Nutritional Status Assessment and Analysis

Nutritional status and food security Screen 1 of 21

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.

Nutritional Status Assessment and Analysis

Nutritional status and food security Screen 2 of 21

Introduction

Understanding these factors is essential in order to:

assess malnutrition,

design programmes which tackle nutrition

problems, and

correctly inform programme management

and evaluation.

What are the factors affecting an individual’s nutritional status?

Nutritional Status Assessment and Analysis

Nutritional status and food security Screen 3 of 21

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.

Nutritional Status Assessment and Analysis

Nutritional status and food security Screen 4 of 21

What is malnutrition?

A distinction must be made between Malnutrition and Undernutrition:

It arises either:

from deficiencies or excesses of specific nutrients, or

from undiversified diets (wrong kinds or proportions of foods).

It is the outcome of insufficient food.

It is caused primarily by an inadequate intake of dietary or food

energy.

Malnutrition

Undernutrition

Nutritional Status Assessment and Analysis

Nutritional status and food security Screen 5 of 21

In many developing countries, under and overnutrition are

occurring simultaneously among different population groups.

What is malnutrition?

This phenomenon is referred to as the “double burden” of malnutrition.

Nutritional Status Assessment and Analysis

Nutritional status and food security Screen 6 of 21

Causes of malnutrition

However, overnutrition and dietary imbalances cut across many socio-economic boundaries.

Poverty is the root cause of malnutrition.

(The underlying causes are food security, health and care).

Nutritional Status Assessment and Analysis

Nutritional status and food security Screen 7 of 21

The most important factors can be grouped under these broad categories:

Causes of malnutrition

FOOD HEALTH CARE

Nutritional status is influenced by multiple and interrelated factors.

Nutritional Status Assessment and Analysis

Nutritional status and food security Screen 8 of 21

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.

Causes of malnutrition

Nutritional Status Assessment and Analysis

Nutritional status and food security Screen 9 of 21

Conceptual frameworks

This is the most commonly used framework for understanding the causes of malnutrition.

(adapted from the UNICEF conceptual framework).

Nutritional Status Assessment and Analysis

Nutritional status and food security Screen 10 of 21

Another conceptual framework for malnutrition:

the Food Insecurity and Vulnerability Mapping System (FIVIMS) framework for food security, livelihoods and nutrition.

Socio-economic and political environment

Performance of the food economy:

• availability

• access

• stability

Care practices

Health and sanitation

Nutritional status

Food consumption

Food utilization

Conceptual frameworks

Nutritional Status Assessment and Analysis

Nutritional status and food security Screen 11 of 21

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...

Nutritional Status Assessment and Analysis

Nutritional status and food security Screen 12 of 21

Nutritional and health status

NUTRITIONAL STATUS

HEALTH STATUS

This can eventually lead to severe malnutrition and death.

Nutrition and health are closely linked:

disease contributes to malnutrition

while malnutrition makes an individual more susceptible to disease.

Nutritional Status Assessment and Analysis

Nutritional status and food security Screen 13 of 21

Nutritional and health status

INADEQUATE DIETARY INTAKE

Weight loss, growth faltering and reduced immunity, which lower the

body’s ability to resist infection.leads to

this causes

Longer, more severe and more frequent disease episodes.

Loss of appetite, malabsorption of nutrients,

altered metabolism and increased nutrient needs.

leads to

this results in

This ‘vicious cycle’ is known as the “malnutrition-infection cycle”:

Nutritional Status Assessment and Analysis

Nutritional status and food security Screen 14 of 21

Certain diseases are particularly frequent causes of poor growth, for example:

diarrhoea,

respiratory infections,

HIV/AIDS and

malaria.

Nutritional and health status

Nutritional Status Assessment and Analysis

Nutritional status and food security Screen 15 of 21

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.

Nutritional Status Assessment and Analysis

Nutritional status and food security Screen 16 of 21

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.

Nutritional status and mortality

NUTRITIONAL STATUS

MORTALITY

Mortality increases exponentially with declining nutritional status.

Consequently, mortality rates cannot be predicted from prevailing rates of malnutrition.

Nutritional Status Assessment and Analysis

Nutritional status and food security Screen 17 of 21

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.

NUTRITIONAL STATUS

LOW BIRTH WEIGHT

Nutritional status and low birth weight

The most significant cause is poor maternal nutrition.

Nutritional Status Assessment and Analysis

Nutritional status and food security Screen 18 of 21

The cycle of poor nutrition perpetuates itself across generations.

This diagram by the Standing Committee on Nutrition shows the intergenerational cycle of growth failure:

Child growth failure Low

weight and

height in teenagersSmall adult

woman

Early pregnancy

Low birth

weight baby

Nutritional status and low birth weight

Nutritional Status Assessment and Analysis

Nutritional status and food security Screen 19 of 21

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.

Nutritional Status Assessment and Analysis

Nutritional status and food security Screen 20 of 21

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

Nutritional Status Assessment and Analysis

Nutritional status and food security Screen 21 of 21

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

If you want to know more...