Malnutrition
| Classification according to ICD-10 | |
|---|---|
| E40 | Kwashiorkor |
| E41 | Alimentary marasmus |
| E42 | Kwashiorkor marasmus |
| E43 | Unspecified significant energy and protein malnutrition |
| E44 | Energy and protein malnutrition of moderate (E44.0) and mild (E44.1) degrees |
| E45 | Delayed development due to energy and protein malnutrition |
| E46 | Unspecified energy and protein malnutrition |
| ICD-10 online (WHO version 2019) | |
Malnutrition is the term used to describe an inadequate or incorrectly composed diet which, unlike a diet, is not prescribed (indicated) by a doctor.
to form
In the case of malnutrition, a basic distinction is made between a quantitative form ( malnutrition ) and a qualitative form (malnutrition), but there are also mixed forms, due to food intolerance or consuming diseases that make nutrition more difficult.
Quantitative malnutrition
- Malnutrition
Malnutrition (quantitative malnutrition) is particularly widespread in developing countries. People's energy needs are not met by food. Malnutrition, especially in childhood, can lead to lagging behind in physical and mental development (retardation), serious illnesses ( dystrophy ) and, in extreme cases, death. As a result, those affected usually suffer from a lack of protein , fat , vitamins and minerals .
In addition, malnutrition due to eating disorders ( anorexia nervosa , bulimia nervosa , orthorexia ) is common in industrialized countries . Older people living alone and patients in old people's and nursing homes as well as the homeless are also at risk.
Jörg Baten , Dorothee Crayen and Hans-Joachim Voth analyzed the long-term effects of malnutrition and in 2014 found not only indications of effects on cognitive (arithmetic) skills, but also on the later employment opportunities of those affected.
Qualitative malnutrition
- Malnutrition
The qualitative malnutrition (also malnutrition) means an undersupply of vitamins and minerals . In children there is a delay in physical and mental development that can be irreparable. Often malnutrition eats too little fruit and vegetables (contains vitamins), dairy products (contain calcium ), sea fish (contains iodine ) and whole grain bread, legumes and potatoes (contain fiber ). Particularly comfortable people or those under time pressure tend to malnutrition with canned or ready-to-eat meals and thus forego a balanced diet if they do not compensate for missing nutritional components in other ways. Malnutrition can lead to frequent infections (runny nose, colds , etc.), constipation, iodine deficiency and bone decalcification ( osteoporosis ). In addition to developing countries, malnutrition often occurs in old people's homes and nursing homes as well as in people living alone ( singles ), in the homeless and in other social poverty.
Dehydration
Dehydration is also a part of malnutrition, i.e. the inadequate balance of fluids in the event of a loss of fluids due to illness or body exhalations (e.g. when sweating). Dehydration can lead to a stroke or anemia and thus death, so it is important to take countermeasures in good time.
Intervention options
- requirements
The person suffering from malnutrition must consent to the intervention. Legal rules must be observed for artificial nutrition during hunger strike and dementia .
Intervention in malnutrition due to a lack of food takes place in developing countries and disaster areas through aid programs such as the United Nations World Food Program .
Intervention in the event of malnutrition can be counteracted through training and education of those affected and, in the case of homes and care facilities, the care staff / management of the home about the imbalance between nutrient intake and nutrient requirement.
- criteria
As a rule of thumb, the body mass index and the guidelines of the German Society for Nutritional Medicine (DGEM) apply: The following guidelines apply to fluid intake: The normal daily requirement of a person is 25 ml / kg. In southern countries and for competitive athletes, an additional 5 ml / kg should be estimated.
In addition to better nutrition with a sufficient supply of energy (calorific value), vitamins and minerals (bulk and trace elements), a study on children in Malawi showed that additional antibiotic therapy improves weight gain and lowers mortality.
risk groups
The risk groups mainly include the poor, the elderly and children.
- poor
Poverty increases the risk of malnutrition.
- Old
Malnutrition in the elderly can have various causes. On the one hand, the sense of taste and smell decrease with age, so that those affected often feel less appetite. In addition, little exercise, little fresh air and a decreased sense of thirst reduce the feeling of hunger. Above all, illnesses and medication can also have a significant impact on appetite. It is so easy for those affected to get into a vicious circle: due to illnesses they eat less, which means that the body lacks nutrients. This in turn increases the susceptibility to disease.
- children
Malnutrition sets in quickly in children because they have very little protein and energy stores. For example, a child weighing 10 kg uses a third of its protein supplies in five days. In the case of an adult, however, the same proportion is only used up after 21 days. In the event of an illness during which the nutrient supply is reduced or interrupted, the loss of nutrients can only be compensated for with the body's reserves to a limited extent and over a comparatively short period of time.
See also
- Cachexia
- Inanition
- Kwashiorkor
- Marasmus
- Starvation metabolism
- German foundation against malnutrition
literature
- Maria Magdalena Schreier, Sabine Bartholomeyczik: Malnutrition in the elderly and in need of care: Causes and prevention from a care perspective. Schlütersche, Hannover 2004, ISBN 3-89993-110-6 .
- JM Bauer, R. Wirth, D. Volker, C. Sieber: Malnutrition, sarcopenia and cachexia around old age - from pathophysiology to therapy. In: German Medical Weekly. Volume 133, 2008, pp. 305-310.
Individual evidence
- ↑ Jörg Baten, Dorothee Crayen, Hans-Joachim Voth: Numeracy and the impact of high food prices in industrializing Britain, 1780-1850. In: Review of Economics and Statistics. 96.3, 2014, pp. 418-430.
- ↑ Forced treatment and force-feeding in inpatient care for the elderly? . Retrieved June 29, 2016.
- ↑ Force- feeding under legal aspects . Archived from the original on June 29, 2016. Retrieved June 29, 22016.
- ↑ Hans-Jürgen Hässler, Christian von Heusinger: Königshausen u. Neumann (Ed.): Culture against War, Science for Peace , ISBN 3-88479-401-9 . therein H. Ziegert, Hamburg, “Development Aid” - Motives, Programs and Reality p. 115 f.
- ↑ a b Specialist portal for nursing professions calculate fluid requirements . Retrieved June 27, 2016.
- ↑ I. Trehan, HS Goldbach, LN LaGrone, GJ Meuli, RJ Wang, KM Maleta, MJ Manary: Antibiotics as Part of the management of severe acute malnutrition. In: N Engl J Med. 2013; 368, pp. 425-435.
- ↑ The Gießen Nutrition Study on the Eating Behavior of Poverty Households (GESA) - qualitative case studies p. 118 f. . Retrieved June 27, 2016.
- ↑ Maria Magdalena Schreier, Sabine Bartholomeyczik: Malnutrition among old people and people in need of care. Causes and prevention from a nursing perspective . Hanover 2004, pp. 32-49.
- ↑ Comprehensive and effective fight against malnutrition in Germany . Retrieved June 27, 2016.
- ↑ Is my child underserved? Nutrini.de, accessed on December 16, 2015
- ↑ Health of children and adolescents in Germany - RKI . Retrieved June 27, 2016.
