Jump to comment:

• Is malnutrition intervention as complex as it seems?
  OMOLARA ELIZABETH OKUNLOLA HERRERA
  Published on: 3 November 2023
• Is malnutrition intervention as complex as it seems?
  OMOLARA ELIZABETH OKUNLOLA HERRERA
  Published on: 15 February 2021

• Published on: 3 November 2023

  Is malnutrition intervention as complex as it seems?

  • OMOLARA ELIZABETH OKUNLOLA HERRERA, Registered Nurse, Public Health officer Taipei Medical University

  Firstly, through out the writing, authors keep switching between the terminologies undernutrion and malnutrition even though they have two different meanings. This made it seems as though under nutriton means malnutrition which is not the case. Accoridng to World Health Organization (WHO) (1) manutrition can be defined as unbalanced diet meaning excess or limited amount of any of the six classes of food. Malnutrition can occur when a food supply is either scarce or abundant. For example :
  Obesity is a form of malnutrition, but it is not undenturtion, but rather overnutriton. Someone who is overweight can be malnourished. Under nutrition on the other hand refers specifically to a deficiency of food, nutrients and/or energy. It the most common form of malnutrition, but not the only type. Undernutrition is caused by inadequate intake, absorption, or use of nutrients, food and energy. It can also mean insufficient intake of energy, and nutrients an individual need to meet or maintain good health. Someone can be malnourished and not undernourished.

  Secondly, the authors mentioned there are three types of undernutition. Accoridng to WHO there are four sub-types of undernutrition which are : stunting, wasting, underweight and deficiency of micronutrients (vitamins and minerals). The authors completely failed to mention the fourth sub-type, although they quickly mentioned about importance of iodine in household cooking salt, but that was all that was mentioned about...

  Show More

  Firstly, through out the writing, authors keep switching between the terminologies undernutrion and malnutrition even though they have two different meanings. This made it seems as though under nutriton means malnutrition which is not the case. Accoridng to World Health Organization (WHO) (1) manutrition can be defined as unbalanced diet meaning excess or limited amount of any of the six classes of food. Malnutrition can occur when a food supply is either scarce or abundant. For example :
  Obesity is a form of malnutrition, but it is not undenturtion, but rather overnutriton. Someone who is overweight can be malnourished. Under nutrition on the other hand refers specifically to a deficiency of food, nutrients and/or energy. It the most common form of malnutrition, but not the only type. Undernutrition is caused by inadequate intake, absorption, or use of nutrients, food and energy. It can also mean insufficient intake of energy, and nutrients an individual need to meet or maintain good health. Someone can be malnourished and not undernourished.

  Secondly, the authors mentioned there are three types of undernutition. Accoridng to WHO there are four sub-types of undernutrition which are : stunting, wasting, underweight and deficiency of micronutrients (vitamins and minerals). The authors completely failed to mention the fourth sub-type, although they quickly mentioned about importance of iodine in household cooking salt, but that was all that was mentioned about vitamins and minerals.

  Furthermore, the authors mentioned collaboration and multisectoral intervention as the only intervention to combat undernutrition. There was several other interventions we must not ignore because they play as much importance as multisectoral interventions if not more. For example:

  1. Empowering mothers, parents, caregivers and even teachers and educating them about the importance of eating healthy diet is very crucial. Encouraging pregnant women from early trimester about the importance of healthy food for both mother and child play crucial role to determine the future nutritional status of the child. Teaching mothers how to plant and cook healthy, non expensive food is very important. The authors mentioned collaboration with ministry of health, agriculture and others. How about including ministry of education to play both educational role and also help with interventions? At the age of 3 to 4 children start going to preschools or kindergarten, educating teachers on making sure the kids do not only learn school materials, but also making sure they know about eating healthy food and also giving them free breakfast and lunch at school will play a big role. For some of the children, the meal they eat at school is the only meal they eat all day. Schools can incorporate free meal packages sponsored by ministry of education and other non governmental organization can go a long way to help with undernutrition.
  2. Just the way we have blood banks where people can donate free blood to people in need. Food bank can also be encouraged in our communities. Encouraging people to donate healthy meals to a place at anytime and anyone especially children can pick up the food without being charged for it. Collaboration with local restaurants is also very important. They can help to provide free or discounted food to children under the age of 5, they can help by cooking food not only high in calories and strach but also food high in proteins, fibers and other essential nutrients they serve the community, especially children.
  3. The authors mentioned introducing solid, semi solid and soft food from 6 month, but mentioned breastfeeding from birth until age 5 months. According to WHO, exclusive breastfeeding should be done from birth until age 6 months without anyone supplement, food or water. Accoridng to United Nation International Children's Emergency Fund (UNICEF) (2) there are 10 action intervention for managing undernutrion which was not included in this stud

  Show Less

  Conflict of Interest:
  None declared.

  • Back to top
• Published on: 15 February 2021

  Is malnutrition intervention as complex as it seems?

  • OMOLARA ELIZABETH OKUNLOLA HERRERA, Registered Nurse, Public Health officer Taipei Medical University, Taiwan.

  The authors did an excellent job explaining this research article. However, there are few gas I will like to fill and address.

  Firstly, through out the writing, authors keep switching between the terminologies undernutrion and malnutrition even though they have two different meanings. This made it seems as though under nutriton means malnutrition which is not the case. Accoridng to World Health Organization (WHO) (1) manutrition can be defined as unbalanced diet meaning excess or limited amount of any of the six classes of food. Malnutrition can occur when a food supply is either scarce or abundant. For example :
  Obesity is a form of malnutrition, but it is not undenturtion, but rather overnutriton. Someone who is overweight can be malnourished. Under nutrition on the other hand refers specifically to a deficiency of food, nutrients and/or energy. It the most common form of malnutrition, but not the only type. Undernutrition is caused by inadequate intake, absorption, or use of nutrients, food and energy. It can also mean insufficient intake of energy, and nutrients an individual need to meet or maintain good health. Someone can be malnourished and not undernourished.

  Secondly, the authors mentioned there are three types of undernutition. Accoridng to WHO there are four sub-types of undernutrition which are : stunting, wasting, underweight and deficiency of micronutrients (vitamins and minerals). The authors completely failed to mention the fourth sub...

  Show More

  The authors did an excellent job explaining this research article. However, there are few gas I will like to fill and address.

  Firstly, through out the writing, authors keep switching between the terminologies undernutrion and malnutrition even though they have two different meanings. This made it seems as though under nutriton means malnutrition which is not the case. Accoridng to World Health Organization (WHO) (1) manutrition can be defined as unbalanced diet meaning excess or limited amount of any of the six classes of food. Malnutrition can occur when a food supply is either scarce or abundant. For example :
  Obesity is a form of malnutrition, but it is not undenturtion, but rather overnutriton. Someone who is overweight can be malnourished. Under nutrition on the other hand refers specifically to a deficiency of food, nutrients and/or energy. It the most common form of malnutrition, but not the only type. Undernutrition is caused by inadequate intake, absorption, or use of nutrients, food and energy. It can also mean insufficient intake of energy, and nutrients an individual need to meet or maintain good health. Someone can be malnourished and not undernourished.

  Secondly, the authors mentioned there are three types of undernutition. Accoridng to WHO there are four sub-types of undernutrition which are : stunting, wasting, underweight and deficiency of micronutrients (vitamins and minerals). The authors completely failed to mention the fourth sub-type, although they quickly mentioned about importance of iodine in household cooking salt, but that was all that was mentioned about vitamins and minerals.

  Furthermore, the authors mentioned collaboration and multisectoral intervention as the only intervention to combat undernutrition. There was several other interventions we must not ignore because they play as much importance as multisectoral interventions if not more. For example:

  1. Empowering mothers, parents, caregivers and even teachers and educating them about the importance of eating healthy diet is very crucial. Encouraging pregnant women from early trimester about the importance of healthy food for both mother and child play crucial role to determine the future nutritional status of the child. Teaching mothers how to plant and cook healthy, non expensive food is very important. The authors mentioned collaboration with ministry of health, agriculture and others. How about including ministry of education to play both educational role and also help with interventions? At the age of 3 to 4 children start going to preschools or kindergarten, educating teachers on making sure the kids do not only learn school materials, but also making sure they know about eating healthy food and also giving them free breakfast and lunch at school will play a big role. For some of the children, the meal they eat at school is the only meal they eat all day. Schools can incorporate free meal packages sponsored by ministry of education and other non governmental organization can go a long way to help with undernutrition.
  2. Just the way we have blood banks where people can donate free blood to people in need. Food bank can also be encouraged in our communities. Encouraging people to donate healthy meals to a place at anytime and anyone especially children can pick up the food without being charged for it. Collaboration with local restaurants is also very important. They can help to provide free or discounted food to children under the age of 5, they can help by cooking food not only high in calories and strach but also food high in proteins, fibers and other essential nutrients they serve the community, especially children.
  3. The authors mentioned introducing solid, semi solid and soft food from 6 month, but mentioned breastfeeding from birth until age 5 months. According to WHO, exclusive breastfeeding should be done from birth until age 6 months without anyone supplement, food or water. Accoridng to United Nation International Children's Emergency Fund (UNICEF) (2) there are 10 action intervention for managing undernutrion which was not included in this study. The action interventions or steps are :
  a. Action 1 : Breastfeeding within the first hour of life, is vital to the survival of children. According to World Health Organization (WHO) breastfeeding, within one hour of life until 6 months protects newborn from infections and reduce the risk diseases and death.

  b. Action 2 exclusive breastfeeding in the first six months of life makes children healthier. Infants who are exclusively breastfed in the first six months of life do not need water, solid food, animal milk, supplement or children cereal to survive . Mothers milk is all they need for survival and optimal growth and development.
  c. Action 3 : Solid foods and mother’s milk after six months of age does not only help infant grow quickly, but also it makes them grow quickly and help their motor skills and cognitive development. After six months of age, infant need both mother’s breast milk and complimentary food which include semi solid food or soft food ensures children grow to their full potential.
  d. Action 4 : The right foods in the right quantity with good quality. This means that feeding children well balanced meal from the six classes of food which include adequate carbohydrate with moderate calories intake, adequate protein as it is needed for body building to reduce the potential of wasting, adequate fats and oil not excess to reduce overweight or obesity, adequate mineral and salt not little or excess, adequate water. Children age 6 months to 2years old need to eat sufficient amounts of age appropriate food like eggs, grains, fibers, fish, meat, diary products, fruits and vegetables, help them fight infection, prevent diseases, constipation, diarrhea and sudden death.

  e. Action 5 :Good hygiene and clean hands.Good hand hygiene is very important for children at this age as it does not only help to keep them healthy but also help to prevent salmonella and other infection that can cause mortality of children under age five. Children at this age are very active and her beginning to explore their immediate environment. It is not uncommon to see them play outside, touching unclean items and even touch their nose, mouth and other body parts.
  f. Action 6 : Essential nutrition. Iron and vitamin A supplement and deworming protect young children from diseases and anemia and poor development.
  g. Action 7 : Nutritious food during and after illness are necessary for child's recovery. Sick children, despite poor appetite, need increased amounts of food and fluids. Feeding them nutritious foods in small quantities and giving them fluids frequently, including breastmilk, help children recover faster.
  h. Action 8 : Life saving food and care given at the right time help severely undernourished children.
  I. Action 9 : Improving nutrition of adolescent girls today secure their nutrition need in the future. Girls because of monthly menstrual discharges. Adolescent girls can be protected against poor nutrition and anaemia through supervised weekly iron and folic acid supplementation, twice-yearly deworming, counselling to improve their diets, and empowerment to stay in school and avoid early marriage and pregnancy.
  j. Good nutrition during pregnancy and lactation is essential to women's health. Pregnant women need to eat a varied diet to ensure that their children are born healthy and have a lower risk of being stunted, developing poorly, or dying. Breastfeeding mothers need to eat a plentiful diet to store and restore energy and nutrients they require and used to breastfeed successfully.
  Lastly, in this modern days of high mobile phone usage, digital users nd social media platforms use in different countries even among low socioeconomic status communities. CThese medium can be used for creating undernutrition awareness, education and interventions. According to research done by Navisa (3) using mobile phone applications to overcome malnutrition, the study evaluated mobile phone interventions to increase nutrition knowledge and enhance behavior related to nutrition. A recent review of factors influencing information and technology in health care services shows that mobile phone, internet, social media are commonly used by patient and heath care providers. Mobile technology allows development of mobile health interventions that have promised to help in low and middle income countries to disseminate information about proper nutrition and lifestyle behavior changes.
  Furthermore, the fight against malnutrition is multifaceted: it does not only depend on governments, though they have a role to play. Children who are malnourished and obese during childhood usually end up being obese during adolescence and even when they are adult. Stopping malnutrition, under nutrition and over nutrition at an early age is the best way to combat malnutrition rather than waiting until they are adults or later in the future. Motivating and empowering mothers, caregivers, health care workers and even teachers using digital technologies can go a long way to combating malnutrition. What children eat at home even as adults usually starts with mothers, what they are being given by their parents to eat; if parents do not have good eating habits or are always eating unhealthy meals the children will also develop similar habits. Motivating care givers, teachers will go a long way to help with malnutrition (4).

  References
  1. World Health Organization. ( 2020, April 1). Malnutrition fact sheet retrieved from www.who.int/malnutrition on December 27th, 2020.
  2.United Nations Children (2018, June 1). 10 proven nutrition interventions : providing children the best chance to grow and develop to their full potential. UNICEF, South Asia. Retrieved from www.unicefsouthAsia on December 27th, 2020.
  3. Seyyedi, N., Rahimi, B., Farrokh Eslamlou, H. et al. Mobile phone applications to overcome malnutrition among preschoolers: a systematic review. BMC Med Inform Decis Mak 19, 83(2019). Httpss:doi.org/10.1186/s12911-019-0803-2
  4. Mohr DC, Schueller SM, Montaguen E, Burns MN, Rashidi P. The behavioral intervention technology model: an integrated conceptual and technological framework foreHealth and mHealth interventions. J Med Int Res.2014;16 (6): e146.p

  Show Less

  Conflict of Interest:
  None declared.

  • Back to top