Nutritional Status Assessment and Analysis
Nutritional status and food security
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Learning objectives
At the end of this lesson you will be able to:
define the concept of malnutrition;
identify the factors influencing nutritional status; and
be aware of the relationships between nutrition, food security,
health and mortality.
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Introduction
What are the factors affecting
an individual’s nutritional status?
Understanding these factors is essential in
order to:
assess malnutrition,
design programmes which tackle nutrition
problems, and
correctly inform programme management
and evaluation.
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What is malnutrition?
The term malnutrition indicates a bad nutritional status.
Nutritional status is the physiological state of an individual,
which results from:
the relationship between nutrient intake and requirements, and
the body’s ability to digest, absorb and use these nutrients.
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What is malnutrition?
A distinction must be made between Malnutrition and Undernutrition:
It arises either:
Malnutrition
from deficiencies or excesses of
specific nutrients, or
from undiversified diets (wrong
kinds or proportions of foods).
It is the outcome of insufficient food.
Undernutrition
It is caused primarily by an
inadequate intake of dietary or food
energy.
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What is malnutrition?
In many developing countries,
under and overnutrition are
occurring simultaneously among
different population groups.
This phenomenon is referred to as the
“double burden” of malnutrition.
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Causes of malnutrition
Poverty is the root cause of
malnutrition.
(The underlying causes are food
security, health and care).
However, overnutrition and dietary
imbalances cut across many socioeconomic boundaries.
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Causes of malnutrition
Nutritional status is influenced by
multiple and interrelated factors.
The most important factors can be grouped under these broad
categories:
FOOD
HEALTH
CARE
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Causes of malnutrition
Food, health and care are interrelated:
actions affecting one area may have significant
consequences on another.
Development policies usually are not
included in the domain of nutrition as such.
However, they impact considerably on the
nutritional well-being of the population.
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Conceptual frameworks
This is the most
commonly used
framework for
understanding
the causes of
malnutrition.
(adapted from
the UNICEF
conceptual
framework).
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Conceptual frameworks
Another conceptual framework for malnutrition:
the Food Insecurity and Vulnerability Mapping System
(FIVIMS) framework for food security, livelihoods and nutrition.
Care practices
Socio-economic
and political
environment
Performance of the
food economy:
Food
consumption
• availability
Nutritional
status
• access
• stability
Health and
sanitation
Food
utilization
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Nutritional status, health, mortality and low birth weight
It is important to consider the relationships between nutritional status
and health status, mortality and low birth weight.
NUTRITIONAL STATUS
HEALTH STATUS
NUTRITIONAL
STATUS
MORTALITY
NUTRITIONAL
STATUS
LOW BIRTH WEIGHT
Let’s see these relationships more in detail...
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Nutritional and health status
Nutrition and health are closely linked:
NUTRITIONAL STATUS
disease contributes to malnutrition
HEALTH STATUS
while malnutrition makes an individual
more susceptible to disease.
This can eventually lead to severe
malnutrition and death.
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Nutritional and health status
This ‘vicious cycle’ is known as the “malnutrition-infection cycle”:
INADEQUATE
DIETARY
INTAKE
leads to
Weight loss, growth faltering and
reduced immunity, which lower the
body’s ability to resist infection.
this causes
this results in
Loss of appetite,
malabsorption of nutrients,
altered metabolism and
increased nutrient needs.
leads to
Longer, more severe
and more frequent
disease episodes.
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Nutritional and health status
Certain diseases are particularly frequent
causes of poor growth, for example:
diarrhoea,
respiratory infections,
HIV/AIDS and
malaria.
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Nutritional and health status
The relationship between nutrition and disease can be
observed in the seasonal changes in nutritional status.
Many communities experience periods in
the year when malnutrition levels are
higher. These are influenced by seasonal
patterns such as:
cropping patterns,
food availability,
disease,
child care,
income sources,
price of foods,
labour demand.
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Nutritional status and mortality
Mortality increases exponentially with
declining nutritional status.
NUTRITIONAL STATUS
MORTALITY
Many factors that impact mortality are
often compromised in situations of
conflict and displacement.
In emergencies there may be varying
levels of mortality associated with the
same level of malnutrition.
Consequently, mortality rates cannot be
predicted from prevailing rates of
malnutrition.
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Nutritional status and low birth weight
NUTRITIONAL STATUS
LOW BIRTH WEIGHT
It is estimated that each year 24 million
babies are born with low birth weight
(LBW)-less than 2.5 kg.
Ninety five percent of these events occur
in developing countries.
The most significant cause is poor
maternal nutrition.
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Nutritional status and low birth weight
The cycle of poor nutrition perpetuates itself across generations.
This diagram by the Standing Committee on Nutrition shows the
intergenerational cycle of growth failure:
Low
birth
weight
baby
Child growth
failure
Early
pregnancy
Small adult
woman
Low
weight
and
height in
teenagers
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Summary
Malnutrition refers to all deviations from adequate nutrition, including
undernutrition (and overnutrition) resulting from inadequacy (or excess)
of food.
Malnutrition carries heavy human and economic costs on individuals
and households, communities and nations. Malnutrition and
undernutrition are often used as synonyms. However, a clear distinction
needs to be made at all times.
The co-existence of undernutrition, micronutrient deficiencies,
overweight/obesity and other nutrition-related chronic diseases occurs in
the same countries, in the same communities and even in the same
households throughout the world today, posing one of the greatest
challenges to national policy makers. This phenomenon is referred to as
the “double burden” of malnutrition.
Even if poverty is the root cause of undernutrition, malnutrition has
multiple and interrelated causes. The direct causes of malnutrition can
be grouped under the broad categories of: food, health and care.
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If you want to know more...
Nutrition and development: a global challenge - adapted from Nutrition and
development - a global assessment, written by FAO and WHO for the International
Conference on Nutrition, 1992.
United Nations Standing Committee on Nutrition/Administrative
Committee on Coordination (ACC/SCN) Second report on the World Nutrition
Situation: Vol.1: Global and Regional Results, ACC/SCN Geneva, 1992.
The double burden of malnutrition – Case studies from six developing
countries. FAO Food and Nutrition Paper 84, Rome 2006.
http://www.fao.org/docrep/009/a0442e/a0442e00.htm
Measurement and Assessment of Food Deprivation and Undernutrition FIVIMS Proceedings, International Scientific Symposium held in FAO, Rome 26-28
June 2002. FAO 2003. http://www.fao.org/DOCREP/005/Y4249E/Y4249E00.HTM
Conducting small-scale nutrition surveys: A field manual. FAO, 1990, 186p,
English, Spanish, French ISBN 202851.
http://www.fao.org/docrep/009/a0442e/a0442e00.htm#Contents
Body mass index - A measure of chronic energy deficiency in adults. FAO
Food and Nutrition Paper 56, 1994.
http://www.fao.org/docrep/T1970E/T1970E00.htm
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If you want to know more...
United Nations Standing Committee on Nutrition Issue No. 33 Diet-related
Chronic Diseases and the Double Burden of Malnutrition in West Africa, 2006,
pages 18-20.
http://www.unsystem.org/scn/Publications/SCNNews/scnnews33.pdf.
Incorporating Nutrition Considerations into Development Policies and
Programmes: Brief for Policy-Makers and Programme Planners in Developing
Countries, FAO 2004. http://www.fao.org/docrep/007/y5343e/y5343e00.htm
The State of Food Insecurity in the World (SOFI): monitoring progress
towards the World Food Summit and Millennium Development Goals (FAO-SOFI,
2004)
http://www.fao.org/docrep/007/y5650e/y5650e00.htm