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It is currently estimated that about half of all American adults have one or more preventable and diet-related chronic diseases, the most common of which include cardiovascular disease and type 2 diabetes. As the rate of these chronic diseases, which are often due to poor nutritional intake and physical inactivity, continues to climb, it is imperative that the role of nutrition in all aspects of health is fully understood.

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A nutritionally adequate diet

Most developed nations in the world have federal agencies that provide detailed guidelines on dietary and nutritional recommendations for the general public.

Within the United States, for example, the U.S. Departments of Health and Human Services (HHS) along with the U.S. Departments of Agriculture (USDA) publish a joint report every 5 years on the latest nutritional guidelines, whereas the Scientific Advisory Committee on Nutrition (SACN) provides dietary guidelines for citizens of the United Kingdom.

Some of the basic dietary guidelines outlined by the U.S. report recommend a diet that includes:

• A range of vegetables, including dark green, orange and red vegetables, legumes, and starchy vegetables
• Fruits, particularly whole fruits
• Grains, particularly whole grains
• Fat-free or low-fat dairy products, such as yogurt, milk, cheeses and/or fortified soy products
• Protein foods, including lean meats and poultry, seafood, legumes, seeds, nuts, and soy products
• Oils

In addition to providing information on the different types of food products that should be incorporated into each individual’s overall eating pattern, the U.S. dietary guidelines also recommend limiting intake of:

• Saturated fats
• Trans fats
• Added sugars
• Sodium

To ensure that each individual is following a healthy eating pattern, it is generally recommended that a variety of nutrient-dense foods across all recommended food groups are consumed in their recommended amounts. By consuming these food products, the overall goal is to ensure that an adequate amount of vitamins, minerals, water carbohydrates, proteins, fats and other nutrients are present to support the cells and tissues without the body.

What is malnutrition?

According to the World Health Organization (WHO), malnutrition is a cellular imbalance that arises between the body’s supply of nutrient and energy sources and the physical demand for these components. This imbalance can reduce the body’s ability to grow and maintain adequate operation of various bodily functions. As a result, malnutrition can lead to a compromised health condition and increase an individual’s risk of several different health conditions.

Malnutrition can be further classified into two broad forms, of which include undernutrition and micronutrient-related malnutrition. Undernutrition can be further divided into four forms that include wasting, stunting, underweight, and deficiencies in vitamins and minerals.

Comparatively, some of the different micronutrient-related malnutrition conditions include obesity and being overweight, diet-related non-communicable diseases, and an inadequate consumption of micronutrients.

Undernutrition

Wasting, which can also be defined as an individual with a low weight for their height, often occurs when said individual has recently lost a significant amount of waste. This severe weight loss can be due to a lack of food consumption, or as a result of an infectious disease, such as diarrhea.

Stunting, which is also known as low height-for-age, is a form of malnutrition that is due to chronic or recurrent undernutrition. Stunting is often associated with poor socioeconomic conditions, poor maternal health and nutrition, frequent illness and/or undernutrition in infants and young children.

Deficiencies in vitamin A, iron, iodine, and zinc are some of the most common outcomes of undernutrition. Vitamin A deficiency (VAD), for example, is the most common cause of preventable blindness and also increases an individual’s risk of serious complications following an illness. In fact, it is currently estimated that VAD is responsible for 630,000 infectious deaths, particularly those due to measles, diarrhea, and malaria, each year.

A lack of both meat and plant consumption can lead to an iron deficiency, which can affect the body’s ability to bind and transport oxygen, regulate cell growth and differentiation, and reduce immune function. Comparatively, an iodine deficiency can inhibit normal thyroid functions that are needed for the regulation of growth, development, and metabolic processes, as well as in the prevention of goiter and cretinism. Furthermore, iodine deficiency disorders (IDD) have also been associated with fetal loss, stillbirth, congenital anomalies, and impaired hearing capabilities.

Micronutrient-related nutrition

An individual who is obese or overweight is considered to be too heavy for his or her height. More specifically, a body mass index (BMI) for an individual who is overweight is typically over 25, whereas an obese individual will often have a BMI greater than 30. Since the early 2000s, abdominal obesity has affected about 50% of all American adults, with its prevalence increasing with age. It is currently estimated that 2.3 billion children and adults are overweight in the world.

The double burden of malnutrition is used to describe the paradox that exists between undernourishment and obesity. Although an obese individual may not appear to be malnourished, they often lack a diet that is rich in fruits, vegetables, whole grains and beans, all of which are necessary to maintain an adequate nutritional status.

In addition to increasing their risk of a number of health conditions such as cardiovascular diseases (CVD), diabetes and hypertension, obesity and malnutrition can also increase an individual’s risk of experiencing various forms of cognitive impairment.

Conclusion

Despite the vast socioeconomic disparities that are present between many nations throughout the world, every single country on Earth is affected by some form of malnutrition. Therefore, ensuring that every person consumes a nutritionally adequate diet is imperative to any global health challenge.

In general, an optimized nutritional intake that is initiated early in life has been shown to offer the best opportunity for long-term health benefits. Malnutrition not only increases an individual’s susceptibility to a wide range of health conditions, but is also associated with reduced productivity and economic growth, both of which can further contribute to the cycle of poverty and health problems in affected communities.

References

• Dietary Guidelines for Americans 2015-2020 Eighth Edition [Online]. Available from: https://health.gov/sites/default/files/2019-09/2015-2020_Dietary_Guidelines.pdf.
• Gondivkar, S. M., Gadbail, A. R., Gondivkar, R. S., et al. (2019). Nutrition and oral health. Disease-a-Month 65(6); 147-154. doi:10.1016/.j.disamonth.2018.09.009.
• Adan, R. A. H., van der Beek, E. M., Buitelaar, J. K., et al. (2019). Nutritional psychiatry: Towards improving mental health by what you eat. European Neuropsychopharmacology 29(12); 1321-1332. doi:10.1016/j.euroneuro.2019.10.011.
• Malnutrition [Online]. Available from: https://www.who.int/news-room/fact-sheets/detail/malnutrition.
• Caulfield LE, Richard SA, Rivera JA, et al. Stunting, Wasting, and Micronutrient Deficiency Disorders. In: Jamison DT, Breman JG, Measham AR, et al., editors. Disease Control Priorities in Developing Countries. 2nd edition. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2006. Chapter 28. Available from: https://www.ncbi.nlm.nih.gov/books/NBK11761/Co-published by Oxford University Press, New York.
• Malnutrition Hits The Obese As Well As The Underfed [Online]. Available from: https://www.npr.org/sections/goatsandsoda/2019/12/23/785566796/malnutrition-hits-the-obese-as-well-as-the-underfed.

Further Reading

• All Nutrition Content
• Macrominerals and Trace Minerals in the Diet
• What is Clean Eating?
• Nutritional / Dietary Supplement
• Diet Supplements and Liver Problems

Written by

Benedette Cuffari

After completing her Bachelor of Science in Toxicology with two minors in Spanish and Chemistry in 2016, Benedette continued her studies to complete her Master of Science in Toxicology in May of 2018.During graduate school, Benedette investigated the dermatotoxicity of mechlorethamine and bendamustine; two nitrogen mustard alkylating agents that are used in anticancer therapy.