When people think of malnutrition, they often focus on people who are not getting enough food and are thus slight in nature as a result. But the truth is, according to global health organizations such as the World Health Organization, there are billions of people who are suffering from malnutrition, many of whom appear to be healthy. So, what exactly constitutes malnutrition, who is at risk of it, and how can nutrition screening protect you from falling into any of the malnutrition categories?
What Is Nutritional Risk?
Nutritionally speaking, there are three main categories into which we all fall. The first is the optimal health category. People who fall here are providing their bodies with all the nutrients (both macro and micro) that are necessary for optimal body functions. As such, they are in good health.
The second category comprises people who are at nutritional risk. In this case, people feel quite okay for the most part. However, since they are not providing their bodies with all the necessary nutrients that they need, their health statuses are declining. If these people continue with their current diets, they could easily fall into malnutrition.
As you have probably guessed, the last category belongs to people who are suffering from malnutrition such that their bodies are actually suffering physical damage from the lack of sufficient nutrients.
Breaking Down Malnutrition
When nutritional risk is left unaddressed, it paves the way for malnutrition. While the common notion is that malnutrition comes about due to deficiencies in nutrition, the truth is that malnutrition is much broader than this. It also encompasses excesses and imbalances in nutritional intake. As such, people with malnutrition can fall into any of the following categories:
Undernutrition: Here, we have four sub-forms, which are wasting, stunting, being underweight, and having deficiencies in vitamins and minerals. Children who fall into this category are often more vulnerable to disease and death compared to children who are having their nutritional needs met. Adults, too, can suffer from undernutrition.
Micronutrient-related malnutrition: Many people have access to food, yet they have deficiencies when it comes to their vitamin and mineral intake. Given that these micronutrients are essential in functions such as hormonal production, consuming a micronutrient-poor diet puts people at risk of health problems. Examples of common deficiencies around the world are iron, vitamin A, and iodine, all of which have been linked to negative health outcomes.
Being overweight, obese, or suffering from diet-related non-communicable diseases: Interestingly, consuming food in excess with regard to your energy or nutritional needs can also put you at risk of malnutrition. Findings show that many people around the world consume diets high in added sugars and fats, which are devoid of key micronutrients, thus resulting in unhealthy weight gain.
So, how prevalent is malnutrition? According to a 2024 World Health Organization report, which was based on 2022 data, 2.5 billion people are overweight, of whom 890 million are obese. At the same time, we have 390 million people who are underweight. Children are heavily affected when it comes to undernutrition, and the report highlighted that 149 million children under 5 had stunted growth and 45 million were wasted. What’s more, nearly 50% of deaths of children under 5 are related to undernutrition. On the other side of the spectrum, 37 million children were either overweight or obese.
Unfortunately, suffering from malnutrition has lasting negative impacts, not just on the individuals but also on their families and society at large.
Why Do People Develop Nutritional Risk?
At a glance, it may seem quite strange that we have billions of people around the world who lack adequate nutrition. But when you consider the nuances that predispose people to malnutrition, you quickly realize that many of us are at risk of developing malnutrition. After all, it can stem from any of the following issues:
Socioeconomic Factors
There are tons of environmental factors that determine whether people can access food, and this accessibility can pave the way for malnutrition. How so?
To start with, there are many people who face food insecurity due to financial challenges. As such, these people often favor cheap and long-lasting foods over their fresh counterparts. Unfortunately, most of these cheaper options often come laden with calories and offer poor nutritional value, thus predisposing these people to micronutrient deficiencies and weight gain.
We also have food deserts in many regions such that people living in these areas find it much easier to access fast food joints compared to fresh food in grocery stores. For the sake of convenience, many of them turn to what is available locally. And finally, we have food illiteracy. Despite the recommendations offered by governments, such as Canada’s food guide, many people are not knowledgeable when it comes to balancing their plates or reading nutrition labels. Thus, even when they have access to food both financially and physically, they struggle with making the right decisions for their health.
Medical Conditions
Besides accessibility, there are many people around the world who have access to food, but in spite of this, they struggle to derive nutrients from the foods they eat. And it all comes down to their impaired abilities to eat, digest, or regulate the nutrients in these foods.
For starters, there are many people who have impaired digestion and malabsorption due to diseases such as Crohn’s and Celiac, such that their bodies are unable to absorb optimal amounts of micronutrients even if they eat enough foods with these nutrients. Others, like those who have chronic infections or have undergone surgery, have such increased metabolic demands that their bodies are able to burn through calories fast, which puts them at risk of being underweight. There are also people who face physical barriers to eating. Examples include people with difficulty swallowing food and those undergoing chemotherapy treatment.
It is also important to note that people with eating disorders and other mental obstacles to eating may find themselves grappling with malnutrition. For instance, people with binge-eating disorders are likely to become obese in the same way that people suffering from anorexia nervosa may find themselves underweight.
Therefore, these people who otherwise have access to food find that they are still at risk of malnutrition because of these physical barriers to nutrient consumption and absorption.
Lifestyle
Our habits shape the way we eat. In this modern world, many people consume diets that are highly processed and unbalanced in terms of micronutrients. As a result, many of them lack the essential nutrients necessary for good health. We also have a good number of people who embark on restrictive diets that call for the elimination of entire food groups without strategizing ways in which they can make up for these nutritional gaps. Vegans, for example, are likely to face B12 deficiencies if they do not supplement this vitamin as their diet lacks it.
What Are The Key Signs Of Nutritional Risk?
The factors we have covered above can help you determine whether you are at risk of developing nutritional deficiencies. But what if you are already at nutritional risk? Are there any signs that can help you get back on track? Why, yes! Let us get into the warning signs that you can look for in yourself and others, and which may be due to nutritional deficiencies.
Physical Signs
When your nutrient intake, absorption, or storage is not optimal, your health suffers, and this shows up in various ways that are visible to you and others. These are:
Differences in Your Physique.
Many people dealing with nutritional deficiencies not only lose fat but also muscle tone on their bodies. As a result, they find that their bodies suffer negative changes. These include rapid weight loss, the loss of muscle tone, and even unexplained puffiness or swelling in the body. For instance, you may find that your pants are sagging yet you have not been on an intentional diet, and this would be a sign of inadequate energy intake.
Changes in Your Skin, Nails, and Hair.
What happens inside our bodies has the tendency to also reflect in our hair, skin, and nails. What’s more, when our bodies are unable to meet the demands of basic functions, they often prioritize these and taper down on maintaining the health of our skin, hair, and nails. Therefore, people with poor nutrition often find themselves dealing with issues such as thinning or shedding hair, pale or dry skin, brittle nails, slow-healing wounds, easy bruising, and dark ridges across nail beds.
Oral and Digestive Changes.
Nutritional deficiencies also cause changes in our oral cavities and digestive tracts. In fact, many people at nutritional risk usually have warning signs such as swollen or bleeding gums, swollen or unusually smooth red tongues, and frequent mouth sores, all of which are indicative of deficiencies. On top of these, some people find themselves unable to eat due to pain when chewing or difficulties in swallowing food.
Declines in Body Function.
A drop in energy levels is often a warning sign that your body is not getting enough nutrients. Usually, people know that trouble is knocking when they can no longer complete tasks with the same vigor they had in the past, such as climbing a flight of stairs. Besides energy drops, many people find that their bodies start experiencing difficulties with regulating their temperature, which results in feeling cold almost all the time. These changes can point to declining metabolic regulation.
Weight gain that puts you in the overweight or obese category is also a warning sign that you could be getting inadequate nutrients.
Behavioral Signs
Sometimes, nutritional risk is not as obvious as the physical signs we mentioned above, and you thus have to dig deeper to look for the possibility that all might not be well. How so?
Changes In How You Eat.
You or the people around you may have developed some eating habits that could put you at risk of not eating enough nutrients. A good example here would be skipping meals or replacing them with endless cups of tea or water. Another example would be a change in how fast you eat. Perhaps you may have started eating so slowly that it takes hours to finish your food. Or you may have started playing with your food rather than eating it.
On the other hand, you may have started bingeing on foods. Some people also find themselves fixated on what they term as their safe foods. In any of these cases (fixation, speed changes, and meal skipping), these are changes that could impact your nutrient intake quite negatively.
Swings in Your Cognitive Abilities.
A good number of people who do not get adequate nutrition struggle with concentration as they often grapple with issues such as forgetfulness, slowed thinking, and difficulty with focusing. These issues can arise due to low energy intake or deficiencies in nutrients such as B vitamins. In addition to the brain fog, many people deal with constant irritability and low moods that not only affect their work but also their social lives.
Changes in Your Patterns.
We all have habits that we rely on to simplify our lives. Examples include the routes we take to work, how often we do our laundry, and so on. These same habits determine how, when, and what we eat. As such, changes to these habits can put us at risk of nutritional deficiencies.
One significant habit in this regard is the push for convenience. Due to changes in finances, schedules, and even mental well-being, it is quite common for people to turn to ultra-processed foods. But while these foods are okay in moderation, relying on them too much can push out healthy foods and thus leave you with minimal nutrient intake. Other changes in habits that could point to trouble include withdrawing socially during mealtimes such that you find excuses not to eat with other people and eating in secret.
These changes take place at the individual level such that they may not be easily noticeable in other people. Even so, you can point them out if you pay attention to your eating habits, or those of other people.
Does Relating To These Signs Mean You Are In Trouble?
Many of the signs that point to nutritional risk can also be due to medical conditions. For example, people with hypothyroidism also have low energy, mood swings, and difficulties with regulating their temperatures. So, just because you can relate to these signs does not mean that you have a cause for concern. However, if you show two or more of these signs and these symptoms last for longer than three weeks, you should consider getting a basic nutritional screening.
How Does Nutrition Screening Address Nutritional Risk?
Showing the signs indicated in this guide could point to various possibilities, with inadequate nutrient intake being one of them. Therefore, getting nutrition screening is advisable as it helps determine whether or not you are at nutritional risk. The screening itself is quite simple, and it relies on tools such as the MNA (Mini Nutritional Assessment) or MUST (Malnutrition Universal Screening Tool) to gauge whether you are showing any signs of nutritional risk.
Following this assessment, you can be categorized based on your risk level, which can be low, moderate, or high. If you do fall into the moderate and high risk categories, your assessor can then guide you on the next path, be it continuous monitoring or specialized care, depending on the severity of your risk.
But why go through screening? Well, the premise behind nutrition screening is to prevent the poor health outcomes that come with malnutrition, as we had discussed earlier. After all, if you do progress to malnutrition, you are likely to suffer from complications such as impaired immune function, muscle wasting, and even death. Therefore, by getting the screening early, you can reduce your likelihood of these health issues and their related costs.
It is important to note, though, that nutrition screening is not a diagnosis but rather a way to determine what level of care each person needs based on their risk level.