Malnutrition Over or Under is in the Details

Before we can begin to discuss questions of malnutrition under or over, it is important that we understand what nutrition is? Nutrition is the study of the interactions of nutrients and other substances in food which the body uses for preservation, development, reproduction, health and reducing the effects of diseases, WHO (2016).  To understand whether the effects of malnutrition, over or under we must explore food. Since nutrition is the intake of food and key for the body’s use, therefore malnutrition over or under is important to eliminate. Food produces six categories of nutrients that the body needs for reproduction, development, preservation and health to reduce the effects of disease. The six nutrients from food are proteins, carbohydrates, fat, fibers, vitamins and minerals and water. Combining the proper amount of these nutrients with daily physical activity along with a well-adjusted mindset is the foundation for good health.  Inadequate nutrition can lead to reduced defense, increased exposure to disease, impaired physical and mental development and reduce output. This is the mechanism that drive organisms to maintain life and grow. However, the whole idea surrounding food is more complicated than substances that we intake to maintain life and grow. In last week assignment food was looked at in terms of what is good for us and what is good to us which provide motive and incentives for our actions. Food determines who we are and what we become, and if we can harness its true meaning than just maybe we can understand why we do the things we do. The starting point is the effects of culture and lifestyle.

Food Culture and Lifestyle

Where we are born, raised and live is influenced and influences everything that we do. Even the food that we consume. Let us investigate a growing global public health problem, childhood obesity. The World Health Organization (2007), reported 20 million children under the age of 5 are overweight. In just 3 years that number had doubled to an estimated 42 million.  The problem with this situation is that the risky of these individuals moving into adolescence and adulthood presents major health concerns, Rooney and Ozanne (2011). One of the prevailing thought is that lifestyle choices are contributing to this epidemic. Keep in mind that culture and lifestyle is undoubtedly the most important processes of human experiences as they determine quality of life. To understand human food condition, it is essential that it begins with culture. Culture is an integrated pattern of knowledge, belief and behavior that are learned and transmitted to succeeding generations. When culture is shaped and highlighted in commonplace life its shared appearance is expressed through lifestyle. Having a shared attitude, value, goals and practices that characterizes a place or time as societal practices are hard to undo.

As we enter the first half of the first quarter of this century we are still challenged by behaviors of the last half of the last century. Illnesses that can be directly tied to our consumption of food (Williams and Wu, 2016, p. 226). What must be kept in mind is that food is a general term that provides us with “nutritious substance” that ensure maintenance and growth of life. Maintaining the proper balance and amount of nutrition substance and their frequency can improve reducing the incident of being a statistic of an illness. Fletcher et al, 1992. When starting and maintaining patterns of behavior whether it is over or under can be viewed as being malnourished.

What is Malnourished?

World Health Organization (2016) defined malnourished as a lack of proper balance and amount of food, a deficiency, excess or imbalance. Malnourished therefore covers two distinct groups. According to the World Health Organization one is “undernutrition” which includes stunting (low height for age), wasting (low weight for height), underweight (low weight for age) and micronutrient deficiencies or insufficiencies (a lack of important vitamins and minerals). The other is “overnutrition” overweight, obesity and diet-related noncommunicable diseases (such as heart disease, stroke, diabetes and cancer).

Barr and Mosby, (2016) noted that malnutrition cannot be found in low and mid income countries but is an issue for high income countries (HIC), the problem of being overweight or obese. They looked at children and adolescents with leukemia and found that the majority of their finding was associated with the nutritional status and a poorer clinical outcome in these children originated in HIC due to obesity. They also found that 80% of children and adolescents with cancer are from low to middle income countries and are defined as being under-nutrition as their nutritional status. The result of this ailment is a lack of energy, protein, and other nutrients that causes measurable detrimental effect on tissue/body system and purpose. Childhood obesity is a public health concern throughout the world. An international task force reported that 1 in 10 children between the age of 5 and 17 are overweight.

Under and Over Nutrition

Abdelhadi et al. 2016, investigated characteristics of hospitalized children diagnosed with malnutrition. They found in their report that greater than 80,000 patients with a coded diagnosis of malnutrition was found to have not been studied. Their report documented the underreporting of malnutrition of pediatric healthcare facilities. Although, their report did not reflect the real frequency of malnutrition in hospitalized children, it does define the population, their length of stay, treatment cost and resources. Under and over nutrition is not only a concern in the world community it is also a concern for refugees in San Diego County California. Rondinelli et al. 2011, reported that in 2007 67 million people worldwide were forcibly displaced from their home of origin due to war or political persecution with 75,000 and 64% admitted to the United States with California having admitted the second largest number. Coming from a foreign country an in-depth interview was conducted and several influencing factors was found, ranging from past habits on present nutrition acculturation, socio-economic, lack of familiarity as well as region settling. In this instance over nutrition was the results of individuals with them reporting that given the abundance of easy to obtain food one could go in a year from 110lbs to over 200lbs. There was also an increase in children weight gain. And more alarming was that not only did they see weight gains many reported that their malnourishment and/or anemia was a problem after being resettled, Rondinelli et al (2011).

The Consequences of Malnutrition

The consequences of malnutrition is well documented by the WHO, who reported the following:

  1. Malnutrition is a worldwide problem
  2. 9 billion adults are overweight
  3. 462 million are underweight
  4. 42 million children under the age of 5 are overweight or obese
  5. 159 million are stunted
  6. 50 million are wasted
  7. 528 million or 29% of women of reproductive age are affected by anemia
  8. Many cannot afford or access enough nutritious foods, while foods that are cheaper are readily available
  9. It is common to find undernutrition and overweight within the same community
  10. It is possible to be both overweight and micronutrient deficient

The consequences of malnutrition is astounding and must be addressed. Within a cultural setting the belief-value connection is so profound whether it applies to the middle, low and even the high-income nation that there is still a need to change these behaviors. Change is not easy, and to that end attempts are a necessity. As Rooney and Ozanne (2011), concluded as maternal obesity increases so does the risk of childhood obesity with the same individual developing adult diseases. They thought that the real and present need for intervention was targeting the development of offspring obesity.


Although the present need worldwide is to reduce the problems of malnutrition it is no doubt an uphill battle. With political unrest within countries that leads to resettling of refugees. Causing families to be uprooted from their cultural roots and planted in a culture that has been shown to produce some of the same health problem of malnutrition. In other situations where warring factions has produced population displacement and famine thereby making it difficult for families especially pregnant mothers, babies and adolescents. This situation is also leading to under malnutrition and other related health problems for these families. As offspring obesity continue to rise targeted prevention interventions must be sort. Creating a program around awareness for the pregnant mothers about their nutrition can help the birth and development of her baby. Low and middle-income countries are not only faced with not being able to buy the necessary food that can help reduce health problems of malnutrition. As the worldwide malnutrition over or under increases it must be addressed. To combat this growing concern there must be an awareness that this problem is in the details.


Jones, D., J., K., and Berkley, A., J., 2014, Severe Acute Malnutrition and Infection, Pediatrics and International Child Health, vol. 34, no. S1, pp. 1-29.

Rondinelli, A., J., Morris, M., D., Rodwell, C., T., Moser, S., K., Paulino, P., Popper., T., and Brouwer, C., K., 2011, Under-and Over-Nutrition Among Refugees in San Diego County, California, J Immigrant Minority Health, vol. 13, pp. 161-168.

Rooney, K., and Ozanne, SE., 2011, Maternal Over-Nutrition and Offspring Obesity Predisposition: Targets for Preventative Interventions, International Journal of Obesity, vol. 35, pp. 883-890.

Barr, D., R., and Mosby, T., T., 2016, Nutritional Status in Children and Adolescents with Leukemia: An Emphasis on Clinical Outcomes in Low and Middle-Income Countries, Hematology, vol., 21, no.4 pp. 199-205.

Tooley, U., A., Makhoul, Z., and Fisher, P., A., 2016, Nutritional Status of Foster Children in the U.S.: Implications for Cognitive and Behavioral Development, Children and Youth Services Review, vol. 70, pp. 369-374.