Malnutrition In Children

Malnutrition  can  be  caused  by  deficiencies,  excesses, or imbalances  in an  individual’s  consumption  of  nutrients. It addresses 3 broad groups of conditions: 

• Undernutrition(stunting, wasting and underweight);

• Hidden hunger caused by a lack of essential nutrients;

• Overweight among children under the age of five.

    As children begin transitioning to soft or solid foods around the six-month mark, too many are introduced to the wrong kind of diet. As they grow older, their exposure to unhealthy food becomes alarming, driven largely by inappropriate marketing and advertising, the abundance of ultra-processed foods in cities but also in remote areas, and increasing access to fast food and highly sweetened beverages. 

There is basically three major 

Causes Off Malnutrition

• Basic causes which include poverty,  insecurity  and  lack  of  access  to  clean  water.

• Underlying Causes This  is  usually  found  at  the  community  level  as  a  result  of  failure  of an  individual  and:  household  to  obtain  proper  nutrition  due  to  food insecurity,  inequitable  distribution  of  wealth  and  poor  housing.

• Immediate Cause include Inadequate  intake  or  poor  absorption  due  to diseases  and  infections  including  malarial,  acute  diarrheal  disease, measles,  HIV-AIDS  and  tuberculosis especially  if  a  delay  occurs  in  seeking  professional  health care.

 

Consequences of malnutrition in the society

The consequences of malnutrition includes increased risk of infection, death, and delayed cognitive development, leading to low adult incomes, poor economic growth and intergenerational transmission of poverty. Children with malnutrition have reduced ability to fight infection and are more likely to die from common diseases such as malaria, respiratory infections and diarrhoeal diseases 

   Globally, malnutrition is regarded as the most important risk factor for illness and death and it is associated with 52.5 % of all deaths in young children. According to UNICEF, WHO and the World Bank, out of the 161 million under-fives estimated to be stunted globally in 2013, over a third resided in Africa. In Nigeria, malnutrition remains a major public health and development concern:49 percent of children under five years of age are not growing well (they are either stunted, wasted or overweight). This is partly because 34 percent of children between six months and two years of age are fed food that is not rich and diversified enough to ensure optimal growth. This puts them at risk of poor brain development, weak learning, low immunity, increased infections and, in many cases, death.

Conclusion

High levels of malnutrition have multidimensional consequences for children which will impact resilience and long-term development of households and children, including intergenerational effects. Addressing malnutrition is not only lifesaving but it is also essential to strengthen the resilience of communities and systems, to support long term development goals and improve human capital,

Reasons For Low Supply of Breast Milk

 

How does milk production work?

By the end of the second trimester, the body is capable of breastfeeding. As early as the third month of pregnancy, the breasts start to prepare for breastfeeding, developing the glandular tissue needed to produce milk and increasing the number of milk ducts in thr breasts.  Once a baby is born, a hormone called prolactin cues milk production, and another hormone, oxytocin, causes tiny muscle cells in the breasts to contract, pushing milk out. As the baby nurses, the prolactin levels increase and more milk is produced, in a continuing cycle of supply and demand: Baby drains milk from your breasts (demand), breasts respond by producing more milk (supply).

Potential causes of low milk supply

Often, mothers think that their milk supply is low when it really isn’t. If your baby is gaining weight well on breastmilk alone, then you do not have a problem with milk supply. But if you’re not quite sure about baby’s current weight gain, if baby is having an inadequate number of wet and dirty diapers then the following reasons may be why you have a low milk supply:

1. The Baby Isn't Latching on Correctly: 

The most common cause of low breast milk supply is a poor latch. If your baby is not latching on to your breast the right way, he can't get the milk out of your breasts very well. The removal of your breast milk from your breasts is what tells your body to make more breast milk. So, if your baby isn't latching on correctly, your milk supply will suffer. If you aren't sure if your baby is latching on well, have someone evaluate your breastfeeding technique.

2. Supplementing. Nursing is a two-way process; supply & demand process. Milk is produced as your baby nurses, and the amount that she nurses lets your body know how much milk is required. Every bottle (of formula, juice or water) that your baby gets means that your body gets the signal to produce that much less milk.

3. You Aren't Breastfeeding Often Enough: Just like a poor latch, not breastfeeding often enough is another common reason mothers develop a low milk supply. Newborns need to breastfeed at least every 2 to 3 hours throughout the day and night. The more you put your baby to the breast, the more you will be stimulating your body to make a healthy supply of breast milk

4. Allowing Others to Influence You: Sometimes the people in your life who didn't breastfeed, or who don't understand breastfeeding, can make you question yourself. They may say that your breasts are too small to make enough breast milk, or that the baby is breastfeeding too often so you must not have enough milk. As long as your child is growing at a consistent healthy rate, there's no need to worry or to listen to the doubts and negative comments of others. 

5. Cutting short the length of nursings. Stopping a feeding before your baby  ends the feeding herself can interfere with the supply-demand cycle. Also, your milk increases in fat content later into a feeding, which helps baby gain weight and last longer between feedings.

ZINC DEFICIENCY AND CHILD DEVELOPMENT

Zinc deficiency is defined as an insufficient zinc or serum zinc level below the normal range  to meet the needs of the body. In humans, zinc deficiency is caused by reduced dietary intake, inadequate absorption, increased loss, or increased body system utilization. According to an article published in the journal Scientific Reports, about 1.1 billion people are zinc-deficient due to inadequate dietary intakes worldwide. Its deficiency is characterized by growth retardation, loss of appetite, and impaired immune function. In more severe cases, zinc deficiency causes hair loss, diarrhea, delayed sexual maturation, impotence, hypogonadism in males, and eye and skin lesions. Recently, zinc deficiency has been linked to decreased growth, increased colds and infections, impaired memory, learning disabilities, and poor attention span. 

    Data shows that zinc deficiency is one of the most common micronutrient deficiencies in the world. Along with low levels of iron, iodine, folate and vitamin A, zinc deficiency is a common contributor to poor growth, intellectual impairments, perinatal complications, and increased risk of morbidity and mortality, according to research published in Annals of Nutrition & Metabolism. Zinc deficiency is such a serious global problem that it’s responsible for 176,000 diarrhea deaths, 406,000 pneumonia deaths and 207,000 malaria deaths — primarily in Africa, the Eastern Mediterranean and South-East Asia.

   Zinc is important for numerous functions and supports growth and development during pregnancy, childhood and adolescence. From birth, infants are confronted with massive amounts of information from multiple sources. They learn to differentiate relevant from irrelevant information so they can focus their attention on the information necessary for their growth and development. Zinc present in the brain contributes to its structure and function. Like iron and iodine, Its deficiency can lead to long-term deficits in children’s neuropsychologic functioning, motor development or activity, behaviour, attention and thus interfere with cognitive development.

 The recommended daily intake of children is as follows:

Age            

0–6 months 2 mg*

7–12 months 3 mg

1–3 years 3 mg

4–8 years 5 mg

N:B: Breast milk provides sufficient zinc (2 mg/day) for the first 4–6 months of life but does not provide recommended amounts of zinc for infants aged 7–12 months, who need 3 mg/day.

The highest concentration of dietary zinc is found in red meat and poultry. Other good food sources include beans, nuts,  certain types of seafood (such as crab and lobster), whole grains, fortified breakfast cereals.

Tips to make zinc more available in the daily diets. 

• Soak legumes (beans) in water before cooking them. This reduces the presence of phytates, making it easier for the body to process the zinc.

• Choose leavened grain products can also help reduce the number of phytates, increasing the amount of zinc for the body to use.

How to Spot Common Nutritional Deficiencies in Children

Nutritional deficiency occurs when the body is not getting enough nutrients such as vitamins and minerals. Children’s nutritional needs differ from those of adults primarily because they are growing. These problems that can have immediate and long-term effects on their health, growth and development. Food allergies, iron deficiency, tooth decay and constipation are common in the early years. If caught early, these nutritional deficiencies are much easier to remedy. 

Iron Deficiency (Anemia): Iron makes it possible for red blood cells to transport oxygen to our vital organs and throughout the body. It is commonly found in infants, preschool children, adolescent girls and pregnant women.

Symptoms of iron deficiency, or anemia, include: tiredness, pale skin (especially around the hands, nails, and eyelids), tongue may be smooth, pale and red, brittle and cracked nails, rapid heartbeat or a heart murmur, irritability, low appetite, dizziness, inability to concentrate.

Vitamin D Deficiency: Vitamin D is critical both in its own right, as well as for its role in the absorption of calcium. Both Vitamin D and calcium are vital in growing strong bones and teeth. Vitamin D is formed by the action of ultraviolet rays from the sun on the precursor sterols in the skin. Deficiency of Vitamin D causes impairment of calcium absorption from digested food, resulting in rickets in children.

Characteristics: Softened skull in infants, soft fragile bones with bowing of legs, swelling of wrists, knee and ankle joints, poorly developed muscles, delayed dentition, restlessness and nervous irritability.

    If the deficiency is not corrected, it can lead to serious skeletal deformities and a condition known as Rickets.

B Vitamin Deficiency: The B Vitamins are needed in every area of our body and help maintain a strong immune system and optimal mental function.

Symptoms of B Vitamin deficiencies may include: decreased urine output, excessive crying accompanied by thin and plaintive whining, inability to learn and focus at school. loss of appetite, bad breath, weakness, abdominal pain, nausea, vomiting, etc

Zinc Deficiency: Zinc is a trace mineral that is an essential element for humans and is  often forgotten in terms of discussions about nutritional needs. It usually takes a backseat to other well-known minerals. It is widely distributed throughout the body but the highest concentrations are found in the skin, eye, hair, nails etc. However, zinc is equally important for growth and healthy development in children.

Symptoms of zinc deficiency is characterized by poor appetite, weight loss, stunted growth, small sex glands in boys, skin changes, lightened pigment in hair(dull hair), white spot on fingernails and poor wound healing and changes in the sense of taste and/or smell. If left unchecked, zinc deficiency can lead to stunted growth, poor wound healing, and hair loss.

Fad diets; All you need to know about!

Several diets are being promoted as the best approach to losing weight. Unfortunately, many of these diets involve eliminating foods that contain necessary nutrients. Some even cut entire food groups. They typically promise rapid weight loss and other health benefits, yet often have no scientific evidence supporting their use. In addition, they are often nutritionally unbalanced and ineffective over the long term.  For example, fad diets may include those that are fat-free, very-low-carbohydrate, or high protein. Some fad diets focus on a particular food, such as grapefruit or cabbage. Some have you eliminate certain foods at specific times of the day. Others allow you certain foods, as long as you eat them along with certain other foods.

   A fad diet is a diet or eating plan that gains rapid popularity. They’re called fad diets because they are riding the waves of a trend. You may be hearing about them from a multitude of sources like television, magazines, friends, and family. Fad diets range far in wide; there’s a new one for everyone. Some of them focus on detox drinks like drinking only lemon or grape juice and others focus on eating only meat. The thing that they all have in common however, is that they all offer some type of rapid weight loss that will happen in a manner of weeks.

   While most fad diets do actually give you some results, this is normally only in the beginning. Most of them will help you lose weight rapidly, but it will not last. It is normally only a matter of time before you begin to put back on the weight. This is primarily because fad diets are unsustainable. You can’t live off solely drinking sugar free lemonade. This means when the diet is over, you inevitably return back to your original eating style – the style that helped you put on all that weight in the first place.

Your weight loss program may be a fad diet if it:

• Promises weight loss of more than 2 pounds (1 kg) per week.

• Does not provide support for long-term weight loss success.

• Is rigid and does not fit into your lifestyle or state of health.

• Cuts out major food categories (like gluten or carbohydrates) and stops you from enjoying your favourite foods.

• Forces you to buy the company’s foods or supplements rather than show you how to make better choices from a grocery store.

• Gives you nutrition advice that is based on testimonials rather than scientific evidence.

• Promotes unproven ways to lose weight such as starch blockers, fat burners and colonic cleanses.

• Encourage little or no  physical activity.

Types of Fad diets

1. It restricts carbs to 20 grams per day, while allowing unlimited amounts of protein and fat.

2. South Beach Diet: The South Beach Diet is a high-protein, lower-carb, lower-fat diet.

3. Vegan Diet: It is a diet that restricts any form of animal product.

4. Ketogenic diets: They typically provide less than 50 grams of total carbs per day, and often less than 30.

5. Paleo Diet: The paleo diet is a balanced, healthy way of eating that eliminates processed foods and encourages its followers to eat a wide variety of plant and animal foods.

6. The Zone diet: The Zone diet specifies a diet composed of 30% lean protein, 30% healthy fat and 40% high-fiber carbs. 

7. The 5:2 diet: The 5:2 diet is a form of alternate-day fasting that involves eating 500–600 calories two days a week, and eating normally otherwise

Some tips that apply to any healthy weight loss plan include:

• Eat breakfast every day and don’t skip meals.

• Limit liquid calories by avoiding soda and alcohol. Choose whole fruits instead of juice. Drink plenty of water every day.

• Eat a variety of foods to ensure that you get all of your daily nutrients.

• Watch what types of fat you consume. Do not eat any trans fats. Trans fats are found in many fried and baked goods. 

• Read nutrition labels as you grocery shop.

• Consume only moderate amounts of sugars, and food and drinks containing added sugars. In particular, limit sugar-sweetened beverages.

• Limit your daily intake of saturated fat and sodium. Try to eat healthy fats instead of opting for a strict low-fat diet. The latter typically is higher in carbs.

• Watch your portions size. 

• Exercise on a regular basis. Pick an activity that you enjoy. Aim for 30 to 60 minutes, 4 to 6 times per week.

Conclusion

Fad diets will always be popular, and new plans will continue to be created to address people’s desire to lose weight quickly. However, just because a diet is effective for weight loss doesn’t mean it is sustainable long-term. To achieve and maintain your weight loss goal, it’s important to find a healthy way of eating that you enjoy and can follow for life. If you need help to figure out what weight loss plan will work best for you, you may want to think about seeing a consulting dietitian in private practice. 

Choline: The New Essential Nutrient

The dietary component choline is the latest addition to the list of essential nutrients. It is an organic, water-soluble compound. It is neither a vitamin nor a mineral though, it is often grouped with the vitamin B complex due to its similarities. It is part of acetylcholine, a neurotransmitter associated with attention, muscle control, learning and memory and several other functions. It impacts liver function, healthy brain development, muscle movement, your nervous system and metabolism. Humans can produce it endogenously in the liver, however you must obtain the majority through your diet or through dietary supplements.

    Functions of choline

• Helps in foetal development: Choline is involved in several vital body processes, starting with your development as a fetus. Prenatal vitamins usually contain choline because it is critical for healthy fetal development, especially the brain and nervous system.

• It helps the efficient use of fat: Choline has a crucial role in bringing fats out of the liver for the body. It helps the body to metabolize fats out of the liver and send it into the bloodstream so that the body can use it for energy, absorb fat-soluble nutrients, and to make brain components such as myelin. On the flipside, if fat stays in the liver, it results to fatty liver disease, which can cause pain, enlargement of the liver, extreme fatigue, and toxic overload.

• DNA synthesis: Choline and other vitamins, such as B12 and folate, help with a process that's important for DNA synthesis.

• Regulates healthy nervous system: This nutrient is required to make acetylcholine, an important neurotransmitter. It's involved in memory, muscle movement, regulating heartbeat and other basic functions.

Who Are at Risk of Deficiency?

Although choline deficiency is rare, certain people are at an increased risk.

• Pregnant women: Choline requirements increase during pregnancy. This is most likely due to the unborn baby requiring choline for development.
• Postmenopausal women: Estrogen helps produce choline in the body. Since estrogen levels tend to drop in postmenopausal women, they may be at greater risk of deficiency.
• Endurance athletes: Levels fall during long endurance exercises, such as marathons. It's unclear if taking supplements improves performance.
• High alcohol intake: Alcohol can increase choline requirements and your risk of deficiency, especially when intake is low.

Sources

Many foods contain choline. The main dietary sources of choline consist primarily of animal-based products—meat, poultry, fish, dairy products, and eggs. Cruciferous vegetables likered-fleshed sweet potato, cauliflower, broccoli etc and certain beans are also rich in choline, and other dietary sources of choline include nuts, seeds, and whole grains. Choline is also present in breast milk and is added to most commercial infant formulas.

NB: Instead of animal products, choose fruits, vegetables, grains, and beans, which are plentiful in choline. 

 

  

World Diabetes Day 2019

World Diabetes Day takes place on the 14th November every year. The purpose of this one day is to raise awareness of a condition that millions of people all around the world live with every day. Essentially, diabetes is about the body’s inability (or lack of it) to produce the required amount of a hormone called insulin to control glucose levels in the blood. There are broadly two types of diabetes: Type 1 (Diabetes Insupidus) requires daily administration of artificial insulin by means of injection or insulin pump. Type 2 (Diabetes Mellitus) is more generally managed by a combination of dietary control and medication in the form of tablets.

    Diabetes incidence have dramatically increased among adults and children in the past decades. It results from improper regulation of blood glucose in either hyperglycemia (high blood glucose) or hypoglycemia (low blood glucose). Diabetes is diagnosed when one's fasting blood glucose is 126 milligrams per 100 milliliters of blood or greater. It ranks sixth among the leading causes of death, and was responsible for four million deaths in 2017. If untreated or unmanaged, it can lead to life-changing complications. These include amputation and several other major diseases, like stroke, heart disease, blindness, and kidney failure.

   

Causes of Diabetes

1. Changes in lifestyle: 

i. Physical inactivity, overnutrition and obesity predispose one to developing diabetes mellitus later in life. Men whose waist circumference is more than 40 inches (102 cm) and more than 35 inches (89cm) in women are at higher risk of diabetes, hypertension, cardiovascular disease and dyslipidaemia. 

ii. Drugs and hormones: several drugs especially the oral contraceptives cause glucose intolerance and in susceptible individuals may induce diabetes

2. Acquired and environmental factors

i. Infection: it may precipitate insulin-dependent diabetes mellitus or non-insulin dependent diabetes mellitus

Symptoms of Diabetes mellitus

A lack of knowledge about diabetes means that spotting the warning sign is an issue impacting a cross-section of society. The warning signs can be so mild that you don't notice them. Some people don't find out they have it until they get problems from long-term damage caused by the disease.

1. Excretion of large amounts of glucose in urine: losing so much solute in the urine causes osmotic diuresis and the volume of urine increases(polyuria). The patient constantly feels thirst.

2. Slow-healing sores or cuts. Over time, high blood sugar can affect your blood flow and cause nerve damage that makes it hard for your body to heal wounds.

3. Pain or numbness in your feet or legs. This is another result of nerve damage (poly-dipsia) and drinks large quantities of water.