As a doctor today I prescribe nutritious food for every hungry child.
"Pathology of Marasmus and Kwashiorkor"
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You cannot tell a hungry child that you gave
him food yesterday. Zimbabwean Proverb.
Obesity is a common problem in both developed and developing urban cities. Numerous blog posts and articles have been written about how to lose weight, health benefits of yoga and regular exercise to stay fit and trim.
As a doctor of a developing urban city, which has faced some of the worst famines in the history of India my today's post is on pangs of hunger due to poverty and serious diseases caused by malnutrition.
Malnutrition is indeed a major health problem in the developing countries particularly Asia and Africa.
The United Nations Food and Agriculture Organization estimates that nearly 870 million people of the 7.1 billion people in the world, or one in eight, are suffering from chronic undernourishment. There are 16 million people undernourished in developed countries. ( 2014 World Hunger and Poverty Facts and Statistics).
Children are the most common victims of hunger.
More than one billion people in the world live on less than one dollar a day. These people cannot buy basic food to protect their children from malnutrition.
Protein-calorie malnutrition is a direct result of inadequate dietary protein together with a deficient intake of the carbohydrates and lipids necessary to provide an adequate energy source.
Marasmus and kwashiorkor are clinically distinct manifestations of severe malnutrition.
These conditions are typically seen at times of famine when all the people in an area have hardly anything to eat. When it lasts for a long time people die of starvation.
A secondary form of this condition arises when disease prevents absorption of nutrients from the intestine or provokes an increased nutritional demand.
It should be recalled that a lack of carbohydrates and lipids results in the oxidation of endogenous protein,a complication that leads to wasting.
These states are found not only in children and adults in endemic areas of restricted food supply, but also in as many hospitalized adult patients, because of the increased nutritional needs associated with the underlying disease.
Manifestations of protein-energy deficiency vary depending on the individual and his or her state of development.
Infants and children are particularly susceptible because of their requirements or growth.
There are two ends of the spectrum of protein-calorie malnutrition, reflecting the relative imbalance between the components of the diet.
A deficiency of calories from all sources leads to marasmus, whereas a diet deficient in protein alone is associated with kwashiorkor.
The classic manifestations of either of these conditions are rare when compared with the high incidence of intermediate states of undernutrition.
Both marasmus and kwashiorkor, as well as their intermediate states, are often complicated by deficiencies in vitamins and minerals.
Marasmus is a condition which is common throughout the developing world, specially when breast feeding is stopped and the child must subsist on inadequate diet with low calories.
The disastrous consequence of inadequate food is growth failure of the child.
Another common diseases of infancy and childhood in the developing world is kwashiorkor, a syndrome that results from a deficiency of protein in a diet relatively high in carbohydrates.
As in the case of marasmus, the disorder commonly occurs after the baby is weaned. Mother's milk is replaced by a protein-poor diet and it usually consists of cheap carbohydrate food.
The Right to Adequate Food is a fundamental human right firmly established in international law (Article 25).
According to World bank report nearly half of India's children- approximately 60 million - are underweight, 45% have stunted growth, 20% are wasted (too thin for their height, indicating acute malnutrition), 75% are anaemic, and 57% are deficient in Vitamin A.
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