NUTRITION – BASIC
CONCEPTS
Country Strategy Workshop –
Juba.
Presentation Overview
• Malnutrition: simple definition
• Different forms of under-nutrition
–Chronic under-nutrition (stunting)
–Acute under-nutrition
–Underweight
–‘Hidden Hunger’ (micronutrient deficiency)
• Causes of malnutrition: Food and Nutrition
Security Conceptual Framework
Malnutrition is …
• “…A broad term for a range of conditions
that hinder good health, caused by
inadequate or unbalanced food intake or
from poor absorption of food consumed.
• It refers to both under-nutrition (food
deprivation) and over-nutrition (excessive
food intake in relation to energy
requirements).
RISKS of being
undernourished
Lowered resistance to
disease
Poor pregnancy/lactation
Increased risk of mortality
Reduced ability for physical
activity
Learning difficulties
Chronic under-nutrition
 Chronic under-nutrition (stunting) is a result
of persistent and cumulative effects of
inadequate nutritional intake and frequent
infections
 Influenced by maternal nutritional status preconception and during pregnancy
 Most evident between 6 – 12 months of age
 Shows no more improvement or worsening after 24
months
 Results in individuals short for their age and suboptimal function later in life
Acute under-nutrition
 Acute under-nutrition (wasting) is a result of a
severe and often sudden lack of food or illness.
 Can occur at any stage of the life-cycle but more
common in infants & younger children.
 Easily reversible by correction of the food deficit or
treatment of illness
 Characterised by thinness and/or the severe clinical
form of oedema
Acute under-nutrition: Oedema
Underweight
 Underweight reflects both wasting and stunting
 Used to monitor/assess child growth in primary health
care systems
 Used to evaluate country progress against the
Millennium Development Goal (MDG) 1 i.e. “Eradicate
extreme poverty and hunger.”
 Characterised by deficits in weight compared to an
individual’s age
Stunting
Stunting
Wasting
Normal
Stunting
‘Hidden Hunger’ (micronutrient
deficiency)
 ‘Hidden hunger’ (micronutrient deficiency)
occurs when people lack one or more essential
micronutrients (vitamins & minerals), even if they
consume adequate amounts of energy and
protein.
 Deficiency starts “sub-clinically”, before visual
presentation: hence ‘hidden’
 Iron, Vitamin A, Iodine and (more recently) Zinc
deficiencies are of global public health significance
 Vitamin C, B3 and B1 deficiencies are associated with
populations suffering reduced access to a varied diet
e.g. IDPs, refugees, etc..
Classification for assessing Severity of Malnutrition
by prevalence ranges among Children under 5
years
Indicator
Severity of Malnutrition by Severity ranges (%)
Low
Medium
High
Very High
Stunting
<20
20-29
30-39
>=40
Underweight
<10
10-19
20-29
>=30
Wasting
<5
5-9
10-14
>=15
Source: WHO
•Simply a starting point for interpretation
•Crucial to put results in context of nutritional risks at time of assessment and
analyse trends, seasonality, “usually observed” rates, etc..
CAUSES OF MALNUTRITION
Food and Nutrition Security Conceptual Framework
EXPOSURE TO SHOCKS AND HAZARDS
Nutrition Status/
Mortality
Individual
Food Intake
Individual
level
Health Status/
Disease
HH level
Context
Household access
To Food
Social and Care
Environment
Access to Health
Care & Health
Environment
Livelihood
Outcomes
Food Availability/
Markets
Political,
Economical,
Institutional,
Security, Social,
Cultural, Gender,
Environment
Agro-ecological
Conditions/
Climate (change)
Livelihood
Strategies
HH Food Production, Income
Generating Activities, Exchange,
Loans, Savings, Transfers
Natural Physical Human
Economic Social
Capital/Assets
Community
HH level
Adapted from UNICEF (1990)
Livelihood
Assets