Under- and overnutrition exist at opposite ends of the same spectrum, threatening healthy growth of children and predisposing them to diseases.
MALNUTRITION comes in different forms -- it can be manifested in children who never reach their normal height and weight or who are thin and weak, and it can also be detected in those who are overweight and obese.
According to the World Health Organisation, malnutrition refers to deficiencies, excesses or imbalances in a person’s intake of nutrients to maintain healthy tissues and organ function. It is deemed the single greatest threat to the world’s public health.
Malnutrition is a broad term which refers to both undernutrition and overnutrition. However, in most cases, malnutrition always refers to undernutrition.
Undernutrition is when a diet does not include essential vitamins, mineral and other nutrients. It can lead to wasting (low weight-for-height), stunting (low height-for-age) and underweight (low weight-for-age), all of which can be detected more in children. An extended period of undernutrition can also cause starvation.
Overnutrition, on the opposite end, is the result of overeating or excessive intake of specific nutrients. This will lead to overweight, obesity and diet-related non-communicable diseases such as heart disease, stroke, diabetes and certain types of cancers.
According to ScienceDaily, a lackof sufficient nutrients to maintain a healthy bodily functions is typically associated with extreme poverty in economically developing countries.
On the other hand, inappropriate dieting, overeating or the absence of a balanced diet is often observed in economically developed countries.
Sunway Medical Centre dietitian Verona Lee Bee Kian says there are multifactorial issues that lead to malnutrition. These are categorised as primary and secondary.
Primary malnutrition is the outcome of poor diet due to inadequate access of nutritious food to meet the body’s daily demands.
Secondary malnutrition is a result of underlying diseases that increase metabolic demands such as infections, endocrine diseases and other critical illnesses.
These factors can compromise the growth and health of a child and adult.
“When a person does not get adequate nutrients for his needs, it affects the immune system, making him more prone to infections.
“And this in turn can increase his metabolic demands, affecting nutrients absorption and further complicate the condition of malnutrition. That is why malnutrition can provoke a rapid deterioration of health that can even lead to death.”
The signs of malnutrition vary depending on the types of nutrients.
Those who are at risk of undernutrition are children, the elderly, pregnant women, lactating mothers, those receiving treatment in the hospital and people with chronic diseases like cancer and organ failure.
Hunger is one of the conditions that lead to malnutrition.
“Hunger can be temporary, such as not having enough to eat for a day or it can be over a long period of time. When a person experienceshunger for a sustained period of time, he can develop malnutrition, either mild or severe, depending on the body’s needs.”
Malaysia is facing the double burden of malnutrition — the coexistence of both undernutrition and overnutrition in the same population.
Based on the Maternal and Child Health Findings from National Health and Morbidity Survey published last year, the prevalence of undernutrition among children under five was much higher than the prevalence of overweight and obesity.
Of this, 13.7 per cent were underweight, 20.7 per cent were stunting and 11.2 per cent were wasting.
The survey also found the overall national prevalence of overweight was 6.4 per cent with the highest prevalence was noted among children aged between two and three years.
For adults, the prevalence of obesity increased more than threefold from 1996 to 2006, with 17.7 per cent being overweight and 30 per cent obese.
The coexistence of double burden of malnutrition in the country is one of the biggest challenges to overcome.
“We have a group of population that is overweight and obese and at the same time there are people who are underweight and undernourished.
“Overnutrition is a lifestyle disease as children and adultseat excessive food with low quality nutrients.
“Efforts have been in place to raise awareness about proper nutrition and a healthy, balanced diet. The government has launched the healthy plate as a guide to ensure we are getting the nutrients we need,”
Parents should ensure children follow a healthy eating habit as soon as possible. Use the food pyramid as a guide and include all food groups in every meal to get energy, protein, vitamins, minerals and fibre that the body needs.
Unfortunately, undernutrition is more complex as it involves a lot of issues, one of which is poverty, both in urban and rural areas. It is a serious issue because undernourished children will grow up with health problems.
“When they are undernourished, they are not growing as scheduled. They are not gaining weight, their size is too small and they are shorter than their peers.
“It will also affect their immune system. When they don’t get enough nutrients, they are more susceptible to infections. When they are sick, they don’t have appetite. It is a vicious cycle that affectsgrowth and development.
“If we can detect the signs early, we can rectify the situation. But if issues persist until they are teenagers, it can be a lifetime problem.”
There is a need to raise awareness on the fact that there is a part of our population who are not eating quality food.
According to a 2016 report by UNICEF Malaysia, despite improvements in health care provision and the near-universal provision of water and sanitation, poverty and poor infant feeding practices remain contributing factors to malnutrition in this country.
The causes of overweight and undernutrition in Malaysia are intertwined. A child whose growth was stunted in early childhood is at greater risk of becoming overweight later in life.
The risk for being overweight goes up with increased access to junk food and drinks, physical inactivity and a sedentary lifestyle.