Malnutrition and Its Impact on Health- A Case Study of Kwashiorkor

Malnutrition and Its Impact on Health- A Case Study of Kwashiorkor

Malnutrition

Malnutrition is a condition that results from inadequate or excess nutrients in the body, causing fatigue, growth impairment, and dizziness. There are various forms of malnutrition, including overweight and obesity, diet-related disease, undernutrition, and micronutrient-related malnutrition (World Health Organization, 2021). Children, geriatrics, and chronically ill patients are the most vulnerable to malnutrition. One of the diseases that can arise from malnutrition is kwashiorkor.

Physiologic effects of kwashiorkor in the body

Kwashiorkor is defined as protein-energy deficiency due to inadequate protein intake. Generally, kwashiorkor causes generalized body swelling, including the face, hands, and feet. Kwashiorkor usually affects children under the age of 5 years and infants who are not exclusively breastfed. According to Benjamin & Lappin (2021), the physiological effects of kwashiorkor include depletion of body fats, decreased albumin levels, increased interstitial fluid accumulation, hypothermia, hypotension, and bradycardia. The hallmark of kwashiorkor is edema. Edema arises from fluid imbalance between oncotic and hydrostatic pressure, causing retention of fluids within the vessels. Due to protein deficiency, the level of albumin is reduced, resulting in intravascular fluid loss to the interstitium. As a result, the body responds by increasing the production of an antidiuretic hormone that causes more fluid accumulation. In addition, the body increases renin production, increasing sodium retention and hence water, and further causes edema. In addition to the above, the other symptoms of kwashiorkor include muscle atrophy, abdominal distension, round face, hepatomegaly due to infiltrates from fatty liver, growth retardation, and retention of subcutaneous associated with loss of skin folds in the inguinal region. The disease also affects the skin and its appendages. The skin may appear dry, thin, scaly, and hyperpigmentation. The hair appears hypopigmented, dry, thin and easily falls out. Like other diseases, kwashiorkor does not spare the psychology, and the psychic effects of kwashiorkor include apathy, anergia, and anorexia. With all these mentioned effects of kwashiorkor, if not well managed, it can complicate and even lead to death.

Relationship of Specific Nutrients to Kwashiorkor

As mentioned in the previous discussion, kwashiorkor occurs due to protein-energy deficiency, hence the name protein-energy malnutrition. According to Benjamin & Lappin (2021), the etiology of kwashiorkor is not well known. However, the disease is often associated with protein deficiency, aflatoxins, and low levels of antioxidants. Children who are often present with kwashiorkor have a history of taking cassavas, rice, and maize without accompanying proteins.

There are no specific nutrients that are contraindicated in children with kwashiorkor. However, it is thought that patients with kwashiorkor tend to develop lactose intolerance, and therefore, the intake of nutrients and feeds containing milk should be initiated slowly. With rapid correction of kwashiorkor, refeeding syndrome occurs. The syndrome is fatal, and it comprises disturbances of metabolism after initiation of feeding after a long fasting period (da Silva et al., 2020). The hallmark of the syndrome is hypophosphatemia and hypokalemia. This, therefore, justifies the importance of the gradual introduction of parenteral nutrition.

The specific nutrients required for kwashiorkor are carbohydrates and proteins. The feeds are introduced gradually, beginning with carbohydrates and followed by proteins. The specific foods that can provide proteins include eggs, fish, meat, nuts, and cereals such as soya beans. Protein is essential for the repair of cells in the body and the synthesis of new cells. For the total parenteral nutrition used in the management of kwashiorkor, the proteins increase the oncotic pressure and, hence, reduce the edema. Since proteins are used in the synthesis of antibodies in the body, the nutrient also improves immunity. In addition, proteins are also essential for growth in children.

Nutritional Recommendations to Combat Kwashiorkor

The treatment of kwashiorkor involves ten steps that are carried out in phases starting from when the patient lands in the ward. The ten steps include treatment or prevention of hypocalcemia, Prevention or treatment of hypothermia, Prevention of dehydration, correction of electrolyte imbalance, prevention and treatment of infections using antibiotics, correction of micronutrient deficiencies such as vitamins, initiation of cautious feeding, Achievement catch feeding to enhance growth, provision of emotional support and sensory stimulation and lastly follow up after recovery (Benjamin & Lappin, 2021). All these steps are aimed at stabilizing severely ill patients.

The recommended dietary management of kwashiorkor includes increasing calorie intake through foods rich in sugar, fats, and carbohydrates to provide immediate energy. However, the calories should be introduced gradually to prevent refeeding syndrome. Secondly is the increase of proteins. If the patient is stable enough, he/she should be given foods rich in proteins, such as eggs, beans, nuts, eggs, fish, poultry, and meat. If the patient is severely malnourished, then total parenteral nutrition is preferred. Lastly is the increase in micronutrients intake, such as vitamins and minerals (Akpeli, 2019). Once food has been initiated, the patient should be supplemented with vitamins and supplements to compensate for deficiencies developed during malnourishment.

As mentioned earlier, edema results from low albumin. Therefore, while the patient is admitted to the ward, they should have an albumin infusion to increase the albumin level. In the absence of albumin infusion, it is advisable to give the patient boiled eggs because egg white contains a good amount of albumin. With increased albumin levels, there will be an increase in the oncotic pressure prevention of interstitial fluid accumulation. In summary, the goal of kwashiorkor treatment is to replenish the body’s protein and energy stores and to relieve the signs and symptoms.

References

Akpeli A. Othuke (2019). Kwashiorkor and Its Dietary Management. Education Research Portal. Durable. Retrieved on 28^th Oct 2021. Available from: https://dutable.com/2019/02/13/kwashiorkor-and-its-dietary-management/#:~:text=Dietary%20management

Benjamin O, Lappin SL. Kwashiorkor. [Updated 2021 Jul 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507876/

Da Silva, J. S., Seres, D. S., Sabino, K., Adams, S. C., Berdahl, G. J., Citty, S. W., … & Parenteral Nutrition Safety and Clinical Practice Committees, American Society for Parenteral and Enteral Nutrition. (2020). ASPEN consensus recommendations for refeeding syndrome. Nutrition in Clinical Practice, 35(2), 178-195. https://doi.org/10.1002/ncp.10474

World Health Organization (2021).Malnutrition. Retrieved on 28^th Oct 2021. Available from: https://www.who.int/news-room/fact-sheets/detail/malnutrition

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Module 04 Content

Nutrition plays a vital role in a person’s overall health and well-being. Not getting enough of the recommended nutrients over the long term can lead to malnutrition, which often results in disease and illness.

In a 3-page paper, written in APA format using proper spelling/grammar, address the following:

Define malnutrition and identify a specific disease that can result from it.

Malnutrition and Its Impact on Health- A Case Study of Kwashiorkor

Perform library research about the selected disease and explain its physiological effects on a person’s body.
Describe the relationship between specific foods/nutrients and the disease. Use the questions below to guide your response.
Does research indicate that a lack of specific foods/nutrients increases a person’s chance of contracting the disease?
Are there specific foods/nutrients that an individual afflicted with the disease should avoid?
How do specific foods/nutrients work physiologically within the body to help combat the disease?
Evaluate nutritional recommendations to help combat the disease.
Cite at least 3 credible references and present the resources in APA format on the References page.

For information about the impact of diseases on body systems and assessing the credibility of resources, consult the resources below.

How do I know if a source is credible?
I need to find information about a disease and the body system it impacts.

Submit your completed assignment to the drop box below. Please check the Course Calendar for specific due dates.

Save your assignment as a Microsoft Word document. (Mac users, please remember to append the “.docx” extension to the filename.) The name of the file should be your first initial and last name, followed by an underscore and the name of the assignment, and an underscore and the date. An example is shown below