1Malnutrition and GI Malnutrition and GI ParasitologyParasitologyin the Communityin the CommunityJill Jill GallinGallin, CPNP, CPNPAssistant Professor of Clinical NursingAssistant Professor of Clinical NursingThe Science of Nursing in the Community The Science of Nursing in the Community N5290N5290MalnutritionMalnutritionwho.int/nut/index.htmwho.int/nut/index.htmThe ‘other end’ of malnutritionThe ‘other end’ of malnutritionAn escalating global epidemic of An escalating global epidemic of overweight and obesity overweight and obesity ––““globesityglobesity””––is is taking over many parts of the world. If taking over many parts of the world. If immediate action is not taken, millions will immediate action is not taken, millions will suffer from an array of serious health suffer from an array of serious health disorders. disorders. Obesity is one of today’s most blatantly Obesity is one of today’s most blatantly visible visible ––yet most neglected yet most neglected ––public public health problems. Paradoxically coexisting health problems. Paradoxically coexisting with with undernutritionundernutrition..www.who.int/nut/index.htm www.who.int/nut/index.htm (9/2004)(9/2004)Protein Energy MalnutritionProtein Energy Malnutrition““ProteinProtein--energy malnutrition (PEM) is energy malnutrition (PEM) is by far the most lethal form of by far the most lethal form of malnutrition. Children are its most malnutrition. Children are its most visible victims. Malnutrition, “the visible victims. Malnutrition, “the silent emergency,” is an accomplice silent emergency,” is an accomplice in at least half of the 10.4 million in at least half of the 10.4 million child deaths each year. These young child deaths each year. These young lives are prematurely lives are prematurely ––and and needlessly needlessly ––lost “lost “Nine year old girlWho is at Risk?Who is at Risk?Protein Energy MalnutritionProtein Energy MalnutritionPeople of impoverished countriesPeople of impoverished countriesseen in the midst of drought or political seen in the midst of drought or political turmoil.turmoil.However as many as 50% of elderly However as many as 50% of elderly persons in nursing homes in the U.S. persons in nursing homes in the U.S. suffer from proteinsuffer from protein--calorie malnutrition.calorie malnutrition.ChildrenChildrenPregnant womenPregnant women2Micronutrient DeficiencyMicronutrient DeficiencyCalled “micronutrients” because they are needed Called “micronutrients” because they are needed in only miniscule amounts, these substances are in only miniscule amounts, these substances are the “magic wands” that enable the body to the “magic wands” that enable the body to produce enzymes, hormones and other produce enzymes, hormones and other substances essential for proper growth and substances essential for proper growth and development. development. As tiny as the amounts are, the consequences of As tiny as the amounts are, the consequences of their absence are severe. Their lack represents a their absence are severe. Their lack represents a major threat to the health and development of major threat to the health and development of populations the world over, particularly to populations the world over, particularly to preschool children and pregnant women in lowpreschool children and pregnant women in low--income countries. income countries. Global Health Macronutrient Global Health Macronutrient DeficiencyDeficiencyIodineIodineVitamin A Vitamin A IronIronVitamin A DeficiencyVitamin A DeficiencyVitamin A deficiency causes night Vitamin A deficiency causes night blindness and is the single most blindness and is the single most important cause of childhood important cause of childhood blindness in developing countries. blindness in developing countries. Every year, about 500,000 children Every year, about 500,000 children lose their sight as a result of vitamin lose their sight as a result of vitamin A deficiency. The majority (about A deficiency. The majority (about 70%) die within one year of losing 70%) die within one year of losing their sight. their sight. Vitamin A DeficiencyVitamin A DeficiencyVitamin A deficiency increases the Vitamin A deficiency increases the risk of severe illness, and even risk of severe illness, and even death, from common childhood death, from common childhood infections such as infections such as diarrhealdiarrhealdiseases diseases and measles. In developing countries and measles. In developing countries 200200––300 million children of preschool 300 million children of preschool age are at risk of vitamin A age are at risk of vitamin A deficiency. deficiency. Vitamin A DeficiencyVitamin A DeficiencyVitamin A deficiency may increase Vitamin A deficiency may increase the risk of maternal mortality in the risk of maternal mortality in pregnant women. Nearly 600,000 pregnant women. Nearly 600,000 women die from childbirthwomen die from childbirth--related related causes each year, the vast majority causes each year, the vast majority of them from complications which of them from complications which could be reduced through better could be reduced through better nutrition, such as vitamin A.nutrition, such as vitamin A.Iron DeficiencyIron Deficiency"As many as 4"As many as 4––5 billion people, 665 billion people, 66––80% of the world's population, may 80% of the world's population, may suffer from reduced learning ability suffer from reduced learning ability and work capacity due to iron and work capacity due to iron deficiency. More than 30% of the deficiency. More than 30% of the world's population, are anemic " world's population, are anemic " Battling iron deficiency anemia WHO Battling iron deficiency anemia WHO 200220023Iron DeficiencyIron DeficiencyIron deficiency impairs the cognitive Iron deficiency impairs the cognitive development of children through to development of children through to adolescence. adolescence. Iron DeficiencyIron DeficiencyIron deficiency damages immune Iron deficiency damages immune mechanisms, and is associated with mechanisms, and is associated with increased morbidity rates. increased morbidity rates. Iron DeficiencyIron DeficiencyIron deficiency impairs physical work Iron deficiency impairs physical work capacity in men and women by up to