Malnutrition can make a person more susceptible to infection and infection also contributes to malnutrition which causes a vicious cycle An inadequate dietary intake leads to weight loss lowered immunity invasion by pathogens and impaired growth and development in children ID: 1044078
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1. Nutrition and Infection
2. Malnutrition and infectionMalnutrition can make a person more susceptible to infection, and infection also contributes to malnutrition, which causes a vicious cycle. An inadequate dietary intake leads to weight loss, lowered immunity, invasion by pathogens, and impaired growth and development in children. A sick person's nutrition is further aggravated by diarrhea, malabsorption, loss of appetite, diversion of nutrients for the immune response, all of which lead to nutrient losses and further damage to defense mechanisms. These, in turn, cause reduced dietary intake. In addition, fever increases both energy and micronutrient requirements
3. Malnutrition and InfectionUndernutrition − Result of undernourishment, poor absorption and/or poor biological use of nutrients consumedUndernutrition Leads to Deficiencies in : Protein − Deficit in amino acids needed for cell structure, metabolic function Energy − Calories (joules) derived mostly from macronutrients a. Protein b. Carbohydrate c. Fat Micronutrients − For example, vitamins A, D, E and K; B-complex (thiamin [B1], riboflavin [B2], niacin (B3), folate (B9), pyridoxine [B6], cobalamin [B12]), vitamin C; iron, zinc, iodine, calcium, others
4. Undernutrition can be milder, “hidden,” affecting: Survival Development Behavior quality of life economic potential
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6. Causes of Childhood UndernutritionMaternal undernutrition leading to intrauterine growth retardation (IUGR; small size at birth)Chronic low energy and protein intakeUnclean/non-nutritious, complementary foods of low energy and micronutrient densityToo early displacement of breastDilution of formulaExclusive breast feeding for too longInfection (e.g., measles, diarrhea, others)Xenobiotics- chemical compounds foreign to a given biological system e. g aflatoxins
7. Malnutrition-infection interactions
8. Effects of Infection on Nutritional StatusProtein catabolism and negative nitrogen balanceAltered priorities for protein anabolismDepletion of CHO storesIncreased gluconeogenesisAltered lipid metabolismTrace element (Fe, Cu, Zn) redistributionIncreased vitamin utilization and excretion
9. Major causes of death among children
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11. Micronutrient Deficiencies: Hidden HungerAbout 2 billion people affectedMajor deficienciesIodine, vitamin A, iron, and zincEffectsPoor growth, increased morbidity, impaired intellect, increased mortalityPreventableSupplements, fortification, diet change
12. Micronutrient Deficiencies and InfectionVitamin A deficiencyIncreases risk of severe diarrhea, malaria, measles severity; child mortalityZinc deficiencyIncreases risk of diarrhea, malaria; (likely child mortality)Other micronutrient deficienciesAdverse effects on host defenses are likely
13. Zinc DeficiencyVast problem!Highly prevalent in cultures with Low meat and fish (low zinc) intakesHigh grain (high phytate) intakesZinc is a trace mineral that is essential for all species and is required for the activities of >300 enzymes, carbohydrate and energy metabolism, protein synthesis and degradation, nucleic acid production, and carbon dioxide transport. It is a cofactor in the formation of enzymes and nucleic acids and plays a critical role in the structure of cell membranes and in the function of immune cells. Zinc deficiency reduces immunity, and suppresses antibody production.
14. Inadequate zinc supply prevents normal release of vitamin A from the liver; Clinically, it is associated with growth retardation, malabsorption syndromes, fetal loss, neonatal death, and congenital abnormalities. Low blood zinc concentrations have also been found in patients with tuberculosis, diarrheal disease, and pneumonia. Zinc deficiency is associated with abnormal pregnancy outcomes and conditions of relative immunocompromise, kidney disease, burns, inflammatory bowel disease, and HIV infection.
15. Zinc supplementation reduces the duration and intensity of diarrheal illness and pneumonia among children living in developing nations. It limits growth stunting in children affected by acute diarrheal illness In patients with sickle cell disease, it decreases the number of infections and hospitalizations . A weekly dose of 70 mg not only reduced the incidence of and prevented death of pneumonia but also had an effect on the incidence of diarrhea, with overall mortality reduced by 85%. Resistance to infection and improved appetite were found with continuous potassium and magnesium as well as zinc supplementation
16. More than 1.5 million children die of acute diarrhea each yearCase fatality can be reduced with ORS, fluids in the home, breast feeding, continued feeding, selective use of antibiotics and zinc supplementation for 10–14 daysProvide 20 mg per day of zinc Available in 20 mg dispersible tablets as zinc sulfate
17. Zinc SupplementationReduces diarrhea, pneumonia, and possibly malaria incidenceReduces diarrhea duration and severityPreliminary—may reduce child death