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Malnutrition is the condition that develops when the body does not get the right amount of the vitamins, minerals, and other nutrients it needs to maintain healthy tissues and organ function.



Malnutrition occurs in people who are either undernourished or overnourished. Undernutrition is a consequence of consuming too few essential nutrients or using or excreting them more rapidly than they can be replaced.
Infants, young children, and teenagers need additional nutrients. So do women who are pregnant or breastfeeding. Nutrient loss can be accelerated by diarrhea, excessive sweating, heavy bleeding (hemorrhage), or kidney failure. Nutrient intake can be restricted by age-related illnesses and conditions, excessive dieting, food allergies, severe injury, serious illness, a lengthy hospitalization, or substance abuse.
The leading cause of death in children in developing countries is protein-energy malnutrition. This type of malnutrition is the result of inadequate intake of calories from proteins, vitamins, and minerals. Children who are already undernourished can suffer from protein-energy malnutrition (PEM) when rapid growth, infection, or disease increases the need for protein and essential minerals. These essential minerals are known as micronutrients or trace elements.
Two types of protein-energy malnutrition have been described—kwashiorkor and marasmus. Kwashiorkor occurs with fair or adequate calorie intake but inadequate protein intake, while marasmus occurs when the diet is inadequate in both calories and protein.
About 1% of children in the United States suffer from chronic malnutrition, in comparison to 50% of children in southeast Asia. About two-thirds of all the malnourished children in the world are in Asia, with another one-fourth in Africa.


In the United States, nutritional deficiencies have generally been replaced by dietary imbalances or excesses associated with many of the leading causes of death and disability. Overnutrition results from eating too much, eating too many of the wrong things, not exercising enough, or taking too many vitamins or other dietary replacements.
Risk of overnutrition is also increased by being more than 20% overweight, consuming a diet high in fat and salt, and taking high doses of:
  • Nicotinic acid (niacin) to lower elevated cholesterol levels
  • Vitamin B6 to relieve premenstrual syndrome
  • Vitamin A to clear up skin problems
  • Iron or other trace minerals not prescribed by a doctor.
Nutritional disorders can affect any system in the body and the senses of sight, taste, and smell. They may also produce anxiety, changes in mood, and other psychiatric symptoms. Malnutrition begins with changes in nutrient levels in blood and tissues. Alterations in enzyme levels, tissue abnormalities, and organ malfunction may be followed by illness and death.

Causes and symptoms


Poverty and lack of food are the primary reasons why malnutrition occurs in the United States. Ten percent of all members of low income households do not always have enough healthful food to eat. Protein-energy malnutrition occurs in 50% of surgical patients and in 48% of all other hospital patients.
Loss of appetite associated with the aging process. Malnutrition affects one in four elderly Americans, in part because they may lose interest in eating. In addition, such dementing illnesses as Alzheimer's disease may cause elderly persons to forget to eat.
There is an increased risk of malnutrition associated with chronic diseases, especially disease of the intestinal tract, kidneys, and liver. Patients with chronic diseases like cancer, AIDS, intestinal parasites, and other gastric disorders may lose weight rapidly and become susceptible to undernourishment because they cannot absorb valuable vitamins, calories, and iron.
People with drug or alcohol dependencies are also at increased risk of malnutrition. These people tend to maintain inadequate diets for long periods of time and their ability to absorb nutrients is impaired by the alcohol or drug's affect on body tissues, particularly the liver, pancreas, and brain.
Eating disorders. People with anorexia or bulimia may restrict their food intake to such extremes that they become malnourished.
Food allergies. Some people with food allergies may find it difficult to obtain food that they can digest. In addition, people with food allergies often need additional calorie intake to maintain their weight.
Failure to absorb nutrients in food following bariatric (weight loss) surgery. Bariatric surgery includes such techniques as stomach stapling (gastroplasty) and various intestinal bypass procedures to help people eat less and lose weight. Malnutrition is, however, a possible side effect of bariatric surgery.


Unintentionally losing 10 pounds or more may be a sign of malnutrition. People who are malnourished may be skinny or bloated. Their skin is pale, thick, dry, and bruises easily. Rashes and changes in pigmentation are common.
Hair is thin, tightly curled, and pulls out easily. Joints ache and bones are soft and tender. The gums bleed easily. The tongue may be swollen or shriveled and cracked. Visual disturbances include night blindness and increased sensitivity to light and glare.
Other symptoms of malnutrition include:
  • anemia
  • diarrhea
  • disorientation
  • night blindness
  • irritability, anxiety, and attention deficits
  • goiter (enlarged thyroid gland)
  • loss of reflexes and lack of muscular coordination
  • muscle twitches
  • amenorrhea (cessation of menstrual periods)
  • scaling and cracking of the lips and mouth.
Malnourished children may be short for their age, thin, listless, and have weakened immune systems.


Overall appearance, behavior, body-fat distribution, and organ function can alert a family physician, internist, or nutrition specialist to the presence of malnutrition. Patients may be asked to record what they eat during a specific period. X rays can determine bone density and reveal gastrointestinal disturbances, and heart and lung damage.
Blood and urine tests are used to measure the patient's levels of vitamins, minerals, and waste products. Nutritional status can also be determined by:
  • Comparing a patient's weight to standardized charts
  • Calculating body mass index (BMI) according to a formula that divides height into weight
  • Measuring skinfold thickness or the circumference of the upper arm.


Normalizing nutritional status starts with a nutritional assessment. This process enables a clinical nutritionist or registered dietician to confirm the presence of malnutrition, assess the effects of the disorder, and formulate diets that will restore adequate nutrition.
Patients who cannot or will not eat, or who are unable to absorb nutrients taken by mouth, may be fed intravenously (parenteral nutrition) or through a tube inserted into the gastrointestinal (GI) tract (enteral nutrition).
Tube feeding is often used to provide nutrients to patients who have suffered burns or who have inflammatory bowel disease. This procedure involves inserting a thin tube through the nose and carefully guiding it along the throat until it reaches the stomach or small intestine. If long-term tube feeding is necessary, the tube may be placed directly into the stomach or small intestine through an incision in the abdomen.
Tube feeding cannot always deliver adequate nutrients to patients who:
  • Are severely malnourished
  • Require surgery
  • Are undergoing chemotherapy or radiation treatments
  • Have been seriously burned
  • Have persistent diarrhea or vomiting
  • Whose gastrointestinal tract is paralyzed.
Intravenous feeding can supply some or all of the nutrients these patients need.


Up to 10% of a person's body weight can be lost without side effects, but if more than 40% is lost, the situation is almost always fatal. Death usually results from heart failure, electrolyte imbalance, or low body temperature. Patients with semiconsciousness, persistent diarrhea, jaundice, or low blood sodium levels have a poorer prognosis.
Some children with protein-energy malnutrition recover completely. Others have many health problems throughout life, including mental retardation and the inability to absorb nutrients through the intestinal tract. Prognosis for all patients with malnutrition seems to be dependent on the age of the patient, and the length and severity of the malnutrition, with young children and the elderly having the highest rate of long-term complications and death.


Breastfeeding a baby for at least six months is considered the best way to prevent early-childhood malnutrition. The United States Department of Agriculture and Health and Human Service recommend that all Americans over the age of two:
  • Consume plenty of fruits, grains, and vegetables
  • Eat a variety of foods that are low in fats and cholesterols and contain only moderate amounts of salt, sugars, and sodium
  • Engage in moderate physical activity for at least 30 minutes, at least several times a week
  • Achieve or maintain their ideal weight
  • Use alcohol sparingly or avoid it altogether.
Every patient admitted to a hospital should be screened for the presence of illnesses and conditions that could lead to protein-energy malnutrition. Patients with higher-than-average risk for malnutrition should be more closely assessed and reevaluated often during long-term hospitalization or nursing-home care.



Beers, Mark H., MD, and Robert Berkow, MD, editors. "Malnutrition." Section 1, Chapter 2. In The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck Research Laboratories, 2004.
Flancbaum, Louis, MD, with Erica Manfred and Deborah Biskin. The Doctor's Guide to Weight Loss Surgery. West Hurley, NY: Fredonia Communications, 2001.


Alvarez-Leite, J. I. "Nutrient Deficiencies Secondary to Bariatric Surgery." Current Opinion in Clinical Nutrition and Metabolic Care 7 (September 2004): 569-575.
Amella, E. J. "Feeding and Hydration Issues for Older Adults with Dementia." Nursing Clinics of North America 39 (September 2004): 607-623.
Bryan, J., S. Osendorp, D. Hughes, et al. "Nutrients for Cognitive Development in School-Aged Children." Nutrition Reviews 62 (August 2004): 295-306.
Grigsby, Donna G., MD. "Malnutrition." eMedicine December 18, 2003.
Gums, J. G. "Magnesium in Cardiovascular and Other Disorders." American Journal of Health-System Pharmacy 61 (August 1, 2004): 1569-1576.
Halsted, G. H. "Nutrition and Alcoholic Liver Disease." Seminars in Liver Disease 24 (August 2004): 289-304.
Reid, C. L. "Nutritional Requirements of Surgical and Critically-Ill Patients: Do We Really Know What They Need?" Proceedings of the Nutrition Society 63 (August 2004): 467-472.


American College of Nutrition. 722 Robert E. Lee Drive, Wilmington, NC 20412-0927. (919) 452-1222.
American Institute of Nutrition. 9650 Rockville Pike, Bethesda, MD 20814-3990. (301) 530-7050.
Food and Nutrition Information Center. 10301 Baltimore Boulevard, Room 304, Beltsville, MD 20705-2351.


World Health Organization (WHO) Nutrition web site. 〈〉.

Key terms

Anemia — Not enough red blood cells in the blood.
Anorexia nervosa — Eating disorder marked by malnutrition and weight loss commonly occurring in young women.
Bariatric — Pertaining to the study, prevention, or treatment of overweight.
Calorie — A unit of heat measurement used in nutrition to measure the energy value of foods. A calorie is the amount of heat energy needed to raise the temperature of 1 kilogram of water 1°C.
Kwashiorkor — Severe malnutritution in children primarily caused by a protein-poor diet, characterized by growth retardation.
Marasmus — Severe malnutritution in children caused by a diet lacking in calories as well as protein. Marasmus may also be caused by disease and parasitic infection.
Micronutrients — Essential dietary elements that are needed only in very small quantities. Micronutrients are also known as trace elements. They include copper, zinc, selenium, iodine, magnesium, iron, cobalt, and chromium.
Gale Encyclopedia of Medicine. Copyright 2008 The Gale Group, Inc. All rights reserved.


poor nourishment resulting from improper diet or from some defect in metabolism that prevents the body from using its food properly. Extreme malnutrition may lead to starvation. Although poverty is still the major cause of malnutrition, the condition is by no means confined to the underdeveloped parts of the world. Anyone can become undernourished by seriously neglecting the diet. A well balanced diet, which varies slightly with a person's age, should include adequate amounts of protein, vitamins, minerals, and carbohydrates. For an explanation of the value of properly balanced diets and guidelines for a healthy diet, see nutrition.

Ignorance of the basic principles of nutrition is probably almost as great a cause of undernourishment as poverty. Misplaced faith in vitamin pills as a substitute for food, for example, can cause undernourishment if carried to extremes. So can over-reliance on excessively processed foods. Modern methods of processing and refining foods can sometimes cause a loss of valuable nutrients, as happens in the refining of certain grains, such as rice. However, this danger is recognized by both the government and the manufacturers who try to retain or restore the nutritional value of many foods. alcoholism, which frequently leads a person to rely on alcohol at the expense of food, is another cause of malnutrition.

People who want to gain or lose weight, or who avoid certain foods, may endanger their health by following an unbalanced diet that lacks essential nutrients. Anyone who plans to follow a special diet should consult with a Registered Dietitian. Malnutrition can also stem from disease. If the organs of the digestive system that transform food into bone, tissue, blood, and energy fail to function properly, the body will not receive adequate nourishment. Such deficiencies can cause certain liver diseases, and some anemias. The endocrine glands and enzymes are also vital to the proper use of food by the body, and defects in their functioning may cause forms of malnutrition.
Symptoms. In general, the symptoms of malnutrition are physical weakness, lassitude, and an increasing sense of detachment from the world. There are also specific symptoms that vary according to the essential substance lacking in the diet. For example, lack of vitamin A can result in night blindness, or poor vision in dim light. In the absence of adequate exposure to sunlight, a lack of vitamin D can cause rickets, which results in malformed limbs in infants and children because the bones fail to harden properly. A lack of vitamin C causes scurvy, with symptoms of bleeding gums and easily bruised skin. Other vitamin deficiency diseases are beriberi and pellagra. If there is not enough iron in the diet, iron deficiency anemia develops. Malnutrition can also result from allergic reactions to foods, as in celiac disease.

In starvation there are signs of multiple vitamin deficiency. There may be edema, abdominal distention, and excessive loss of weight. As starvation progresses, fat cells become small and accumulations of fat are depleted. The liver is reduced in size, the muscles shrivel, and the lymphoid tissue, gonads, and blood deteriorate.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.


Faulty nutrition resulting from malabsorption, poor diet, or overeating.
Farlex Partner Medical Dictionary © Farlex 2012


(măl′no͞o-trĭsh′ən, -nyo͞o-)
Poor nutrition because of an insufficient or poorly balanced diet or faulty digestion or utilization of foods.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.


A state caused by prolonged nutritional defects—e.g., decreased proteins, minerals, vitamins or calories.
• Exogenous—poverty, alcohol, mental disorders (e.g., severe depression), infection (e.g., TB, malignancy, or nosocomial due to total parenteral nutrition).
• Endogenous—metabolic defects (congenital or acquired), malabsorption.

Clinical findings
Weakness, apathy, anorexia, diarrhoea, skin pigmentation and/or ulceration.
Reduced folic acid, iron, magnesium, bile synthesis, disaccharidase activity, protein, vitamin B12.

See Kwashiorkor, Marasmus.
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.


The result of prolonged nutritional defects–eg, ↓ proteins, minerals, vitamins, or calories Etiology–exogenous Poverty, alcohol, mental disorders–eg, severe depression, infection–eg, TB, malignancy, or nosocomial due to TPN Endogenous Metabolic defects–congenital or acquired, malabsorption Clinical Weakness, apathy, anorexia, diarrhea, skin pigmentation and/or ulceration Lab ↓ Folic acid, iron, magnesium, bile synthesis, disaccharidase activity, protein, vitamin B12. See Kwashiorkor, Marasmus.
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.


Faulty nutrition resulting from malabsorption, poor diet, or overeating.
Medical Dictionary for the Health Professions and Nursing © Farlex 2012


Any disorder resulting from an inadequate diet or from failure to absorb or assimilate dietary elements. The term is now often used to describe the effects of an ill-chosen, even if calorifically adequate, diet or of excessive food intake. See also SPRUE, MALABSORPTION, COELIAC DISEASE, CROHN'S DISEASE, ANOREXIA NERVOSA, VITAMIN DEFICIENCY, BERI-BERI, PELLAGRA, SCURVY, XEROPHTHALMIA, RICKETS and KWASHIORKOR.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005


Faulty nutrition resulting from malabsorption, poor diet, or overeating.
Medical Dictionary for the Dental Professions © Farlex 2012

Patient discussion about malnutrition

Q. How do I now if my nutrition is correct? I guess it's not... and Id like to fix it but dont really know what should I change...

A. Read more about the recommended nutrition, and learn how to analyze yours here (, and if you have further concerns, you may want to consult a professional (e.g. dietitian). In general, nutrition should include about 30-35 calories per kg per day.

Eat a healthy diet with a lot of vegetables, fruits, and whole grains and a limited amount of red meat. Get at least five servings of fruits and vegetables every day. More is even better. Tips for achieving this goal include: Make fruits and vegetables part of every meal. Frozen or canned can be used when fresh isn't convenient. Put fruit on your cereal. Eat vegetables as snacks. Have a bowl of fruit out all the time for kids to take snacks from.

Cut down on bad fats (trans fatty acids and saturated fats) and consume good fats (polyunsaturated and monounsaturated fat like olive oil and canola oil). Tips for achieving this goal include: Choose chicken, fish, or beans instead of red meat and ch

Q. Will it be good and what is its nutritional value? I wish to take oats as my breakfast with milk or juice. Will it be good and what is its nutritional value?

A. It is undoubtedly a good idea to have oats as your breakfast with milk or juice. It is well known for its high fiber content which is the best remedy for constipation and also plays a vital role in the cholesterol management and smoothens the digestive process. It also helps you in loosing body weight. It is even good for nervous system and in turn treats depression as well. Around 150gm of oat gives 600kcal energy. Apart from protein, lipid, carbohydrate and fiber content, it is a very good source of minerals such as calcium, iron sodium, zinc, and vitamins like vitamin C, B, A.

Q. What is the nutritional value of oats? I am having oats for my morning breakfast from last week, as I know it is good to have them. But what is the nutritional value of oats?

A. oats are rich with vitamins, energy and protein. makes a wonderful breakfast! (at least when my wife makes it!!).
here's a link to a nutritional value list of oats:

and here's a link to some recipes!:
bread -

Biscuits -


bon apetite!

More discussions about malnutrition
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References in periodicals archive ?
"As of now, I have checked two children who are suffering from malnutrition and have Thalassemia," she said.
HORROR: Symptom of kwashiorkor "It's unforgivable so many children suffer from malnutrition and ministers should be ashamed.
Malnutrition is not just about food, or just about health care, but is an issue that requires action from different angles.
'In 2018, we reached out to 700,000 children with RUTF to tackle malnutrition.'
Malnutrition reduces the growth of the baby and increases chances of it having a low birth weight, and later suffering from childhood infections and mortality.
"The malnutrition level is spiking day by day in Afghanistan," Muqeem Shah Miakhil, Head of Malnutrition Department of the Nangarhar Regional Hospital, told Ruptly.
He said that due to lake of proper medical facilities in the remote areas, malnutrition has high rate in country and soon it would be handled.
'We cannot tell you how many children will die; but we can tell you that a child with severe acute malnutrition is 11 times more likely to die than their healthy peers,' he explained, noting that malnutrition reduces people's resistance to disease.
Malnutrition like other disease contributes to child mortality because it affects the physiological processes of the body, reducing the body's ability to fight infections and as such may lead to death if not treated, he said.
PHOTO | DELFIN MUGO class="MsoNormalACUTE MALNUTRITION class="MsoNormalMs Nakuruka's baby is one of the 54,264 children under the age of five years, suffering from acute malnutrition in Turkana county, according to statistics by the Kenya Food and Nutrition Situation Seasonal Assessment Report (March, 2019).
Aaliya Habib, Coordinator SUNCSA, said media is an integral part of civil society and its involvement is essential for addressing the challenging situation of malnutrition in Pakistan.