growth as a measure of nutritional status

Question 1

malnutrition

Answer 1

group of conditions in children and adults generally related to poor quality or insufficient quantity of nutritent intake, absorption or utilisation
effects every country
3 forms- stunting, wasting + obesity
protein energy malnutrition- resulting from deficieincies in any or all nutrients
micronutrient deficiency disease- resulting from a deficiency of specific micronutrients

Question 2

protein energy malnutrition (3 types)

Answer 2

acute malnutrition- wasting or thinness- leading to rapid weight loss or failure to gain weight normally (during war or famine)
chronic malnutrition- stunting or shortness- inadequate nutrition over long period of time leading to failure of linear growth (in poverty)
acute + chronic- underweight- combination so could occur as a result of wasting stunting or both

Question 3

wasting

Answer 3

low weight for height- due to acute malnutrition- height is normal but they are thin due to an intense period with no food
MUAC is used to measure if a child is wasted
less than -2SD of normal weight for length is moderate and -3SD is severe

Question 4

stunting

Answer 4

low height for age- due to chronic malnutrition- they are short but thin/ wasted- caused by longer term growth insult + could be from generations before
doesnt pose an immediate threat but is still important
less than -2SD moderate or -3SD is severe

Question 5

u

underweight

Answer 5

low weight for age- mix of acute and chronic

Question 6

kwashiorkor

Answer 6

some children with acute protein energy malnutrition develop oedema
is an accumalation of fluid in the tissue, esp feet and legs, meaning child may look fat or swollen
caused by protein deficiency with adequate energy intake
form of malnutrition but is hard to diagnose

Question 7

marasmus

Answer 7

severe form of malnutrition characterised by energy deficiency
body weight reduced to less than 60% of normal body weight + child loses subcutaneous fat
develop severe thinness
life threatening medical emergency

Question 8

when does malnutrition occur

Answer 8

need to know when so can introduce preventative method
2 years- when the window to intervene ends, in order to prevent child from being severely malnourished
can also look to intervne in puberty due to large period of growth here

Question 9

recovery

Answer 9

adolescence proposes an additional window of opportunity which height recovers over 1 Z score
grow for longer during adolesence
some papers suggest that infanct is the optimal window of opportunity within which growth promoting nutritional intervntions should be focused

Question 10

where does it occur

Answer 10

highest rates in sub sahara africa
+ south asia

Question 11

public health impotence

Answer 11

undernutrition- including fetal growth restriction, stunting, wasting and deficiences of vit A and zinc + suboptimal breastfeeding is cause of 3.1million child deaths annyaly
stunting is best indicator of overall health status
cause of death is not stunting but it contributes to the problems, underlying conditions are responsible for death

Question 12

early life origins

Answer 12

stunting is higher in children who are low birthweight or pre term (2x increase odds of stunting)
foetal period is important and effects are shown when born so need to interven in early pregnancy to prevent this
shows that stunting is an intergenerational issue (cycle)

Question 13

consequences for lifelong health

Answer 13

stunting in childhood may turn out to be a healthy adult but with increased risk of morbidity and mortality
stuniting implications are not always instant but span lives, even after the insult is out of the picture

Question 14

consequences for future generations

Answer 14

doesnt just last lives but generations
offspring of stunted parents have increased risk of various diseases
offspring of short mothers are 4.7 times more likely to be stunted adults themselves
stunting is intergenerational but wasting is not as the individual will either die or recover

Question 15

breaking the cycle

Answer 15

higher quality food for pregnant women (supplementation)
ensuring children have adequate nutriton
adequate complementary feeding (post breastfeeding)
addressing poverty
access to healthcare
stunting can be reduced by 36% using interventions such as micronutrient supplementation

Question 16

preventing stunting

Answer 16

nutrition is only one factor that affects growth and is an explanation for stunting/wasting
agriculture- some countries have no variety of food/ crops
hygiene and sanitation - more likely to contract diarrheal diseases
gender equity - malnutrition in women- child is effected when pregnant
health care- infectious diseases grow and cause stunting