Malnutrition

Synonyms

Malnutrition, quantitative malnutrition

General

The human body needs daily large amounts of energythat he uses different Metabolic processes in motion to put. Also the supply of the organs and the Brain can only be guaranteed under energy consumption. In the course of this, the organism is on a regular intake of nutritional components, such as carbohydrates, Fats, Proteins, Fiber, Vitamins and Trace elements, reliant.

Malnutrition is a special form of malnutrition. If the intake of food components is too low, the daily metabolic rate (i.e. the energy that various metabolic processes consume during the day) exceeds the energy suppliers consumed.
There is a negative energy balance, which ultimately leads to a reduction in body weight.

From general malnutrition (here there is a lack of almost all nutritional components), partial malnutrition can be distinguished, for example in which not enough protein or carbohydrates are consumed.
Malnutrition can have devastating effects on the mental and physical development of adults, but especially adolescents. In addition to the occurrence of acute underweight, short stature or mental retardation, prolonged undernourishment can lead to organ failure and even death.

causes

Malnutrition does not usually arise if too little food is consumed over a short period of time. The human body has so-called energy reserves (for example fat tissue) from which it can mobilize energy. Only when too little food is distorted over several weeks or months do the first signs of malnutrition become noticeable.

• Lack of food:
  Probably the most obvious cause of malnutrition is a lack of food supply (financial aspect). Basic poverty or disproportionately high food prices can be a reason why not enough food can be bought and consumed. In the third world in particular, malnutrition plays a central role. In these areas, many people cannot be adequately supplied with food and drinking water. The exact reasons for this are complex.
• Malnutrition:
  In addition to this financial aspect, incorrect eating habits are the cause of malnutrition among many affected people. The term incorrect eating habits is understood to mean a condition in which a person eats insufficiently or unbalanced food despite sufficient food. In most cases, this wrong / unhealthy diet results in so-called malnutrition, in which the organism only lacks one or more nutritional components. In contrast to normal malnutrition, however, there are other energy suppliers in sufficient quantities. In most cases, malnutrition is inherited and is based on a lack of knowledge about healthy and balanced nutrition. Furthermore, malnutrition can also be chosen deliberately. Inadequate knowledge of vegan nutrition can also lead to malnutrition, this danger is particularly common in children (see also: Vegan Diet in Children). Unrealistic ideal dimensions arouse the desire to lose weight, especially in young people. For this reason, many people deliberately refrain from eating a regular and balanced diet and thereby steer themselves into malnutrition.
• Aging process:
  Another cause of malnutrition that should not be underestimated is the aging process. In the course of aging, the human body and the metabolic processes that take place in it change. For many people, appetite steadily decreases over the course of the second half of life. Chewing and swallowing are also becoming increasingly difficult, for example due to the lack of teeth. In addition, the organism needs a different diet in old age. The decline in physical and / or mental performance also plays a decisive role in the occurrence of malnutrition in old age.
• Diseases:
  Illnesses and a variety of drugs can also provoke malnutrition. This fact can be justified, for example, in the fact that many diseases curb the appetite, make the absorption of individual food components more difficult or curb their metabolism. In addition, the chewing and swallowing of food can be hindered in the course of an illness and food intake can be restricted as a result.Especially chronic diseases of the gastrointestinal tract can lead to malnutrition due to the occurrence of nausea and vomiting. In the case of disease-induced malnutrition, the person affected is in a disproportion between food intake (this decreases) and energy requirements (this increases in the event of illness).
  The following diseases are particularly relevant in this context:
  • fever
  • Infections
  • Overactive thyroid (Hyperthyroidism)
  • Burns
  • large open wounds
  • Kidney disease with blood washing
• Since various drugs also have a strong influence on the metabolism and thus influence the basal metabolic rate, patients may have to adjust their eating habits. Drugs that can lead to malnutrition include:
  • Blood sugar lowering drugs such as insulin or oral anti-diabetic drugs
  • Pain relievers and anti-inflammatory drugs
  • Chemotherapy drugs
  • Corticosteroids such as cortisone
• Other causes:
  In addition, perfectly healthy growing children and women who are breastfeeding or pregnant also have an increased energy requirement. Even those people who suffer from intense physical exertion or stress generally have a greatly increased energy requirement, which has to be compensated for by increased food intake.

Symptoms / consequences

The symptoms of malnutrition are versatile and do not express themselves in the same way for every person affected.
The most important factors in the appearance of certain symptoms are the extent of the malnutrition and the length of time that the malnutrition has been present.

In most cases, the unwanted weight loss the first and clearest symptom of malnutrition. As a rule, those affected perceive that clothing that was once well-fitting and that certain parts of the body (especially the face and hands) collapse.
Then in the course of time various deficiency symptoms in the area of ​​the individual organ systems. Most people will notice the onset of immediately after the onset of weight loss paleness, weakness, more permanent fatigue and Trouble sleeping. It can also be in the wake of malnutrition severe limitations in performance be recorded. In most cases, those affected also suffer from pronounced lack of drive.

Especially the skin reacts particularly sensitively to deficiencies of any kind. Acute malnutrition can be avoided for this reason very early due to the appearance of skin changes detect. Next noticeable discoloration can a delayed wound healing be an indication of malnutrition. In the field of Mucous membranes observe many of those affected painful, swollen lesions. Especially the Lips and corners of the mouth (so-called Angular rhinitis) are often affected. It also occurs in the course of malnutrition severe inflammation of the lining of the mouth and gums. Furthermore, typical changes and complaints arise in the area of ​​the nails and hair. Severe hair loss and the Formation of grooves and spots on the fingernails are not uncommon in malnourished patients.

After a while the lack of energy begins internal organs and the blood-forming structures to tug.
Consequence is a acute decrease in all blood cells with occurrence of Anemia. Sooner or later this leads to a decreasing oxygen supply to the organs, fatigue, Difficulty breathing (Drop in red blood cells), one immunodeficiency With increased susceptibility to infection (Drop in white blood cells) and one Decrease in blood platelets with an increased tendency to bleed.

Also the Musculature suffers increasingly in the course of malnutrition. In order to mobilize energy reserves, the malnourished organism begins the Reduce muscle mass. Especially in the field of Temples and the Upper arms can be done quite quickly Atrophies observe. In addition, there is a Muscle weakness with quicker fatigue of the remaining muscle fibers. In later stages it shows up Muscle loss also in the heart and the Respiratory muscles. Consequently the efficiency of the heart decreases, it comes to Cardiac arrhythmias, Heart failure and to Bradycardia. These symptoms and the occurrence of breathing problems should be taken seriously. A visit to the doctor is strongly recommended!

Furthermore, the eyes affected by the effects of malnutrition very early on. Patients who cannot meet their energy needs for a long period of time suffer from Visual disturbances and night blindness.

In the field of bone it happens especially with children and adolescents Stunted growth and osteoporosis.

diagnosis

Self-tests, which the person concerned must answer honestly, can provide an initial indication of the presence of malnutrition. People who suspect malnutrition should try to answer two questions:
1. Have I accidentally lost weight in the past few months? (We are talking about several kilograms here)
2. Have I eaten significantly less food or eaten very unbalanced in the last few months?
Patients who can answer both questions very clearly with “yes” should consult a doctor as soon as possible and let him rule out malnutrition.
Even the detailed doctor-patient conversation gives the practitioner an initial insight into the nutritional behavior of the person concerned. In addition to food intake, the following points are in the foreground:

• Current complaints (symptoms)
• the living situation
• Discomfort when chewing and swallowing
• the stool behavior
• Underlying diseases
• past treatments and operations.

Following the doctor-patient conversation (briefly: anamnesis), a detailed physical examination takes place in which the person concerned is examined from head to toe.

In addition, various screening tests (especially the so-called Nutritional Risk Screening; short: NSR 2002) in everyday clinical use. The NSR 2002 is divided into several sections. In the first section, three questions must be answered:

• In which range is the body mass index (BMI) of the data subject?
  A BMI less than 20.5 kg / m2 is classified as underweight.
• Has the person lost weight in the past three months?
• Has the person concerned ate less and / or unbalanced in the last few weeks?

According to this screening, malnutrition is already present if only one of these three questions is answered with “yes”.
The medical world divides the question of whether this screening method is reliable.
Since the BMI as such is rather controversial, the question remains whether it can actually provide reliable information about a person's nutritional situation. The fact is that the body mass index correlates body weight with body size, but does not place any value on the body fat percentage. As a result, for example, athletic people who weigh a little more due to their muscles can have a higher BMI.

Laboratory methods can also provide indications of malnutrition. For example, read about this: Urea decreased

therapy

In order to successfully treat malnutrition you must first determine the exact cause become.
The main goal of therapy is Supply of the organism with a sufficient amount of energy suppliers.

Since the causes of malnutrition can in many cases also be traced back to psychological factors, a appropriate psychotherapy be initiated. Help with most of those affected Meal plans regain a normal relationship to food and ingestion and put an end to malnutrition. When creating such a menu, the preferences of the patient and the chewing and swallowing options should be taken into account.
In addition to food intake, the Providing the body with sufficient fluids (at least 1.5 to 2 liters per day) don't miss out.
However, since such a menu is not always sufficient to lead those affected out of malnutrition, additional special drink-food preparations be distorted. These usually have a very high percentage of calories (i.e. energy units) and can usually cushion the organism's lack of energy more quickly. In addition, the intake of certain food components can be influenced well by this drinking food. Special solutions have different levels of carbohydrates, proteins and protein.
In extreme cases of malnutrition, however, a successful treatment cannot be guaranteed even with high-calorie drinking packets. In these patients the artificial nutrition become necessary. With this type of diet, a thin tube (called a gastric tube) is inserted through the nose or directly through the abdominal wall and placed in the stomach. In this way, a high-calorie chyme can be brought directly into the stomach and the absorption of energy suppliers can be increased.