitive disorders and/or dementia, as well as dental disorders, in particular, especially among older people, difficulty moving. , whether for shopping or preparing meals., specifies Raphaël Gruman. “In the case of overeating, eating compulsions, taking medications such as cortisone that increases appetite, a depressive syndrome, etc. may be involved. Finally, in both cases there may be an economic factor: financial difficulties, people may be induced to buy. less food, which translates into a diet that is inferior to their needs, or resorting to cheap products with low nutritional value (chips, cookies, etc.)”.completes Florence Foucaut.

What are the consequences of malnutrition?

Malnutrition is a condition that can have serious repercussions on health and fitness.

In children, malnutrition can be responsible for growth delays (a vitamin D deficiency, for example, can cause rickets), bone deficiencies with risk of fractures, cognitive disorders such as difficulty concentrating, “learning and memorizing”, fatigue extreme related to anemia, drop in immune defenses”Raphaël Gruman’s list.

Le surpoids et l’obésité provoqués par une malnutrition liée à une surconsommation Alimentaire peut favoriser le développement de maladies comme un diabète de type 2, des troubles cardiovasculaires (hypertension arterielle, infarctus, AVC, maladies coronariennes…), voire des cancers, de l ‘Sleep apnea…

Malnutrition can cause loss of muscle mass, which can lead to frailty and increase the risk of falls and fractures. Malnutrition in general can be responsible for complicating already existing diseases. It also causes intense and widespread fatigue and can lead to depression.

When should you consult?

It may be useful to consult your GP for an assessment in the following cases:

  • You have symptoms of intense fatigue, you get sick frequently, you are very irritable, your sleep quality is poor;
  • Are overweight/underweight;
  • Their diet is not very diversified.

NO to diets, YES to WW!

What are the treatments for malnutrition?

Malnutrition is a condition that can be controlled. Make an appointment with your treating doctor. The first step will be to treat the underlying cause, if there is one. “A food search is then carried out to assess dietary difficulties. specifies Florence Foucaut. This can be done by your doctor or a dietitian.“. The following medical examination allows diagnosing malnutrition: measurement of weight and height in children, analysis of height and weight curves in the medical history, examination of muscles and muscle strength and then prescription of tests biological:

  • Albumin dose that allows assessing the severity of malnutrition: it is a protein produced by the liver, but also provided by certain foods, in particular milk and eggs. It is the most used marker for the diagnosis or monitoring of malnutrition. A serum albumin level less than 35 g/L is a criterion for malnutrition in adults, according to the High Health Authority (HAS). Malnutrition is considered serious when this level falls below 30 g/l.4 ;
  • Analysis of the proper functioning of the liver and kidneys;
  • Check for vitamin and mineral deficiencies;
  • Investigation of inflammatory biomarkers that could explain malnutrition.
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Treatment then consists of rebalancing the diet both in quantity to more closely match the person’s physiological needs and in quality to ensure macronutrient and nutrient coverage. To do this, it is recommended to consume fresh and varied products and limit the use of processed products. “It is often necessary to be supervised by a nutritional professional to learn how to balance meals.advises Florencia Foucaut.

If the blood test reveals deficiencies, a supplement may be prescribed for a renewable period of 3 months. It comes in the form of capsules or foods enriched with proteins and lipids, such as oral nutritional supplements rich in protein and energy (Fortimel®, Renutryl Boost ®, etc.).

If food intake remains insufficient, doctors may decide to implement artificial nutrition: it can be “enteral” or “parenteral”. “In the first case, the digestive system works correctly, essential nutrients, such as proteins, lipids and carbohydrates, contained in a bag, in liquid form, are administered directly into the stomach or intestine with the help of a tube; In the second case, the digestive tract is no longer able to absorb nutrients, so food is administered intravenously, through a catheter placed in a vein until the biological markers improve, re-evaluated every week.”explains Florencia Foucaut.

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