Gurjinder Manyani
Malnutrition is the most widespread condition affecting the health of children. It is concerned primarily with the part played by nutrients in body growth, development and maintenance; food means not only proteins, fats, minerals, vitamins and other nutrients- but much more; it is part of security and civilization. Nations and civilizations are linked together not only by ideas, but also by bread. Hunger and malnutrition are problems everywhere and have harassed mankind and threatened peace throughout history. Malnutrition has been defined as “a pathological state resulting from a relative or absolute deficiency or excess of one or more essential nutrients”. The effects of malnutrition on the community are both direct and indirect. The direct effects are nutrition deficiency diseases and indirect effects are a high morbidity and mortality among young children. According to data collected by National Nutrition Monitoring Bureau in 10 states in India, the percentage of preschool children suffering from severe, moderate, mild and no malnutrition was 8.4, 34.4 and 14.3 respectively. Today, malnutrition is less visible. We need more sophisticated understanding of this dangerous problem. Children of all shapes and sizes can be malnourished, since nourishment is dependent upon nutrient intake not body weight. Physically, these malnourished children do not appear nutrient deficient. They are malnourished, because their foods lack the nutrients their bodies need. Since their bodies are still growing, children are particularly affected.According to food production, it is said that there will be very little malnutrition in India today if all the food available can be equally distributed in accordance with physiological needs. Health and other services like nutritional surveillance, nutritional rehabilitation, nutritional supplementations and health education are the key elements in identifying the realistic picture of nutritional status and its development. The surviving underweight children likely to be stunted will suffer from frequent illness; lower mental ability and achievement, in schooling are more likely to drop out of primary school.
The diets and nutritional status of urban slum children is far away from being satisfactory. The nutritional status of slum children is worst amongst all urban groups and is poorer than the rural average. Three fourths of the world’s malnourished children are Asian.
Improved healthcare system
Infections like malaria, measles and diarrhea are prevalent in our society and they precipitate acute malnutrition among children and infants. A good health care system that provides immunization, oral rehydration, periodic deworming, early diagnosis and proper treatment of common illnesses can go a long way in preventing malnutrition in the society.
Nutrition education
People can be educated on
* The nutritional quality of common foods
* Importance and nutritional quality of various locally available and culturally accepted low cost foods
* Importance of exclusive breastfeeding for six months and continuing to breast feed up to two years or beyond.
* Damage caused by irrational beliefs and cultural practices of feeding
* Recipes for preparing proper weaning foods and good supplementary food from locally available low cost foods.
* importance of including milk, eggs, meat or pulses in sufficient quantities in the diet to enhance the net dietary protein value.
* Importance of feeding children and adults during illness
* Importance and advantages of growing a kitchen garden
* Importance of immunizing their children and following proper sanitation in their day to day life.
Early detection of malnutrition and intervention
* The longer the developmental delays remain uncorrected, the greater the chance of permanent effects and hence intervention must occur during pregnancy and first three years of life.
* A well recorded growth chart can detect malnutrition very early. Velocity of growth is more important than the actual weight at a given time
* If growth of the child is slowed or is arrested as shown by flat curve on the growth card, physician should be alerted and any hidden infection or any reason for nutritional deficiency must be evaluated and taken care of.
* If growth chart is not maintained, anthropometric indices like, weight, height mid arm circumference, and chest circumference etc. can be measured and used for evaluation of nutrition.
Nutrition supplementation
Usually, biologically vulnerable groups like pregnant women, infants, preschool going and school going children are targeted by various welfare measures conducted by the government. Calories, proteins and micronutrients like iron, vitamin A and zinc can be supplemented.
Direct nutrition and health interventions
Infections like malaria, measles and diarrhea are prevalent in our society and they precipitate acute malnutrition among children and infants. A good health care system that provides immunization, oral rehydration, periodic deworming, early diagnosis and proper treatment of common illnesses can go a long way in preventing malnutrition in the society.
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