Malnourishment

Malnourishment also called malnutrition is when there's an imbalance of nutrients needed to support essential body functions.

This imbalance can occur with overnutrition where nutrient intake is more than the body requires. Like with obesity or with undernutrition where nutrient intake is insufficient to meet the body's needs as seen in starvation.

So the three primary nutrients crucial for overall health are carbohydrates, proteins and fats. First, carbohydrates are the primary source of glucose used for energy and include monosaccharides, oligosaccharides and polysaccharides.

Monosaccharides are simple carbohydrates like table sugar. They're easily broken down and less nutrient dense oligosaccharides and polysaccharides are more complex.

Carbohydrates like soybeans and whole grains. These take longer to break down and are more nutrient dense.

Next, proteins are complex chains of amino acids and are the building blocks of the body. They construct tissues and important molecules like enzymes and hormones and they repair tissues.

Proteins can also be used for energy if needed. Amino acids are categorized as essential, meaning they must be ingested through the diet and non essential because they're produced within the body.

High protein foods include animal products like meat and dairy or plant based foods like legumes and nuts. Lastly, fats or lipids are composed of glycerol and fatty acids.

Fats are another source of energy and they're a critical component of cells and tissues. They also help absorb fat soluble vitamins and make up important molecules like steroids based on their chemical structure.

Fats are either saturated like butter or unsaturated. Like the fats found in avocado.

Once ingested nutrients are broken down by the digestive system absorbed and used in various ways. Carbohydrates are broken down into glucose which is transported throughout the body and used by cells for energy.

Any excess glucose is primarily stored as glycogen in the liver and muscles for later use. But once glycogen storage has reached capacity, the remaining glucose is converted into fatty acids and stored as adipose tissue.

Likewise, after proteins are broken down into amino acids, they can be converted into adipose tissue if they're not used by the tissues or for energy.

Lastly, fats are broken down into glycerol and fatty acids and used to make new types of lipids for use by the body as an energy source or stored as adipose tissue.

Now, obesity occurs when caloric intake exceeds body requirements and stems from a combination of factors. Lifestyle factors are related to dietary choices like eating an excess of high calorie foods or consuming large portions and activity level like being physically inactive or sedentary.

Certain endocrine and metabolic conditions can contribute to obesity like Cushing's syndrome which elevates glucose levels and hypothyroidism which slows metabolism.

Environmental factors can increase the risk of obesity as well including low socioeconomic status. Since high calorie, low nutrient foods tend to be more affordable and accessible and there's often less availability of parks and playgrounds.

There are also psychosocial factors like eating in times of stress or depression. Other factors include alterations in the gut microbiome and genetic and epigenetic influences.

On the other hand, starvation can occur when nutritional requirements aren't met. Sometimes calories are purposely restricted such as with anorexia, nervosa.

While in other cases, socioeconomic and environmental factors like poverty and famine are also involved. Now, obesity is a disease of body weight regulation.

It's characterized by an excess accumulation of adipose tissue which is composed of fat cells called adipocytes. Adipocytes secrete biologically active factors called adipokines, which along with hormones act on cells organs and the brain to regulate energy balance, appetite and metabolism.

However, excess accumulation of adipose tissue and dysfunction in this regulatory system leads to several complications of obesity such as type two diabetes, mellitus stroke and cancer.

On the other end of the spectrum, starvation is a gradual process involving a severe deficiency of energy intake and a decrease in the metabolic rate.

First, glucose and glycogen stores are used up after these are depleted, fat reserves are broken down through a process called lipolysis.

Once all fat reserves have been used, proteolysis begins where muscle tissue is broken down as a last effort to obtain energy needed to sustain in life.

This ultimately results in organ dysfunction and death. Now, an individual is considered obese if their body mass index or BMI is 30 kg per meter squared or higher.

However, BMI isn't a perfect measurement of obesity. In fact, some racial and ethnic groups may experience complications of obesity at lower BMI S.

While others with higher BMI S but less adipose tissue do not. Clinical manifestations associated with obesity typically include an excessive accumulation of adipose tissue with visceral and peripheral distribution.

Visceral obesity refers to body fat that's centered around the upper body and abdomen most often seen in biological males.

Whereas peripheral obesity surrounds the thighs and buttocks and is typically associated with postmenopausal biological females.

Other findings include evidence of regulatory dysfunction such as hyperglycemia, dyslipidemia and hypertension. Clinical manifestations of starvation include severe weight loss, weakness and fatigue.

Other findings stem from the depletion of protein stores and impaired synthesis of plasma proteins like albumin. As a result oncotic pressure in the intravascular space is reduced, causing a fluid shift into the interstitial tissues leading to edema.

The fluid shift can also cause drying of mucous membranes and skin while lack of protein can result in thin brittle hair, long term protein deprivation and starvation can contribute to marasmus characterized by a gross wasting of muscle and adipose tissue and quasi archer where peripheral edema and a protuberant belly are present.

All right. It's a quick recap malnourishment is when there's an imbalance of nutrients needed to support essential bodily functions.

This imbalance can occur with obesity, which is a disease of body weight regulation or with starvation, which is a severe deficiency of energy intake.