In the last post, we mentioned a little about adult malnutrition. In this post we will discuss more on malnutrition and some of the most common forms of malnutrition.
As for adult malnutrition, there is not usually a singular test to diagnose it. Instead, various assessment methods tend to be utilized to determine it. The six characteristics outlined previously (former post) are usually considered when assessing for adult malnutrition i.e., weight loss, reduced functional status, loss of muscle, limited energy intake, generalized or localized fluid accumulation and loss of subcutaneous fat. If a patient has at least 2 or more of the characteristics, a BMI that is lower than recommended (less than 23 among older adults and less than 18.5 among adults),and has significant weight loss (weight loss between 1%-2% in a week, 5% in a month, 7.5 % in 3 months and 10% in 6 months), then he or she is likely malnourished. During pregnancy, inadequate maternal weight gain tends to be a useful anthropometric indicator that a pregnant woman could be at risk of malnutrition.
A client’s history pertaining to diet and nutrition may also be indicative of whether one is at risk of becoming malnourished. For instance, an individual who consistently consumes inadequate protein and energy sources may be at risk of malnutrition, and also one with excessive alcohol intake (interferes with one’s ability to acquire adequate nutrients).
Malnutrition can be either uncomplicated or disease-associated (complicated).With uncomplicated malnutrition, you have no medical complications whilst with complicated malnutrition, you present with other medical complications. A patient with uncomplicated malnutrition may appear wasted and thin, have lower body temperature, blood pressure and heart rate, have sparse hair and changes in nails while a patient with complicated malnutrition may present with either a thin or normal appearance, ascites, peripheral oedema, discolouration of skin and hair, muscle wasting and the retention of body fat.
When determining the diagnosis of inadequate protein intake, nutrition assessment relies on anthropometric indicators whereby severe weight loss (weight loss > 1%-2% in a week,> 5% in a month, > 7.5 % in 3 months and > 10% in 6 months) may signify insufficient intake of both energy and protein intake. Other assessment methods such as dietary assessment tools or a client’s history can reveal findings such as delayed would healing and the omission or restriction of protein food groups such as meat or dairy sources that could prove the inadequate intake of protein and energy.
The 2 forms of protein –energy malnutrition include:
Kwashiorkor-is protein deficiency. It presents with discolouration of hair and skin and oedema. Over time, it causes loss of muscle mass, reduced immunity and stunting among children.
Marasmus -is the deficiency of macro-nutrients including energy, fats and protein. It presents with severe malnutrition, atrophy and chronic calorie deficit. Signs of marasmus include: thin hair, fat and muscle wasting. Among children, marasmus is mainly recognized by growth failure whereas among adults and older children, wasting is the common sign.