1. Diseases related to Hunger or Over-Nutrition HFA 4M – Unit 3

2. Glossary Malnutrition: Poor nutrition because of an insufficient or poorly balanced diet or faulty digestion or utilization of foods. The World Health Organization: a specialized agency of the United Nations(UN) that is concerned with international public health. WHO cites malnutrition as the greatest single threat to the world's public health.

3. These are the diseases we are going to look at: kwashiorkor, marasmus, beriberi, xerophthalmia, rickets, ariboflavinosis, pellagra, scurvy, iron deficiency anemia, goiter, cretinism, cardiovascular disease

4. Kwashiorkor Kwashiorkor is a form of malnutrition that occurs when there is not enough protein in the diet. Causes, incidence, and risk factors Kwashiorkor is most common in areas where there is: – Famine – Limited food supply – Low levels of education (when people do not understand how to eat a proper diet)

5. This disease is more common in very poor countries. It often occurs during a drought or other natural disaster, or during political unrest. These conditions are responsible for a lack of food, which leads to malnutrition.

6. Symptoms Changes in skin pigment Decreased muscle mass Diarrhea Failure to gain weight and grow Fatigue Hair changes (change in color or texture) Increased and more severe infections due to damaged immune system Irritability Large belly that sticks out (protrudes)

7. Marasmus Marasmus is a form of severe protein-energy malnutrition characterized by energy deficiency. A child with marasmus looks emaciated. Body weight may be reduced to less than 80% of the average weight that corresponds to the height Marasmus occurrence increases prior to age 1, whereas kwashiorkor occurrence increases after 18 months.

8. Symptoms The malnutrition associated with marasmus leads to extensive tissue and muscle wasting, as well as variable edema. Other common characteristics include dry skin, loose skin folds hanging over the buttocks (glutei) and armpit (axillae), etc. There is also drastic loss of adipose tissue (body fat) from normal areas of fat deposits like buttocks and thighs. The afflicted are often fretful, irritable, and voraciously hungry.

9. Child suffering with Marasmus in India.

10. Beriberi Beriberi is a disease in which the body does not have enough thiamine (vitamin B1). Causes, incidence, and risk factors There are two major types of beriberi: – Wet beriberi affects the cardiovascular system. – Dry beriberi and Wernicke-Korsakoff syndrome affect the nervous system.

11. Beriberi is rare in N. America because most foods are now vitamin enriched. If you eat a normal, healthy diet, you should get enough thiamine. Today, beriberi occurs mostly in patients who abuse alcohol. Drinking heavily can lead to poor nutrition, and excess alcohol makes it harder for the body to absorb and store thiamine.

12. Symptoms Symptoms of dry beriberi include: Difficulty walking Loss of feeling (sensation) in hands and feet Loss of muscle function or paralysis of the lower legs Mental confusion/speech difficulties Pain Strange eye movements (nystagmus) Tingling Vomiting

13. Symptoms of wet beriberi include: Awakening at night short of breath Increased heart rate Shortness of breath with activity Swelling of the lower legs

14. Xerophthalmia Dry eye syndrome is when the eye is unable to maintain a healthy layer of tears to coat it. In areas of the world where malnutrition is common, vitamin A deficiency is a cause. This is rare in N. America. Signs include: – Reduced visual acuity – Thick cornea

15. Rickets Rickets is a disorder caused by a lack of vitamin D, calcium, or phosphate. It leads to softening and weakening of the bones. Causes, incidence, and risk factors Vitamin D helps the body control calcium and phosphate levels. If the blood levels of these minerals become too low, the body may produce hormones that cause calcium and phosphate to be released from the bones. This leads to weak and soft bones. Vitamin D is absorbed from food or produced by the skin when exposed to sunlight. Lack of vitamin D production by the skin may occur in people who: – Live in climates with little exposure to sunlight – Must stay indoors – Work indoors during the daylight hours

16. Not getting enough calcium and phosphorous in your diet can also lead to rickets. Rickets caused by a lack of these minerals in diet is rare in developed countries, because calcium and phosphorous are found in milk and green vegetables.

17. Symptoms Bone pain or tenderness Dental deformities Impaired growth Increased bone fractures Muscle cramps Short stature (adults less than 5 feet tall) Skeletal deformities

18. Ariboflavinosis Medical condition caused by deficiency of riboflavin (vitamin B 2 ). Ariboflavinosis is most often seen in association with protein-energy malnutrition, and also in cases of alcoholism. It was originally known as pellagra sin pellagra (pellagra without pellagra), as it exhibits certain similarities to the niacin deficiency pellagra.

19. Causes The most common cause of riboflavin deficiency is an inadequate diet; thus, it occurs most frequently in populations consuming limited quantities of riboflavin- containing foods such as meats, eggs, milk, cheese, yogurt, leafy green vegetables and whole grains.

20. Symptoms The signs and symptoms of riboflavin deficiency typically include sore throat with redness and swelling of the mouth and throat mucosa(cracking of the lips and corners of the mouth) glossitis (magenta tongue with atrophy) seborrheic dermatitis (moist, scaly skin particularly affecting the scrotum or labia majora folds) decreased red blood cell count with normal cell size and hemoglobin content (anemia).

21. Pellagra Pellagra is a vitamin deficiency disease most commonly caused by a chronic lack of niacin (vitamin B 3 ) in the diet. Pellagra is classically described by "the four D's": diarrhea, dermatitis, dementia and death

22. Man with Pellagra

23. Scurvy Scurvy is a disease resulting from a deficiency of vitamin C, which is required for the synthesis of collagen in humans. Scurvy is one of the accompanying diseases of malnutrition (other such micronutrient deficiencies are beriberi or pellagra) and thus is still widespread in areas of the world depending on external food aid.

24. Scurvy often presents itself initially as symptoms of malaise and lethargy, followed by formation of spots on the skin, spongy gums, and bleeding from the mucous membranes. Spots are most abundant on the thighs and legs, and a person with the ailment looks pale, feels depressed, and is partially immobilized. As scurvy advances, there can be open, suppurating wounds, loss of teeth, jaundice, fever, neuropathy and death.

25. Iron Deficiency Anemia When your body does not have enough iron, it will make fewer red blood cells or red blood cells that are too small. This is called iron deficiency anemia. Causes, incidence, and risk factors Iron deficiency anemia is the most common form of anemia. Red blood cells bring oxygen to the body's tissues. Healthy red blood cells are made in your bone marrow. Red blood cells move through your body for 3 to 4 months. Parts of your body then remove old blood cells.

26. Symptoms Symptoms of the conditions that cause iron deficiency anemia include: Dark, tar-colored stools or blood Heavy menstrual bleeding (women) Pain in the upper belly (from ulcers) Weight loss (in people with cancer)

27. Goiter Worldwide, over 90% cases of goitre are caused by iodine deficiency. The main symptom is a swollen thyroid gland. The size may range from a single small nodule to a large neck lump. The swollen thyroid can put pressure on the windpipe and esophagus, which can lead to: – Breathing difficulties (may rarely occur with very large goiters) – Cough – Hoarseness – Swallowing difficulties

29. Cretinism A congenital condition caused by a deficiency of thyroid hormone during prenatal development and characterized in childhood. Iodine Deficiency.

30. Neurological cretinism: Mental deficiency Deaf mutism Spasticity Ataxia (lack of muscular coordination) Hypothyroid cretinism: Dwarfism Hypothyroidism

31. Cardiovascular Disease More related to over-nutrition. The term malnutrition usually refers to decreased intake of calories, protein, vitamins and minerals. This is not a cause of coronary artery disease, but it can lead to other abnormalities in the heart. For example, vitamin B1 (Thiamine) deficiency can occur with malnutrition and can lead to Beri Beri with an associated Cardiomyopathy. Malnutrition can also lead to low levels of certain electrolytes such as Magnesium and Potassium. Low potassium increases the risk of abnormal heart rhythms which can potentially be fatal.