Malnutrition, a term often associated with images of famine in distant lands, is a complex spectrum that affects millions of people across the world, regardless of geographic or economic boundaries. This phenomenon, both cause and consequence of poverty and social inequality, manifests itself in various forms, ranging from undernutrition to obesity, each with its challenges and implications.
I. A Multiplicity of Factors:
Malnutrition is a complex problem influenced by a multitude of factors, the variety and interaction of which highlight the complexity of this issue at the global level.
Here is a detailed overview of these various types and factors:
1. Types of Malnutrition:
Malnutrition can manifest in several ways, each with its characteristics and implications.
Here is a detailed overview of the different types of malnutrition:
– Undernutrition: Characterized by wasting, stunted growth, underweight, and vitamin and mineral deficiencies.
●Wasting: Characterized by a low weight-for-height ratio, often a sign of recent and severe weight loss due to insufficient nutrition and/or infectious diseases such as diarrhea.
●Stunting: A low height/age ratio, resulting from chronic or recurrent undernutrition, often associated with poverty, poor maternal and nutritional health, frequent illnesses,/or poor diet inappropriate care in early childhood.
●Underweight: A low weight/age ratio, which may indicate stunted growth and/or wasting.
These conditions often result from chronic undernutrition, linked to disadvantaged socio-economic factors, poor health, and inadequate feeding of infants and young children.
– Overweight and Obesity: Result from an imbalance between energy intake and expenditure. Diets high in sugar and fat, combined with reduced physical activity, contribute to this problem.
– Micronutrient Malnutrition: This includes deficiencies in essential vitamins and minerals, such as iodine, vitamin A, and iron, which are crucial for every individual’s health.
2. Political and Economic Factors:
– Agricultural Policies and Marketing: Agricultural intensification policies and their impact on the environment, as well as the dependence of farmers on multinationals for GMO seeds, affect access to food.
– Conflicts and Instability: Conflicts hamper the distribution of food, as in the cases of several countries on the African continent, where foodstuffs do not reach their recipients or are destroyed.
– Rural Poverty: Influenced by falling prices of agricultural products and competition from imports, limiting farmers’ income and their ability to produce.
3. Multisectoral Approach to Nutrition:
– The Six “Ps”: An approach including Production, Food Preservation, Population, Poverty, Politics, and Pathology (diseases), for a more complete vision of malnutrition and its solutions.
– Recommended Actions: Improving household food security, promoting breastfeeding, preventing micronutrient deficiencies and integrating nutritional objectives into development policies.
II. Diverse and Profound Consequences:
The consequences of malnutrition are vast and serious, affecting both physical and mental health.
1. Physical Consequences:
– Malnutrition leads to an imbalance between food intake and energy expenditure, leading to weight loss, a reduction in muscle mass, and various harmful consequences on physical health. It particularly affects children, the elderly, and hospitalized patients.
– Four main types of malnutrition are identified: wasting, stunted growth, underweight, and vitamin and mineral deficiencies. Wasting, for example, indicates recent, severe weight loss, often due to insufficient nutrition or infectious disease. Stunted growth, resulting from chronic undernutrition prevents children from reaching their physical and cognitive potential.
– Deficiencies of essential micronutrients (such as iodine, vitamin A, and iron) threaten health and development, especially in children and pregnant women.
2. Mental and Psychological Consequences:
– Malnutrition in children can cause growth delays, difficulty concentrating, sleep disorders, and chronic fatigue. Prolonged deficiency of certain nutrients, such as vitamin C, can cause serious illnesses such as scurvy, and iron deficiency can lead to anemia.
– In adults, malnutrition can manifest as profound fatigue, lack of motivation, irritability, and even depression. It can also lead to fat gain and muscle loss.
– Studies have shown that strengthening the parent-child bond and psychosocial support as part of treatment for malnutrition allows for more effective nutritional recovery in children. Conversely, the absence of mental health support can compromise recovery.
3. Socio-economic consequences:
– Malnutrition increases health care costs, reduces productivity, and slows economic growth, fueling a vicious cycle of poverty and poor health.
– In contexts of war and displacement, as observed by Médecins Sans Frontières, the psychological consequences of malnutrition are accentuated by the trauma experienced by refugee families, impacting their recovery and social integration.
Combating malnutrition therefore requires a holistic approach that addresses not only nutritional needs but also the psychosocial and economic support of affected individuals and communities.
III. Diseases and health problems caused by malnutrition:
Malnutrition, in all its forms, is a key factor in the development of various non-communicable diseases (NCDs).
Here’s how malnutrition contributes to these diseases:
1. Overweight and Obesity:
– Often come from excessive consumption of ultra-processed foods, high in calories, fats, salt, and sugar, but poor in nutrients.
– These dietary habits lead to excessive fat accumulation, increasing the risk of cardiovascular disease, type 2 diabetes, certain cancers, and contributing to high blood pressure and high cholesterol.
2. Cardiovascular Diseases and Stroke:
– A diet high in salt is a major risk factor for these diseases. It increases blood pressure, which can lead to cardiovascular disease and stroke, as well as chronic kidney failure.
3. Type 2 Diabetes:
– Linked to excessive sugar consumption and obesity. These dietary factors can lead to high blood sugar and insulin resistance, which are hallmarks of type 2 diabetes.
4. Cancers:
– Certain types of cancer, such as those of the esophagus, bronchi, lung, oral cavity, nasopharynx, and colorectal, are associated with an unbalanced diet, including low consumption of fruits, vegetables, fiber, nuts, and seeds, and high consumption of saturated and trans fats.
5. Impact on Children:
– Malnutrition in early childhood, including stunting and wasting, can have long-term consequences, increasing the risk of obesity and NCDs in adulthood. Breastfeeding is crucial to protect against childhood malnutrition.
6. General Consequences of Malnutrition:
For children, it can cause growth retardation, concentration problems, and a weakening of the immune system. In adults, it manifests itself as profound fatigue, gain in fat mass, and loss of muscle mass, and can lead to irritability or depression.
In summary, malnutrition, whether manifested by undernutrition or overnutrition, disrupts the nutritional balance necessary for the proper functioning of the body and increases the risk of various NCDs.
IV. Complex but Feasible Solutions:
To combat malnutrition, a complex and varied approach is needed, involving both local and global solutions, integrating health, nutrition, education, and policy.
1. Improving Access to Nutritious Foods:
– Raising awareness of good dietary practices is essential. This can include teaching how to prepare balanced meals with local and inexpensive products, as in the case of UNICEF initiatives in Congo previously where awareness sessions and cooking demonstrations are organized for families.
2. Strengthening Health Systems:
– It is crucial to strengthen the skills and capacities of health structures to manage acute and moderate malnutrition, avoiding creating a system parallel to the national system. Programs like those of the Red Cross are a good example of this approach.
– Early detection and appropriate management of children suffering from malnutrition, with ready-to-use therapeutic foods, are also effective strategies, as illustrated by UNICEF programs.
3. Nutritional Education:
– Nutrition education can help prevent cases of malnutrition. This may include teaching the importance of a balanced diet and methods to achieve it, particularly in vulnerable contexts.
4. Development of Inclusive Public Policies:
– Public policies must support access to nutritious and affordable food, the promotion of sustainable food systems, and nutritional education.
– Policies should also aim to address the root causes of malnutrition, such as poverty, inequality, and food insecurity.
5. Collaboration between Different Sectors:
– Collaboration between governments, NGOs, and private sectors is crucial. This collaboration can be manifested through financial support, sharing of knowledge and resources, and joint implementation of intervention and education programs.
6. Local and Adapted Solutions:
– Solutions must be adapted to local contexts, taking into account cultural, economic, and environmental particularities. For example, local agricultural projects can be developed to improve access to nutritious food in disadvantaged communities.
Finally, it is essential to understand that malnutrition is a complex problem requiring a multidimensional approach and the active participation of all relevant stakeholders, from the local community to international organizations.
Conclusion:
Malnutrition is not inevitable. It reflects political, economic, and social choices. Changing these choices requires collective will and concerted action. Every effort, big or small, to fight malnutrition, is a step towards a fairer, more equitable, and healthier world.
