Malnutrition
Information on symptoms, treatments, and prognosis of nutrient deficiency in the body.
Symptoms and Causes
Malnutrition is a disorder that occurs when the body does not receive, absorb, or utilize the adequate amount of calories or essential nutrients required for proper functioning. As a result, it manifests as growth retardation, underweight, loss of muscle mass, alterations in the immune system and vital organ function, or psychomotor disorders.
Depending on the type of deficiency present, malnutrition is classified into three different types:
- Kwashiorkor: an acute condition caused by protein deficiency, often accompanied by insufficient energy intake. This is a form of severe malnutrition.
- Marasmus: a chronic condition resulting from a deficiency of both calories and proteins. It is a severe form of malnutrition.
- Mixed malnutrition: a combination of the two above, and therefore the most dangerous type.
The prognosis of malnutrition depends on its causes, severity, and the damage it has caused prior to diagnosis. Although it is reversible in some cases, it can also lead to irreversible disorders, including death.
Symptoms
The most characteristic symptoms of malnutrition include:
- Involuntary weight loss
- Extreme fatigue
- Muscle weakness
- Dizziness
- Fainting
- Weakened immune system
- Impaired wound healing
- Decreased body temperature
In patients with kwashiorkor, common manifestations include:
- Rounded, moon-shaped face
- Extreme thinness
- Loss of muscle mass with presence of fat
- Protuberant abdomen
- Moist skin lesions
- Thin, weak, pale hair
- Flag sign: alternating patches of discolored and normal hair
- Hepatomegaly: enlargement of the liver
- Apathy
- Lethargy
- Anemia: insufficient red blood cells
- Edema (fluid accumulation) generalized or in specific areas such as the face, hands, legs, or feet
In patients with marasmus:
- Sunken face with loss of fat and aged appearance
- Pants sign: flaccid, wrinkled skin forming folds
- Loss of subcutaneous fat and muscle mass
- Dry skin
- Fine hair that is easily pulled out
- Alert mental state
Causes
Malnutrition can have diverse causes, including:
- Poor diet
- Eating disorders
- Chronic diarrhea
- Difficulties digesting food, which may be caused by:
- Stress
- Gastroparesis: impaired stomach muscle function
- Gastritis: inflammation of the stomach lining
- Gastroesophageal reflux: stomach acids rising into the esophagus
- Peptic ulcer: sores in the stomach or intestines
- Liver disease
- Gallbladder dysfunction
- Nutrient malabsorption due to conditions such as:
- Celiac disease: chronic digestive disorder in which the immune system reacts to gluten and damages the small intestine
- Lactose intolerance: deficiency of enzymes required to break down lactose, leading to improper digestion
- Crohn's disease: intermittent inflammation of the digestive tract
- Short bowel syndrome: part of the intestine loses functionality or has been surgically removed
- Whipple disease: digestive organs are damaged due to infection by Tropheryma whipplei
- Excessive consumption of low-quality calorie-rich foods, leading to overnutrition characterized by high energy intake but insufficient nutrient intake
Risk Factors
The risk of malnutrition is higher in cases of:
- Poverty
- Lack of access to food
- Living in unsanitary conditions
- Presence of any of the diseases described above
- Mental health disorders
- Age: more frequent in children under 5 years and adults over 60 years
Complications
Malnutrition can lead to serious complications, including:
- Delayed physical and intellectual development
- Immune system weakness
- Metabolic alterations that may result in hypercholesterolemia, obesity, or hypertension
- Inadequate development of the central nervous system, affecting motor skills
- Impaired function of vital organs
- In extreme cases, death
Prevention
The best ways to prevent malnutrition include:
- Following a balanced diet rich in fruits, vegetables, cereals, and proteins from meat, fish, and eggs. Processed foods, saturated fats, artificial colorings, and added sugars should be avoided.
- Prioritizing nutrient-dense foods
- Maintaining adequate hydration
- Breastfeeding
- Administering vitamin supplements when necessary and recommended by a specialist
Which Specialist Treats Malnutrition?
Malnutrition is usually diagnosed within family and community medicine, although treatment may involve specialists in gastroenterology and endocrinology and nutrition.
Diagnosis
The diagnosis of malnutrition is clinical and based on the following procedures:
- Patient history: evaluating dietary habits and access to healthy food and potable water
- Clinical examination: including:
- Measurement of weight and height
- Determination of body mass index (BMI)
- Estimation of muscle and fat mass: arm circumference and triceps skinfold thickness are measured
- Examination of skin and hair changes
- Observation and palpation of the abdomen and extremities to confirm or rule out edema
- Blood tests: help detect deficiencies in vitamins, albumin (protein deficiency), minerals, and white blood cells
Treatment
Nutrition therapy involves gradually increasing caloric intake to avoid adverse health effects. Typically, a five-meal-per-day plan is created, consisting of small amounts of nutrient-rich foods.
When the patient has swallowing difficulties or a pathology affecting gastrointestinal function, enteral nutrition is administered. This involves placing a tube through the nose or mouth directly into the stomach, through which essential nutrients are delivered. In cases of severe gastrointestinal damage, parenteral nutrition is administered intravenously.
To prevent prolonged malnutrition, it is essential to treat the underlying cause.
