The following points highlight the six major nutritional problems caused due to deficiency disorders. The nutritional problems are: 1. Deficiency Diseases 2. Indigestion 3. Constipation 4. Vomiting 5. Jaundice 6. Diarrhoea.
Nutritional Problem # 1. Deficiency Diseases:
The important deficiency disorders include protein energy malnutrition (PEM) and disorders due to deficiencies of Vitamin A, iron and iodine. Deficiency of protein and energy or both, called PEM, has been identified as major health and nutritional problems in India.
Protein and energy intake are difficult to separate because diets adequate in energy are adequate in protein. Young children (0-6 years) require more protein for each kilogram of body weight than adults. So they are more prone to malnutrition. Malnutrition is not only an important cause of childhood mortality and morbidity, but it also leads to permanent impairment of physical and mental growth of those who survive.
(i) PEM:
It is an important nutritional problem among pre-school children. It leads to various degrees of growth retardation. This is due to lack of adequate quantity of protein or carbohydrate or both.
PEM is of 2 types: Kwashiorkor and Marasmus.
The child suffering from PEM can recover if adequate quantities of protein and carbohydrate rich food are given.
(ii) Night blindness and Xerophthalmia:
These diseases are due to deficiency of vitamin A.
(iii) Anaemia:
This disease is caused by deficiency of iron.
(iv) Goitre:
Goitre is caused due to deficiency of iodine in food. In addition to above mentioned deficiency diseases, the following deficiency diseases may be mentioned. Name of deficient is written in the bracket. Rickets in children and osteomalacia in adult (vitamin D), muscular dystrophy (vitamin E), Beri beri (B1), Cheilosis (B2), Pellagra (vitamin B3), Megaloblastic anaemia (Folic acid), Pernicious anaemia (B12), Scurvy (vitamin C).
Nutritional Problem # 2. Indigestion:
Incomplete digestion usually accompanied by one or more of the following symptoms— pain, nausea (feeling before vomiting), vomiting, heartburn, acid regurgitation, accumulation of gas and send-out of gas from the stomach.
Hunger (desire for food) and appetite (inclination towards food) are extremely important automatic regulatory systems. If they are not maintained they cause indigestion. Chewing (mastication) — cutting of food by incisors however, grinding of food by molars. Most of the muscles of chewing are innervated by the motor branch of Vth cranial nerve.
The chewing process is controlled by nuclei in the stem brain. Swallowing (deglutition) is also important mechanism which has already been described. Improper chewing and swallowing, inadequate digestive enzymes and gastrointestinal hormones anxiety, over eating, spicy food and high fever cause indigestion of food.
Nutritional Problem # 3. Constipation:
Constipation refers to infrequent or difficult defecation caused b’ decreased motility of the intestines. Because the faeces remain in the colon for prolonged periods, excessive water absorption occurs, and the faeces become dry and hard.
Constipation may be caused by poor habits (delaying defecation), spasms of the colon, insufficient fibre in the diet, inadequate fluid intake, lack of exercise, emotional stress, and certain drugs. A common treatment is a mild laxative, such as milk of magnesia, which induces defecation.
However, many physicians maintain that laxatives are habit-forming and that adding fibre to the diet, increasing the amount of exercise and increasing fluid intake are safer ways of controlling this common problem.
Nutritional Problem # 4. Vomiting:
The skeletal muscles of the abdominal wall and diaphragm contract, increasing intra-abdominal pressure, the cardiac sphincter relaxes and the soft palate rises to close off the nasal passages. As a result, the stomach (and perhaps duodenal) contents are forced upward through the oesophagus and pharynx and out the mouth.
Excessive vomiting can lead to dehydration. Since a large amount of HCI is lost, the blood becomes alkaline. This reflex action is controlled by vomit centre in the medulla oblongate of the brain. A feeling of nausea precedes vomiting.
Nutritional Problem # 5. Jaundice:
Jaundice is a yellowish colouration of the sclerae (whites of the eyes), skin and mucous membranes due to a build-up of a yellow compound called bilirubin. After bilirubin is formed from the breakdown of the heme pigment in aged red blood cells, it is transported to the liver, where it is processed and eventually excreted into bile.
The three main categories of jaundice are:
(1) Pre-hepatic jaundice, due to excess production of bilirubin;
(2) Hepatic jaundice, due to congenital liver disease — cirrhosis of the liver, or hepatitis; and
(3) Extra-hepatic jaundic due to blockage of bile drainage by gallstones or cancer of the bowel or the pancreas.
Because the liver of a newborn functions poorly for a week or so, many babies experience a mild form of jaundice called neonatal jaundice that disappears as the liver matures. Usually, it is treated by exposing the infant to blue light which converts bilirubin into substances the kidneys can excrete.
Nutritional Problem # 6. Diarrhoea:
Diarrhoea is an increase in the frequency, volume and fluid content of the faeces caused by increased motility of and decreased absorption by the intestines. When chyme passes too quickly through the small intestine and faeces pass too quickly through the large intestine, there is not enough time for absorption.
Frequent diarrhoea can result in dehydration and electrolyte imbalances. Excessive motility may be caused by lactose intolerance, stress, and microbes that irritate the gastrointestinal mucosa.
i. Malnutrition is a condition caused by not getting enough food or right kind of food. Malnutrition covers problems of both under-nutrition and over-nutrition. Under-nutrition is due to unbalanced diet, however, excess intake of food is over-nutrition.