MALNUTRITION

S.OVIYADHARSHINI
XI-A
11A12
CONTENTS

1
AIM
THEORY
INTRODUCTION
HISTORY
EFFECT
SYMPTOMS
CAUSES
PREVENTION
TREATMENT
CONCLUSION

2
 MALNUTRITION
Aim:
This project is about Malnutrition. Every living organism
needs food for its sustenance on earth, which is very important
for carrying out its mentally and physically related activities,
development and growth. Man needs such nutritional
requirements such as sugars, proteins, carbohydrates, vitamins,
nutrients, starch, and water in the proper proportion and
adequate quantity for natural progress and expansion that he
gets from the food he consumes. A healthy diet is considered a
meal that contains all these important nutrients in the right
proportions.

Theory: 
The loss or even imbalance of any of these in the diet of
individual results in eating disorders, which can be collectively
considered Malnutritional disorders. Malnutrition is the disease
in which persons become poor and ill due to inadequate and
unbalanced nutrition. Due to hunger, lack of schooling,
misinformation and regular pregnancies, a substantial number of
individuals in our nation and other developing nations suffer from
malnutrition.

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INTRODUCTION:
Malnutrition is a condition that results from eating a diet which does
not supply a healthy amount of one or more nutrients. This includes
diets that have too little nutrients or so many that the diet causes
health problems. The nutrients involved can
include calories, protein, carbohydrates, fat, vitamins or minerals. A
lack of nutrients is called under nutrition or undernourishment while a
surplus of nutrients cases overnutrition. Malnutrition is most often
used to refer to undernutrition - when an individual is not getting
enough calories, protein, or micronutrients. If undernutrition occurs
during pregnancy, or before two years of age, it may result in
permanent problems with physical and mental development. Extreme
undernourishment, known as starvation or chronic hunger, may have
symptoms that include: a short height, thin body, very poor energy
levels, and swollen legs and abdomen. Those who are malnourished
often get infections and are frequently cold.The symptoms
of micronutrient deficiencies depend on the micronutrient that is
lacking.
Undernourishment is most often due to a lack of access to high-quality,
nutritous food. This is often related to high food prices and poverty. A
lack of breastfeeding may contribute to undernourishment. Infectious
diseases such as gastroenteritis, pneumonia, malaria, and measles,
which increase nutrient requirements, can also cause malnutrition.
There are two main types of undernourishment: protein-energy
malnutrition and dietary deficiencies. Protein-energy malnutrition has
two severe forms: kwashiorkor (a lack of protein) and marasmus (a lack
of protein and calories). Common micronutrient deficiencies include a
lack of iron, iodine, and vitamin A. Deficiencies may become more
4
common during pregnancy, due to the body's increased need of
nutrients. In some developing countries, overnutrition, in the form
of obesity is beginning to appear within the same communities as
undernutrition. This is because the food that is often available is not
healthy. Other causes of malnutrition include an orexia
nervosa and bariatric surgery.
Efforts to improve nutrition are some of the common forms
of development aid. Breastfeeding is often promoted, in order to
reduce rates of malnutrition and death in children, and some efforts to
promote the practice have been successful. In young children, providing
food (in addition to breast milk) between six months and two years of
age improves outcomes. There is also good evidence supporting
the supplementation of a number of micronutrients to women during
pregnancy and young children in the developing world. Sending food
and money is a common form of development aid, aimed at helping
people in need to obtain food. Some strategies help people buy food
within local markets. Simply feeding students at school is
insufficient. Management of severe malnutrition within the person's
home with ready-to-use therapeutic foods is possible much of the
time. In those who have severe malnutrition complicated by other
health problems, treatment in a hospital setting is recommended. This
often involves managing low blood sugar and body temperature,
addressing dehydration, and gradual feeding. Routine antibiotics are
usually recommended due to the high risk of infection. Longer-term
measures include: improving agricultural practices, reducing poverty
and improving sanitation.
In 2018, There were 821 million undernourished people in the world
(10.8% of the total population).This is a reduction of about 176 million

5
people since 1990 when 23% of the world were undernourished.
However, there has been an increase of hunger since 2015, when about
795 million, or 10.6%, were undernourished. In 2012, it was estimated
that another billion people had a lack of vitamins, and minerals. In
2015, protein-energy malnutrition was estimated to have resulted in
323,000 deaths—down from 510,000 deaths in 1990. Other nutritional
deficiencies, which include iodine deficiency and iron deficiency
anemia, resulted in another 83,000 deaths.In 2010, malnutrition was
the cause of 1.4% of all disability adjusted life years. About a third of
deaths in children are believed to be due to undernutrition, although
the deaths are rarely labelled as such.] In 2010, it was estimated to have
contributed to about 1.5 million deaths in women and children, though
some estimate the number may be greater than 3 million. An additional
165 million children were estimated to have stunted growth from
malnutrition in 2013. Undernutrition is more common in developing
countries. Certain groups have higher rates of undernutrition, including
women—in particular while pregnant or breastfeeding—children under
five years of age, and the elderly. In the elderly, undernutrition is more
commonly due to physical, psychological, and social factors, not a lack
of food.
Reducing malnutrition is key part of Sustainable Development Goal
2 (SDG2) "Zero hunger" with a malnutrition target alongside reducing
under nutrition and stunted child growth. According to the World Food
Programme (WFP) 135 million suffer from acute hunger,[27] largely due
to manmade conflicts, climate changes, and economic
downturns. COVID-19 could double the number of people at risk of
suffering acute hunger by the end of 2020.

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HISTORY:
While hunger has been a perennial human problem, there was
relatively little awareness of the qualitative aspects of malnutrition until
the early 20th century. Throughout history, various peoples have
known the importance of eating certain foods to prevent the outbreak
of symptoms now associated with malnutrition. Yet such knowledge
appears to have been repeatedly lost and then re-discovered. For
example, the symptoms of scurvy were reportedly known to the
ancient Egyptians. Anti-scurvy measures were sometimes undertook by
14th century Crusaders, who would ensure that citrus fruits were
planted on Mediterranean islands, for use on sea journeys. Knowledge
of the importance of such measures appears to have been forgotten by
Europeans for several centuries, to be rediscovered in the 18th century.
In the early 19th century the British navy ensured their ship's crews
were given frequent rations of lemon juice, massively reducing deaths
from scurvy and giving the British a significant advantage in
the Napoleonic wars. Later in the 19th century, the British navy
replaced lemons with limes, not aware at the time that limes were
much less effective than lemons at preventing scurvy.
According to historian Michael Worboys, it was between the wars that
malnutrition was essentially discovered, and the science of nutrition
established. This built on work such as Casimir Funk's 1912
formulisation of the concept of vitamins. There was increased scientific
study of malnutrition in the 1920s and 1930s, and this became even
more pronounced after world war 2. Charities and United Nations
agencies would devote considerable energy to alleviating malnutrition
around the world. The exact methods and priorities for doing this
tended to fluctuate over the years, with varying levels of focus on

7
different types of malnutrition like Kwashiorkor or Marasmus; varying
levels of concern on protein deficiency compared to vitamins, minerals
and lack of raw calories; and varying priorities given to the problem of
malnutrition in general compared to other health and development
concerns. The green Revolution of the 1950s and 1960s saw
considerable improvement in capability to prevent malnutrition.
One of the first official global documents addressing Food security and
global malnutrition was the 1948 Universal Declaration of Human
Rights(UDHR). Within this document it stated that access to food was
part of an adequate right to a standard of living. The Right to food was
asserted in the International Covenant on Economic, Social and Cultural
Rights, a treaty adopted by the United Nations General Assembly on
December 16, 1966. The Right to food is a human right for people to
feed themselves in dignity, be free from hunger, food insecurity, and
malnutrition. As of 2018, the treaty has been signed by 166 countries,
by signing states agreed to take steps to the maximum of their available
resources to achieve the right to adequate food.
However, after the 1966 International Covenant the global concern for
the access to sufficient food only became more present, leading to the
first ever World Food Conference that was held in 1974 in Rome, Italy.
The Universal Declaration on the Eradication of Hunger and
Malnutrition was a UN resolution adopted November 16, 1974 by all
135 countries that attended the 1974 World Food Conference. This
non-legally binding document set forth certain aspirations for countries
to follow to sufficiently take action on the global food problem.
Ultimately this document outline and provided guidance as to how the
international community as one could work towards fighting and
solving the growing global issue of malnutrition and hunger.

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Adoption of the right to food was included in the Additional Protocol to
the American Convention on Human Rights in the area of Economic,
Social, and Cultural Rights, this 1978 document was adopted by many
countries in the Americas, the purpose of the document is, "to
consolidate in this hemisphere, within the framework of democratic
institutions, a system of personal liberty and social justice based on
respect for the essential rights of man."
A later document in the timeline of global inititaves for malnutrition
was the 1996 Rome Declaration on World Food Security, organized by
the Food and Agriculture Organization. This document reaffirmed the
right to have access to safe and nutritious food by everyone, also
considering that everyone gets sufficient food, and set the goals for all
nations to improve their commitment to food security by halving their
amount of undernourished people by 2015. In 2004 the Food and
Agriculture Organization adopted the Right to Food Guidelines, which
offered states a framework of how to increase the right to food on a
national basis.

EFFECTS OF MALNUTRITION:

Malnutrition increases the risk of infection and infectious

disease, and moderate malnutrition weakens every part of the
immune system.[44] For example, it is a major risk factor in the
onset of active tuberculosis. Protein and energy malnutrition
and deficiencies of specific micronutrients (including iron, zinc,
and vitamins) increase susceptibility to infection. Malnutrition
affects HIV transmission by increasing the risk of transmission

9
from mother to child and also increasing replication of the
virus. In communities or areas that lack access to safe drinking
water, these additional health risks present a critical problem.
Lower energy and impaired function of the brain also represent
the downward spiral of malnutrition as victims are less able to
perform the tasks they need to in order to acquire food, earn
an income, or gain an education.
Vitamin-deficiency-related diseases (such as scurvy and rickets).
Hypoglycemia (low blood sugar) can result from a child not
eating for 4 to 6 hours. Hypoglycemia should be considered if
there is lethargy, limpness, convulsion, or loss of consciousness.
If blood sugar can be measured immediately and quickly,
perform a finger or heel stick.

SYMPTOMS:

In those with malnutrition some of the signs of dehydration

differ. Children; however, may still be interested in drinking,
have decreased interactions with the world around them, have
decreased urine output, and may be cool to touch.

Site SYMPTOMS

Face Moon face (kwashiorkor), simian facies (marasmus)

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 Dry eyes, pale conjunctiva, Bitot's spots (vitamin A),
Eye
periorbital edema

Angular stomatitis, cheilitis, glossitis, spongy bleeding

Mouth
gums (vitamin C), parotid enlargement

Teeth Enamel mottling, delayed eruption

Dull, sparse, brittle hair, hypopigmentation, flag sign

(alternating bands of light and normal color),
Hair
broomstick eyelashes, alopecia, and overall thinning of
the hair follicles

Loose and wrinkled (marasmus), shiny and edematous

(kwashiorkor), dry, follicular hyperkeratosis, patchy
Skin
hyper- and hypopigmentation, erosions, poor wound
healing

Nail Koilonychia, thin and soft nail plates, fissures or ridges

Musculature Muscles wasting, particularly in the buttocks and thighs

Deformities usually a result of calcium, vitamin D, or

Skeletal
vitamin C deficiencies

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 Distended – hepatomegaly with fatty liver, ascites may
Abdomen
be present

Bradycardia, hypotension, reduced cardiac output,

Cardiovascular
small vessel vasculopathy

Global development delay, loss of knee and ankle

Neurologic
reflexes, poor memory

Hematological Pallor, petechiae, bleeding diathesis

Behavior Lethargic, apathetic, anxious

CAUSES OF MALNUTRITIONS:

Major causes of malnutrition include poverty and food prices, dietary

practices and agricultural productivity, with many individual cases being
a mixture of several factors. Clinical malnutrition, such as cachexia, is a
major burden also in developed countries. Various scales of analysis
also have to be considered in order to determine the sociopolitical
causes of malnutrition. For example, the population of a community
that is within poor government , may be at risk if the area lacks health-
related services, but on a smaller scale certain households or
individuals may be at an even higher risk due to differences in income
levels, access to land, or levels of education.
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Diseases
Malnutrition can be a consequence of health issues such
as gastroenteritis or chronic illness, especially the HIV/AIDS
pandemic.] Diarrhea and other infections can cause malnutrition
through decreased nutrient absorption, decreased intake of food,
increased metabolic requirements, and direct nutrient loss. Parasite
infections, in particular intestinal worm infections (helminthiasis), can
also lead to malnutrition. A leading cause of diarrhea and intestinal
worm infections in children in developing countries is lack
of sanitation and hygiene.
People may become malnourished due to abnormal nutrient loss (due
to diarrhea or chronic illness affecting the small bowel). This conditions
may include Crohn's disease or untreated coeliac disease. Malnutrition
may also occur due to increased energy expenditure (secondary
malnutrition).
Dietary practices

Undernutrition
A lack of adequate breastfeeding leads to malnutrition in infants and
children, associated with the deaths of an estimated one million
children annually. Illegal advertising of breast milk substitutes
contributed to malnutrition and continued three decades after its 1981
prohibition under the WHO International Code of Marketing Breast Milk
Substitutes.
Maternal malnutrition can also factor into the poor health or death of a
baby. Over 800,000 neonatal deaths have occurred because of deficient
growth of the fetus in the mother's womb

13
Deriving too much of one's diet from a single source, such as eating
almost exclusively corn or rice, can cause malnutrition. This may either
be from a lack of education about proper nutrition, or from only having
access to a single food source.
It is not just the total amount of calories that matters but specific
nutritional deficiencies such as vitamin A deficiency, iron
deficiency or zinc deficiency can also increase risk of death.
Overnutrition.
Overnutrition caused by overeating is also a form of malnutrition. In the
United States, more than half of all adults are now overweight—a
condition that, like hunger, increases susceptibility to disease and
disability, reduces worker productivity, and lowers life expectancy.
Overeating is much more common in the United States, where for the
majority of people, access to food is not an issue. Many parts of the
world have access to a surplus of non-nutritious food, in addition to
increased sedentary lifestyles. Yale psychologist Kelly Brownell calls this
a "toxic food environment" where fat and sugar laden foods have taken
precedence over healthy nutritious foods.
The issue in these developed countries is choosing the right kind of
food. More fast food is consumed per capita in the United States than
in any other country. The reason for this mass consumption of fast food
is its affordability and accessibility. Often fast food, low in cost and
nutrition, is high in calories and heavily promoted. When these eating
habits are combined with increasingly urbanized, automated, and more
sedentary lifestyles, it becomes clear why weight gain is difficult to
avoid.

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Not only does obesity occur in developed countries, problems are also
occurring in developing countries in areas where income is on the rise.
Overeating is also a problem in countries where hunger and poverty
persist. In China, consumption of high-fat foods has increased while
consumption of rice and other goods has decreased.Overeating leads to
many diseases, such as heart disease and diabetes, that may result in
death.
Poverty and food prices

A child with extreme malnutrition

In Bangladesh, poor socioeconomic position was associated with

chronic malnutrition since it inhibits purchase of nutritious foods such
as milk, meat, poultry, and fruits. As much as food shortages may be a
contributing factor to malnutrition in countries with lack of technology,
the FAO (Food and Agriculture Organization) has estimated that eighty
percent of malnourished children living in the developing world live in
countries that produce food surpluses. The economist Amartya
Sen observed that, in recent decades, famine has always been a
problem of food distribution and/or poverty, as there has been
sufficient food to feed the whole population of the world. He states

15
that malnutrition and famine were more related to problems of food
distribution and purchasing power.
It is argued that commodity speculators are increasing the cost of food.
As the real estate bubble in the United States was collapsing, it is said
that trillions of dollars moved to invest in food and primary
commodities, causing the 2007–2008 food price crisis.]
The use of biofuels as a replacement for traditional fuels raises the
price of food. The United Nations special rapporteur on the right to
food, Jean Ziegler proposes that agricultural waste, such as corn cobs
and banana leaves, rather than crops themselves be used as fuel.
Agricultural productivity
Local food shortages can be caused by a lack of arable land, adverse
weather, lower farming skills such as crop rotation, or by a lack of
technology or resources needed for the higher yields found in
modern agriculture, such as fertilizers, pesticides, irrigation, machinery
and storage facilities. As a result of widespread poverty, farmers cannot
afford or governments cannot provide the resources necessary to
improve local yields. The World Bank and some wealthy donor
countries also press nations that depend on aid to cut or eliminate
subsidized agricultural inputs such as fertilizer, in the name of free
market policies even as the United States and Europe extensively
subsidized their own farmers. Many, if not most, farmers cannot afford
fertilizer at market prices, leading to low agricultural production and
wages and high, unaffordable food prices. Reasons for the unavailability
of fertilizer include moves to stop supplying fertilizer
on environmental grounds, cited as the obstacle to feeding Africa by
the Green Revolution pioneers Norman Borlaug and Keith Rosenberg.

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Future threats
There are a number of potential disruptions to global food supply that
could cause widespread malnutrition.
Global warming is of importance to food security, with 95 percent of all
malnourished peoples living in the relatively stable climate region of
the sub-tropics and tropics. According to the latest IPCC reports,
temperature increases in these regions are "very likely." Even small
changes in temperatures can lead to increased frequency of extreme
weather conditions. Many of these have great impact on agricultural
production and hence nutrition. For example, the 1998–2001 central
Asian drought brought about an 80 percent livestock loss and 50
percent reduction in wheat and barley crops in Iran. Similar figures
were present in other nations. An increase in extreme weather such as
drought in regions such as Sub-Saharan Africa would have even greater
consequences in terms of malnutrition. Even without an increase of
extreme weather events, a simple increase in temperature reduces the
productivity of many crop species, also decreasing food security in
these regions.
Colony collapse disorder is a phenomenon where bees die in large
numbers. Since many agricultural crops worldwide are pollinated by
bees, this represents a threat to the supply of food.

PREVENTION:

Food security;
17
The effort to bring modern agricultural techniques found in the West,
such as nitrogen fertilizers and pesticides, to Asia, called the Green
Revolution, resulted in increased food production and corresponding
decreases in prices and malnutrition similar to those seen earlier in
Western nations. This was possible because of existing infrastructure
and institutions that are in short supply in Africa, such as a system of
roads or public seed companies that made seeds available.
[78]
 Investments in agriculture, such as subsidized fertilizers and seeds,
increases food harvest and reduces food prices. For example, in the
case of Malawi, almost five million of its 13 million people used to need
emergency food aid. However, after the government changed policy
and subsidies for fertilizer and seed were introduced against World
Bank strictures, farmers produced record-breaking corn harvests as
production leaped to 3.4 million in 2007 from 1.2 million in 2005,
making Malawi a major food exporter.[70] This lowered food prices and
increased wages for farm workers.[70] Such investments in agriculture
are still needed in other African countries like the Democratic Republic
of the Congo. The country has one of the highest prevalence of
malnutrition even though it is blessed with great agricultural potential
John Ulimwengu explains in his article for D+C.[80] Proponents for
investing in agriculture include Jeffrey Sachs, who has championed the
idea that wealthy countries should invest in fertilizer and seed for
Africa's farmers.[70][81]
In Nigeria, the use of imported Ready to Use Therapeutic Food (RUTF)
has been used to treat malnutrition in the North. Soy Kunu, a locally
sourced and prepared blend consisting of peanut, millet and soya beans
may also be used.[82]

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New technology in agricultural production also has great potential to
combat undernutrition.[83] By improving agricultural yields, farmers
could reduce poverty by increasing income as well as open up area for
diversification of crops for household use. The World Bank itself claims
to be part of the solution to malnutrition, asserting that the best way
for countries to succeed in breaking the cycle of poverty and
malnutrition is to build export-led economies that will give them the
financial means to buy foodstuffs on the world market.

Economics[edit]
There is a growing realization among aid groups that giving cash or cash
vouchers instead of food is a cheaper, faster, and more efficient way to
deliver help to the hungry, particularly in areas where food is available
but unaffordable.[84] The UN's World Food Program, the biggest non-
governmental distributor of food, announced that it will begin
distributing cash and vouchers instead of food in some areas, which
Josette Sheeran, the WFP's executive director, described as a
"revolution" in food aid.[84][85] The aid agency Concern Worldwide is
piloting a method through a mobile phone operator, Safaricom, which
runs a money transfer program that allows cash to be sent from one
part of the country to another.[84]
However, for people in a drought living a long way from and with
limited access to markets, delivering food may be the most appropriate
way to help.[84] Fred Cuny stated that "the chances of saving lives at the
outset of a relief operation are greatly reduced when food is imported.
By the time it arrives in the country and gets to people, many will have
died."[86] U.S. law, which requires buying food at home rather than
where the hungry live, is inefficient because approximately half of what

19
is spent goes for transport.[87] Cuny further pointed out "studies of every
recent famine have shown that food was available in-country—though
not always in the immediate food deficit area" and "even though by
local standards the prices are too high for the poor to purchase it, it
would usually be cheaper for a donor to buy the hoarded food at the
inflated price than to import it from abroad."[88]

A soup kitchen in Montreal, Quebec, Canada in 1931.

Food banks and soup kitchens address malnutrition in places where

people lack money to buy food. A basic income has been proposed as a
way to ensure that everyone has enough money to buy food and other
basic needs; it is a form of social security in which all citizens or
residents of a country regularly receive an unconditional sum of money,
either from a government or some other public institution, in addition
to any income received from elsewhere.[89]
Ethiopia has been pioneering a program that has now become part of
the World Bank's prescribed method for coping with a food crisis and
had been seen by aid organizations as a model of how to best help
hungry nations. Through the country's main food assistance program,
the Productive Safety Net Program, Ethiopia has been giving rural
residents who are chronically short of food, a chance to work for food
or cash. Foreign aid organizations like the World Food Program were
then able to buy food locally from surplus areas to distribute in areas
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with a shortage of food.[90] Ethiopia been pioneering a program, and
Brazil has established a recycling program for organic waste that
benefits farmers, urban poor, and the city in general. City residents
separate organic waste from their garbage, bag it, and then exchange it
for fresh fruit and vegetables from local farmers. As a result, the
country's waste is reduced and the urban poor get a steady supply of
nutritious food.[64]

World population[edit]
Restricting population size is a proposed solution. Thomas
Malthus argued that population growth could be controlled by natural
disasters and voluntary limits through "moral restraint."[91] Robert
Chapman suggests that an intervention through government policies is
a necessary ingredient of curtailing global population growth. [92] The
interdependence and complementarity of population growth with
poverty and malnutrition (as well as the environment) is also
recognised by the United Nations.[93] More than 200 million women
worldwide do not have adequate access to family planning services.
According to the World Health Organisation, "Family planning is key to
slowing unsustainable population growth and the resulting negative
impacts on the economy, environment, and national and regional
development efforts".[94]
However, there are many who believe that the world has more than
enough resources to sustain its population. Instead, these theorists
point to unequal distribution of resources and under- or unutilized
arable land as the cause for malnutrition problems.[95][96] For example,
Amartya Sen advocates that, "no matter how a famine is caused,
methods of breaking it call for a large supply of food in the public

21
distribution system. This applies not only to organizing rationing and
control, but also to undertaking work programmes and other methods
of increasing purchasing power for those hit by shifts in exchange
entitlements in a general inflationary situation."[66]

Food sovereignty[edit]
Main article: Food sovereignty
One suggested policy framework to resolve access issues is
termed food sovereignty—the right of peoples to define their own
food, agriculture, livestock, and fisheries systems, in contrast to having
food largely subjected to international market forces. Food First is one
of the primary think tanks working to build support for food
sovereignty. Neoliberals advocate for an increasing role of the free
market.

Health facilities[edit]
Another possible long-term solution would be to increase access to
health facilities to rural parts of the world. These facilities could
monitor undernourished children, act as supplemental food distribution
centers, and provide education on dietary needs. These types of
facilities have already proven very successful in countries such as Peru
and Ghana.[97][98]

Breastfeeding[edit]
As of 2016 is estimated that about 823,000 deaths of children less than
five years old could be prevented globally per year through more
widespread breastfeeding.[99] In addition to reducing infant death, breast
milk feeding provides an important source of micronutrients, clinically
proven to bolster the immune system of children, and provide long-

22
term defenses against non-communicable and allergic diseases.
[100]
 Breastfeeding has also been shown to improve cognitive abilities in
children, with a strong correlation to individual educational
achievements.[100][101] As previously noted, lack of proper breastfeeding is
a major factor in child mortality rates, and a primary determinant of
disease development for children. The medical community
recommends exclusively breastfeeding infants for 6 months, with
nutritional whole food supplementation and continued breastfeeding
up to 2 years or older for overall optimal health outcomes.[101][102]
[103]
 Exclusive breastfeeding is defined as only giving an infant breast milk
for six months as a source of food and nutrition.[101][103] This means no
other liquids, including water or semi-solid foods.[103]
Barriers to breastfeeding[edit]
Breastfeeding is noted as one of the most cost effective medical
interventions for providing beneficial child health.[102] While there are
considerable differences within developed and developing countries:
income, employment, social norms, and access to healthcare were
found to be universal determinants of whether a mother breast or
formula fed her children.[101][102] Community based healthcare workers
have helped alleviate financial barriers faced by newly made mothers,
and provided a viable alternative to traditional and expensive hospital
based medical care.[101] Recent studies based upon surveys conducted
from 1995 to 2010 shows exclusive breastfeeding rates have gone up
globally, from 33% to 39%.[103] Despite the growth rates, medical
professionals acknowledge the need for improvement given the
importance of exclusive breastfeeding.[103]

21st century global initiatives[edit]

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There was renewed international media and political attention focused
on malnutrition from about 2009, which resulted in part from issues
caused by spikes in food prices, the 2008 financial crisis, and the then
emergent consensus that interventions against malnutrition were
among the most cost effective ways to contribute to development. This
led to the 2010 launch of the UN's Scaling up Nutrition movement
(SUN).[104]
In April 2012, the Food Assistance Convention was signed, the world's
first legally binding international agreement on food aid. The May
2012 Copenhagen Consensus recommended that efforts to combat
hunger and malnutrition should be the first priority for politicians and
private sector philanthropists looking to maximize the effectiveness of
aid spending. They put this ahead of other priorities, like the fight
against malaria and AIDS.[105]
In June 2015, the European Union and the Bill & Melinda Gates
Foundation have launched a partnership to combat undernutrition
especially in children. The program will initiatilly be implemented in
Bangladesh, Burundi, Ethiopia, Kenya, Laos and Niger and will help
these countries to improve information and analysis about nutrition so
they can develop effective national nutrition policies.[106]
The Food and Agriculture Organization of the UN has created a
partnership that will act through the African Union's CAADP framework
aiming to end hunger in Africa by 2025. It includes different
interventions including support for improved food production, a
strengthening of social protection and integration of the right to food
into national legislation.[107]

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The EndingHunger campaign is an online communication campaign
aimed at raising awareness of the hunger problem. It has many worked
through viral videos depicting celebrities voicing their anger about the
large number of hungry people in the world.
After the Millennium Development Goals expired in 2015, the main
global policy focus to reduce hunger and poverty became
the Sustainable Development Goals. In particular Goal 2: Zero hunger
sets globally agreed targets to end hunger, all forms of malnutrition and
promote sustainable agriculture.[108] The partnership Compact2025, led
by IFPRI with the involvement of UN organisations, NGOs and private
foundations develops and disseminates evidence-based advice to
politicians and other decision-makers aimed at ending hunger and
undernutrition in the coming 10 years, by 2025.

TREATMENT:

In response to child malnutrition, the Bangladeshi

government recommends ten steps for treating severe malnutrition.
They are to prevent or treat dehydration, low blood sugar, low body
temperature, infection, correct electrolyte imbalances and
micronutrient deficiencies, start feeding cautiously, achieve catch-up
growth, provide psychological support, and prepare for discharge and
follow-up after recovery.
Among those who are hospitalized, nutritional support improves
protein, calorie intake and weight.

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Measuring children is crucial to identify malnourished children. Which
is why the IMMPaCt team has created a program that consists of
testing children with a 3D scan using an iPad or tablet. Although, this
might have a chance of error. It would soon help doctors decide on
where to start when it comes to providing more efficient treatments.
A systematic review of 42 studies found that many approaches to
mitigating acute malnutrition show equivalent effectiveness, and thus,
intervention decisions can be based on factors related to cost. The
evidence for the effectiveness of acute malnutrition interventions is
overall not robust. The limited evidence related to cost indicates that
community and out-patient management of children with
uncomplicated malnutrition may be the most cost-effective.

Food
The evidence for benefit of supplementary feeding is poor. This is due
to the small amount of research done on this treatment. A 2015
systematic review of 32 studies found that supplementary feeding of
children under 5 has limited benefits, most significant for younger,
poorer, and more undernourished children.
Specially formulated foods do however appear useful in those from the
developing world with moderate acute malnutrition.] In young children
with severe acute malnutrition it is unclear if ready-to-use therapeutic
food differs from a normal diet. ]They may have some benefits in
humanitarian emergencies as they can be eaten directly from the
packet, do not require refrigeration or mixing with clean water, and can
be stored for years.
In those who are severely malnourished, feeding too much too quickly
can result in refeeding syndrome.[121] This can result regardless of route

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of feeding and can present itself a couple of days after eating with heart
failure, dysrhythmias and confusion that can result in death.[121][122]
Manufacturers are trying to fortify everyday foods with micronutrients
that can be sold to consumers such as wheat flour for Beladi bread in
Egypt or fish sauce in Vietnam and the iodization of salt.[120]
For example, flour has been fortified with iron, zinc, folic acid and other
B vitamins such as thiamine, riboflavin, niacin and vitamin B12.[62]

CONCLUSION:
Malnutrition is an barrier to development, and its
presence indicates that basic physiological needs have not been
met. What is observed as malnutrition is not only the result of
insufficient or inappropriate food, but also a consequence of
other conditions, such as poor water supply and sanitation and
a high prevalence of disease. Thus reversing the procedure is
complex, because many issues need to be addressed more or
less simultaneously. And every situation is different, so that
there is no single solution for all.

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