What Exactly Is Malnutrition?

Symptoms and a brief education on the disorder that affects people of all socioeconomic strata.

Malnutrition: The word conjures up images of suffering children in Third World countries, with swollen bellies, protruding ribs, and sunken eyes. But while those children are certainly severely malnourished, the condition is not restricted to those in dire poverty.  
Malnutrition takes many forms and affects people of all socioeconomic strata—including the affluent and educated—all over the world. But what, exactly, is malnutrition?

In the broadest sense, it encompasses both undernutrition and overnutrition—that is, a state in which the body does not have the correct amount of vitamins, minerals, and other nutrients needed to maintain healthy tissues and organ function. In a nutshell, it means it’s quite possible to eat a lot and still not be adequately nourished.

According to the World Health Organization (WHO), malnutrition is the “gravest single threat to global public health…, especially in developing countries.” But even right here in Westchester, there are people who are malnourished and may not even realize it.
“Malnourishment can have so many different causes,” says Maria Capparelli, MD, an internal medicine physician at Westchester Medical Center who says that even someone who eats a wholesome, organic diet can suffer from malnutrition. This is also true for someone who is overweight or at a healthy weight, for that matter. Erica Leon, a White Plains registered dietitian, says, “I see people from affluent areas who can and do eat healthy foods but don’t get the vital nutrients, vitamins, and minerals that their bodies need and, over time, become malnourished.”

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So, how do you know if you’re malnourished? Outward appearance—like dry, brittle hair, cracked nails, excess belly fat, and rashes—can sometimes be signs of poor nutrition, says Erika Krauss, DO, an internist with WESTMED Medical Group. Other signs occur slowly over time and may be less obvious, like poor wound healing, easy bruising, and dental problems. Unintentional weight loss, poor concentration, depression, and fatigue may also  point to malnourishment. Additionally, blood tests may reveal low albumin or protein levels, and sometimes elevated liver enzymes, says Dr. Krauss, who adds that kidney function may be off, as well.
But it’s not just the foods you eat (or don’t eat) that can lead to malnourishment. Certain medications, like proton-pump inhibitors (Prilosec, Nexium), taken for GERD or heartburn, may cause malabsorption of certain sugars, fats, proteins, or vitamins, says Dr. Capparelli. So can some cholesterol-lowering medications (like cholestyramine), as well as long-term use of  tetracycline and medications for gout (colchicine), she says. Additionally, health conditions such as AIDS, HIV, celiac disease, and certain types of cancer can cause the body to become malnourished, by interfering with its ability to absorb and retain the nutrients it needs to thrive.

Malnutrition is treated by replacing missing nutrients with nutritional supplements and/or foods, as well as treating the underlying cause of the disorder.  

“We’ve always thought that malnutrition equals starvation, but that’s not the case,” says Dr.    Capparelli. “The condition does not discriminate. You can be very educated and healthy and still be malnourished.”

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