health issues related with malnutrition

 Health issues associated with malnutrition

Important Points

Malnutrition is a common, undiagnosed, and untreated condition among hospital patients.

Malnutrition caused by disease results from reduced dietary intake, malabsorption, increased nutrient losses, or altered metabolic demands.

Malnourished patients experience wide-ranging changes in physiological function, leading to an increase in morbidity and mortality.

Routine nutritional screening should be performed on all hospitalised patients using a validated tool, such as the Malnutrition Universal Screening Tool.

Malnourished patients have significantly higher healthcare costs.

what is malnutrition?

mal means bad 

nutrition means nutrition 

So malnutrition means bad nutrition

Although malnourished individuals can be under- or overnourished, 

Malnutrition Causes

Malnutrition is still more common in developed countries, owing to poverty, social isolation, and substance abuse. However, the majority of adult malnutrition is caused by disease and can occur as a result of:

lowered dietary intake

reduced macro- and/or micronutrient absorption increased losses or altered requirements increased energy expenditure (in specific disease processes).

Nutritional intake

Reduced dietary intake is most likely the single most important aetiological factor in disease-related malnutrition. This is thought to be due to changes in cytokines, glucocorticoids, insulin, and insulin-like growth factors, which cause a decrease in appetite sensation. 6 Failure to provide regular nutritious meals in an environment where they are protected from routine clinical activities and where they are monitored may exacerbate the problem in hospital patients.

Malnutrition's ramifications

Malnutrition has an impact on the function and recovery of all organ systems.

Muscle activity

Weight loss due to fat and muscle mass depletion, including organ mass, is frequently the most visible sign of malnutrition. Muscle function declines before changes in muscle mass, implying that altered nutrient intake has a significant impact independent of muscle mass effects. Similarly, improvements in muscle function with nutrition support occur faster than can be explained by muscle mass replacement alone.

One explanation for these findings is downregulation of energy-dependent cellular membrane pumping, also known as reductive adaptation. This can happen after only a short period of starvation. If dietary intake is insufficient to meet needs over a longer period of time, the body draws on functional reserves in tissues such as muscle, adipose tissue, and bone, resulting in changes in body composition. There are direct consequences for tissue function over time, resulting in a loss of functional capacity and a brittle, but stable, metabolic state. Injuries such as infection and trauma cause rapid decompensation. Importantly, malnourished patients are at risk of decompensation and refeeding syndrome if their energy intake is unbalanced or increases suddenly.

Cardiopulmonary function

In malnourished people, there is a decrease in cardiac muscle mass. The resulting decrease in cardiac output affects renal function by lowering renal perfusion and glomerular filtration rate. Micronutrient and electrolyte deficiencies (for example, thiamine) can also impair cardiac function, especially during refeeding. Poor diaphragmatic and respiratory muscle function reduces cough pressure and secretion expectoration, causing respiratory tract infections to progress more slowly.

Function of the gastrointestinal tract

Adequate nutrition is critical for GI function preservation: chronic malnutrition alters pancreatic exocrine function, intestinal blood flow, villous architecture, and intestinal permeability. The colon's ability to reabsorb water and electrolytes declines, and ion and fluid secretion occurs in the small and large bowel. This can cause diarrhoea, which has a high mortality rate in severely malnourished patients.

Wound healing and immunity

Immune function is also compromised, increasing the risk of infection as a result of impaired cell-mediated immunity, cytokine, complement, and phagocyte function. In malnourished surgical patients, delayed wound healing is also well documented.

Psychosocial effects

Malnutrition has both physical and psychological repercussions, including lethargy, sadness, anxiety, and self-neglect.

e function, blood flow through the gut.