Dwarfed disposition – Stunting is the compromised growth and development that children suffer from due to poor nourishment, recurrent infection, and a lack of psychosocial stimulation. Children are defined as stunted if their height-for-age is more than two SD’s below the WHO Child Growth Standards median (WHO).
– Consequence of long-term under nutrition, prolonged lack of sufficient macronutrients to support normal growth
– Also due to repeated infections during the infancy stage
– 20% of stunting leads from utero-under nutrition and anaemia during pregnancy, leading to low birth-weight
– Unable to attain complete potential height
– Diminished brain development
– Severely debilitated immunity
– Inclined to obesity in adulthood
– Pregnancy complications, delivering low birth weight babies
– Affects productivity (General economic progress of country), lessening the ability to contribute to society
Micronutrient Deficiency (Epidemiology)
Scarcities in iron, iodine, vitamin A and zinc are still major public health concerns in developing countries, but vitamins C, D and B deficiencies have dropped considerably in recent years. MNDs affect at least 2 billion people worldwide. Since there are often no reliable organic indices of marginal micronutrient status, RCTs of supplementation is the top method in studying the relation between MNDs and health constraints in human populations.
Globally, 740 million people are deficient in iodine, including up to 300 million with goitre and 20 million with brain damage from maternal iodine deficiency during their foetal development. About 2 billion people are deficient in zinc; 1 billion have iron-deficiency anaemia. Vitamin A deficiency affects some 250 million, mainly young children and pregnant women in developing countries.
Pathophysiology ; Clinical Features
? Protein–energy malnutrition and micronutrient deficiencies overlap, and the lack of 1 micronutrient is typically associated with deficiencies of others. Iron is an important component of haemoglobin, myoglobin and various enzymes. Hence, this leads mainly to anaemia, but also several other adverse effects. A lack of iodine reduces the production of thyroid hormone and increases that of thyroid-stimulating hormone. As a result, the thyroid gland becomes goitrous, and hypothyroidism develops.
? Vitamin A deficiency contributes to anaemia by immobilizing iron in the reticuloendothelial system and increasing susceptibility to infections. It is essential for functioning of eyes and the immune system. Although diarrhoea and related mortality has clearly been shown to be associated with vitamin A deficiency, evidence for associations with acute infections of the lower respiratory tract and with malaria is much weaker.
? Essential for the functioning of many enzymes is zinc. Thus, it is involved in a large number of metabolic processes, like RNA and DNA synthesis. Furthermore, zinc deficiency interferes with a variety of biological functions, such as gene expression, protein synthesis, skeletal growth, gonad development, appetite and immunity. Zinc deficiency is a major cause for diarrhoea and pneumonia, but evidence about its role in malaria and growth retardation is conflicting.
? Management ; Control
? Food containing high contents of absorbable micronutrients are considered the best means for preventing micronutrient deficiencies. In communities where supplies of such foods are sparse, specific preventive and curative interventions are needed.
? There is growing unanimity on the importance of multiple micronutrient interventions in populations with a high prevalence of malnutrition. However, compatible and incompatible interactions between micronutrients have to be taken into consideration during the development of appropriate formulations.