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Malnutrition


imageMalnutrition

Malnutrition or malnourishment is a condition that results from eating a diet in which nutrients are either not enough or are too much such that the diet causes health problems. It may involve calories, protein, carbohydrates, vitamins or minerals. Not enough nutrients is called undernutrition or undernourishment while too much is called overnutrition. Malnutrition is often used specifically to refer to undernutrition where there is not 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, may have symptoms that include: a short height, thin body, very poor energy levels, and swollen legs and abdomen. People also 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 not enough high-quality food being available to eat. This is often related to high food prices and poverty. A lack of breastfeeding may contribute, as may a number of infectious diseases such as: gastroenteritis, pneumonia, malaria, and measles, which increase nutrient requirements. There are two main types of undernutrition: protein-energy malnutrition and dietary deficiencies. Protein-energy malnutrition has two severe forms: marasmus (a lack of protein and calories) and kwashiorkor (a lack of just protein). Common micronutrient deficiencies include: a lack of iron, iodine, and vitamin A. During pregnancy, due to the body's increased need, deficiencies may become more common. In some developing countries, overnutrition in the form of obesity is beginning to present within the same communities as undernutrition. Other causes of malnutrition include anorexia nervosa and bariatric surgery.



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BP-5 Compact Food


BP-5 Compact Food (also known as a BP-5 biscuit) is a high-calorie, vitamin fortified, compact, compressed and dry food, often used by relief agencies for the emergency feeding of refugees and internally displaced persons.

BP-5 is available in packs of 2 biscuit bars. Each box of 9 packs contains 500g of food, with approximately 2,300 calories per box. Shelf life is 5 years. The food is produced by Compact AS, based in Norway, and purchased by agencies through UNICEF.

Ingredients include baked wheat flour, partially hydrogenated soybean oil, sugar, soy protein concentrate, malt extract, minerals, amino acids, and vitamins.

BP-5 is used for disaster relief and disaster preparedness, and for emergency food rations in refugee camps, particularly for malnourished children. It is eaten directly, or mixed with water to make a porridge.

Typically, an adult is given 250g per day. Although this is a calorie deficit, it provides the recommended protein and basic vitamin requirements. Because it is easily digestible, neutral tasting, and contains no dairy or meat products the food may be widely used, even for people with severe malnourishment.

One study found that its portability made it susceptible to cheating, and recommended dispensing pre-prepared food instead when practical.

BP-5, along with Plumpy Nut (a peanut-butter supplement) was fed to visitors to a small mobile refugee camp created by Médecins Sans Frontières (Doctors Without Borders) to travel to major world cities to raise awareness.



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Catabolysis


Catabolysis is a biological process in which the body breaks down fat and muscle tissue in order to stay alive. Catabolysis occurs only when there is no longer any source of protein, carbohydrate, or vitamin nourishment feeding all body systems; it is the most severe type of malnutrition.

Due to the normal metabolic rate of humans catabolysis becomes life-threatening only after 1–2 months from the cessation of nutrition going into the body. After this time, the damage to muscles and organs can be permanent and can also eventually cause death, if left untreated. Catabolysis is the last metabolic resort for the body to keep itself — particularly the nervous system—functional.

Protein stores, especially in muscle tissue, provide the amino acids needed for the process. Amino acids are released into the blood and converted in the liver to alpha keto acids. Alpha keto acids can then be converted to glucose to maintain proper blood sugar levels.

The situation can become dire when one begins to lose muscle mass; this is a sign that the fat has been expended and the body is now metabolizing the muscle tissue. This results in muscle atrophy, a loss of strength and, ultimately, a depletion of muscular tissue completely. Muscle weakness is not necessarily a symptom of catabolysis: the muscles will normally feel fatigued when they are not receiving enough energy or oxygen. Ultimately, catabolysis can progress to the point of no return when the body's machinery for protein synthesis, itself made of protein, has been degraded to the point that it cannot handle any protein. At this point, attempts to correct the disorder by giving food or protein are futile.



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Coeliac disease


imageCoeliac disease

Coeliac disease, also spelled celiac disease, is an autoimmune disorder affecting primarily the small intestine that occurs in people who are genetically predisposed. Classic symptoms include gastrointestinal problems such as chronic diarrhoea, abdominal distention, malabsorption, loss of appetite, and among children failure to grow normally. This often begins between six months and two years of age. Non-classic symptoms are the most common, especially in people older than two years. There may be mild or absent gastrointestinal symptoms, a wide number of symptoms involving any part of the body, or no obvious symptoms. Coeliac disease was first described in childhood; however, it may develop at any age. It is associated with other autoimmune diseases, such as diabetes mellitus type 1 and thyroiditis, among others.

Coeliac disease is caused by a reaction to gluten, which are various proteins found in wheat and in other grains such as barley, and rye. Moderate quantities of oats, free of contamination with other gluten-containing grains, are usually tolerated but problems may depend on the type consumed. Upon exposure to gluten, an abnormal immune response may lead to the production of several different autoantibodies that can affect a number of different organs. In the small-bowel this causes an inflammatory reaction and may produce shortening of the villi lining the small intestine (villous atrophy). This affects the absorption of nutrients, frequently leading to anaemia.



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