PERSONAL, COMMUNITY AND
ENVIRONMENTAL HEALTH
BPED 3
MARISH LOU G. FERNANDEZ, RN,MAEd
Part-time Lecturer
College of Education
Bachelor of Physical Education 3
First Semester, S.Y. 2022-2023
Lesson 2:
Malnutritio
LEARNING OBJECTIVES
At the end of the lesson, the students will be able to:
Define what is Malnutrition
Identify the Categories of Malnutrition
Define what is Undernutrition and Overnutrition
Identify and Explain the different types Growth Failure
Determine and explain what is micronutrient malnutrition.
Differentiate the effects of micronutrient deficiency and excess.
Identify and discuss the types and effects of overnutrition.
LEARNING GUIDE
Malnutrition
Malnutrition refers to deficiencies, excesses or imbalances in a person’s intake of
energy and/or nutrients. So, intake of nutrients in proper amount is needed.
MALNUTRITION
Undernutrition Overnutrition
Micronutrient Growth Diet-related
noncommunicable OVERWEIGHT &
Malnutrition Failure
disease OBESITY
WASTING STUNTING
- Vit A Deficiency - Heart Disease
- Iron - Hypertension
- Iodine - Stroke
- Zinc - Cancer
UNDERWEIGHT PROTEIN-
- Vit B Complex ENERGY - Diabetes
- Calcium MALNUTRITION
- Sodium (PEM)
- Potassium
- Magnesium
MARAMSMUS KWASHIORKOR
Personal, Community and Environmental Health
Undernutrition
lack of proper nutrition, caused by not having enough food or not eating
enough food containing substances necessary for growth and health
Growth
Failure
a. STUNTING
Stunting is a form of under-nutrition where a person is too short for his/her age
compared to other healthy individuals of the same age and sex (< -2 standard
deviations below the growth reference)
It may be as a result of long-term inadequate food intake, frequent illnesses,
inappropriate feeding practices and/or poor absorption of nutrients in the body.
This condition reflects growth failure and is irreversible if not addressed
within the first two years of the child’s life.
Average Height
Gender Moderate Stunting Severe Stunting
(5 years old)
Girls 109 cm 95.2 to 99.9 cm Below 95.2 cm
Boys 110 cm 96.1 to 100.7 cm Below 96.1
b. WASTING
Weight is less than the normal amount for one’s height because of acute food
shortages or disease.
Refers to low weight-for-height where a child is thin for his/her height bu not
necessarily short.
Wasting is catheterized by rapid deterioration in nutritional status over a short
period of time in children under five years of age.
In children, it can be measured using the weight-for-height nutritional index or
mid-upper arm circumference (MUAC). There are different levels of severity
of acute malnutrition: Moderate acute malnutrition (MAM) and severe acute
Malnutrition (SAM).
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c. UNDERWEIGHT
An individual is underweight when he/she has low weight compared to the
average weight of healthy individuals of the same age and sex.
It may develop slowly or suddenly depending on the cause of malnutrition.
Refers to people with a Body Mass Index (BMI) of under 18.5 or a weight
15% to 20% below that normal for their age and height group.
d. PROTEIN-ENERGY MALNUTRITION (PEM)
WHO defines malnutrition as “the cellular imbalance between the supply of
nutrients and energy and the body’s demand for them to ensure growth,
maintenance, and specific functions.
The term protein-energy malnutrition (PEM) applies to a group of related
disorders. That includes marasmus, and kwashiorkor.
Occurring most frequent in infants and young children and commonly
associated with infection.
The basic problem is usually a lack of food intake.
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Micronutrient
Malnutrition
Suboptimal nutritional status caused by a lack of intake, absorption or use of
one or more vitamins or minerals.
Prolonged failure by individuals to eat foods rich in vitamins and minerals
may lead to the development of vitamin and mineral deficiency disorders.
Manifestations of vitamin and mineral deficiencies take long to develop and
individuals may not realize that they are affected.
By the time signs are seen, the conditions are in advanced stages; for this
reason, vitamin and mineral deficiencies are also referred to as hidden or silent
hunger
Ingesting fat-soluble vitamins in larger than necessary amounts can cause a
build-up to toxic levels.
The international community has focused on several micronutrient that remain
issues globally including:
Fat-soluble vitamins:
Fat-soluble vitamins are vitamins that are transported and absorbed by fat. The body is able to
store fat-soluble vitamins in fatty tissue.
VITAMIN A DEFICIENCY
Deficiency Excess
Xeropthalmia – drying of the Toxic in large doses, increase in
cornea bone fractures, birth defects (polar
Night-blindness, dry, flaky skin bear liver contains toxic amounts
for humans)
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VITAMIN D DEFICIENCY
Deficiency Excess
Rickets -Defective bone formation Excessive calcium deposits and
mental retardation in children
VITAMIN E DEFICIENCY
Deficiency Excess
anemia High doses may be toxic to infants
VITAMIN K DEFICIENCY
Deficiency Excess
Hemorrhagic disease in newborns, High doses may be toxic in infants
slow clotting of blood
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Water-Soluble Vitamins:
Water soluble vitamins are vitamins that dissolve in water. They are not stored in your body,
so they must be eaten every day. Excess amounts are not usually a problem because they are
excreted.
VITAMIN C
Deficiency:
Scurvy – spontaneous hemorrhages,
slow wound healing, swollen,
bleeding gums
VITAMIN B1 DEFICIENCY (Thiamine)
Beriberi- nerve impairment,
can lead to heart
failure
VITAMIN B2 DEFICIENCY (Riboflavin)
Photophobia, fissuring of skin
Early symptoms of riboflavin deficiency can include weakness,
fatigue, mouth pain, burning eyes and itching.
VITAMIN B3 DEFICIENCY (Niacin)
Pellagra – produces skin lesions.
A risk where corn is the staple
Carbohydrate
VITAMIN B6 (Pyridoxine)
Dermatitis, nervous disorders
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VITAMIN B9 DEFICIENCY (Folic Acid)
Birth defects, anemia
VITAMIN B12 DEFICIENCY (cobalamin)
Pernicious anemia
Minerals are inorganic substances that are needed to carry out many processes in the body.
They cannot be manufactured by the body. Most are required in very small amounts and, like
vitamins, are classified as micronutrients.
CALCIUM
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Deficiency Excess
Weakening of bones Deposited in the kidneys forming
kidney stones
PHOSPHORUS - Aids in bone formation,
helps to maintain chemical balance of blood.
Deficiency Excess
Weakening of bones Can interfere with calcium
absorption – associated with excess
consumption of carbonated
beverages
IRON
Deficiency Excess
Anemia Most frequent cause of poisoning
deaths among children
IODINE
Deficiency Excess
Goiter – swelling of the thyroid
gland
MAGNESIUM - Enzyme activator related to carbohydrate metabolism
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Deficiency Excess
Cardiovascular problems Coma and death – also associated
with kidney failure
SODIUM
Deficiency Excess
nausea, dizziness, poor High blood pressure
concentration and muscle
weakness
POTASSIUM -
Part of the system that controls acid-
base and liquid balances; muscle
contraction; transmission of nerve impulses
Deficiency Excess
Muscle cramping Excess can be toxic, affecting the
heart – generally associated with
kidney failure
Overnutrition
Overnutrition is a form of malnutrition in which the intake of nutrients is
Oversupplied. The amount of nutrients exceeds the amount of required for n
normal growth, development, and metabolism.
Overnutrition can develop intro overweight and obesity, which increase the
risk of serious health conditions including cardiovascular diseases
(hypertension, heart disease, stroke), cancer and diabetes.
Causes: Lipids, carbohydrates, proteins
Diet-related
noncommunicable
disease
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Cardiovascular Diseases
HEART DISEASE
Coronary Heart Disease - Blocked coronary arteries (supply blood
to the heart) leading to chest pain and/or heart attack.
Caused by diets rich in saturated fats and cholesterol.
HYPERTENSION
Persistent elevated high blood pressure
Caused by increased intake of sodium/salt
When you eat too much salt, which contains sodium, your body
holds extra water to “wash” the salt from your body. In some
people, this may cause blood pressure to rise. The added water puts
stress on your heart and blood vessels.
STROKE
Blocked or ruptured blood vessels in the brain causing temporary,
permanent damage or death.
Maybe caused by persistent and untreated hypertension, and
diabetes.
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Diabetes Mellitus
Caused by excessive intake of carbohydrates.
Pancreas fails to produce hormone insulin to regulate glucose level.
The kidneys are unable to reabsorb the glucose. Excess is removed in the
urine.
If not treated, can lead to kidney failure, cataracts, blindness and
cardiovascular disorders. Wounds will be also slow to heal.
Cancer
Cancer of the rectum or colon.
Caused by:
High fat intake – high saturated fats
Obesity
Low fiber intake
OVERWEIGHT &
OBESITY
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OVERWEIGHT
Body weight that exceeds some average for stature, perhaps age.
An excess of body weight
OVERFAT
Body fat that exceeds an age-and/or gender appropriate average by
some amount
OBESITY
Defined as excessive accumulation of fatty tissue and can hinder
the effective functioning of the human body.
Having BMI of higher than 30
Having a waist measurement:
Women – over 86 cm
Men – over 102 cm
Overfat condition that accompanies components of obese
syndrome.
CAUSES OF OBESITY
o Obesity is a long-term process.
o Obesity frequently begins in childhood. Obese
parents likely haver overweight children.
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o Regardless of final body weight as adults, overweight children exhibit more illnesses
as adults than normal kids
o Excessive fatness also develops slowly through
adulthood, most weight gain occurring between ages
25 – 44 years.
o Overeating and other factors
o Factors that cause human obesity:
- genetics
- environmental
- metabolic
- behavioral
- social
o Factors that predispose a person to gain excessive weight gain.
- Eating patterns - Eating environment
- Food packaging - Food availability
- Body image - Physical inability
- Basal body temp - Dietary thermogenesis
- Fidgeting - Biochemical differences
- Quantity and sensitivity to satiety hormones
o Nutrition transition shifts in dietary structure toward higher energy density with
greater fat and added sugars, greater saturated fat, reduced complex CHO and fiber,
and reduced fruits & vegetables.
o Food consumption expressed in kCal per capita per day has increased.
o Decreased energy expenditure for all populations of the world.
o Characteristics of fast food linked to increased
adiposity:
- Higher energy density
- Greater saturated fat
- Reduced complex carbohydrates & fiber
- Reduced fruits and vegetables.
o Genetics plays a role.
- How much variation in weight gain among individuals
can be accounted for by genetic factors?
- Familial association is not proof of genetic
inheritance-families share eating & exercise habits.
- Largest transmissible variation is cultural.
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o What is leptin?
- A satiety hormone that influences the appetite control in the hypothalamus.
- A defective gene may cause inadequate leptin production.
- The brain receives an under assessment of body’s adipose stores & urge to eat.
o Physical Inactivity: an important component
o Each hour increase in TV by adolescents 2%
increase obesity.
o Adults 15 & over spent average 2.73 hr/day
watching TV in 2010.
o Each hour increase in TV by adults increase risk of
death 11%.
COMPLICATIONS OF OBESITY
o Type 2 diabetes
o Hypertension/High blood pressure
o Stroke
o Heart Disease
o Gallbladder disease
o Osteoarthritis
o Poor wound healing
o Sleep apnea (dangerous sleep disorder in which breathing repeatedly stops and starts.)
o High cholesterol and tryglycerides
o Metabolic syndrome
o Cancer
o Depression
And many other conditions, moreover the quality of life may be lower, and may be
the individual can’t do everything they want and like as easily as they would like.
They can’t join some family activities or may feel some shame or depressed.
And this is a list of some weight-related states:
o Depression
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o Sexual problems
o Physical disability
o Discomfort
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