Malnutrition isn’t just about being undernourished

Published May 4, 2021, 1:47 PM

by Cheshire Que

The silent pandemic amid the pandemic

There are a lot of things we don’t know about malnutrition
An estimated 47 million children younger than five years and living in the sub-Saharan Africa and South Asia were moderately or severely wasted according to the UNICEF/World Health Organization/The World Bank Group joint child malnutrition estimates in 2020.
Globally, approximately 149 million children are chronically undernourished or stunted and 50 million are acutely undernourished or wasted as reported by the Global Nutrition Report in 2020 by R Micha et al.
With the unprecedented social and economic crisis brought about by COVID-19, the nutritional status of children, as well as adult family members, are greatly threatened. As stated by Derek Headey and colleagues in their publication on the impact of COVID-19 on childhood malnutrition and nutrition-related mortality on July 27, 2020, “The economic, food, and health systems disruptions resulting from the COVID-19 pandemic are expected to continue to exacerbate all forms of malnutrition.”
Let us get closer to home as the Nutritionist Dietitians’ Association of the Philippines’ PRO Juvy Martillos-Sy sheds light on the impact of this pandemic on the nutritional status of Filipinos. She says, “Malnutrition is the remarkable impact of the pandemic on the nutritional status of every Filipino. Firstly, it can be overnutrition for those with good sources of food supply leading to eating too many calories, fatty and salty food, resulting to different specific diseases like obesity, diabetes, stroke, and other chronic diseases due to a sedentary lifestyle. Secondly, undernutrition for those individuals who are unable to meet their caloric and other nutrient requirements due to limited food access. Thirdly, other individuals may suffer from a specific nutrient deficiency or nutrient toxicity while looking physically fit.”
Indeed, malnutrition is not all about being undernourished. Overnourishment is also considered as a form of malnutrition. The Global Nutrition Report in 2020 showed that 40 million children under five years of age are overweight and 678 million are obese among the adult population.
Sy explained that malnutrition is not merely based on the body mass index (BMI). From a clinical perspective, medical history, dietary history, laboratory or metabolic panels such as hemoglobin, iron, albumin, etc. are also included in the criteria for malnutrition.
When asked about the risk of getting infected with COVID-19 if an individual is malnourished, Sy replied, “As an effect of malnutrition, we will be at the highest risk level of getting infected due to a poor immune system. Through proper nutrition, adequate calories, enough vitamins and minerals, and hydration, our bodies are strengthened to fight infection making our immune system strong and healthy. It resolves the signs and symptoms of infection, as well as the mental state of an individual.”
Currently the chief dietitian of the Asian Hospital and Medical Center, Juvy Sy is one of the active frontliners in managing positive cases of COVID-19 and recovering patients. She emphasizes the role of a registered nutritionist dietitian in managing malnutrition amid pandemic, as well as their crucial role in helping COVID-19 positive patients combat this highly communicable disease.
“As active frontliners in the hospital and the community, we provide proper nutrition care to the patients by applying nutrition assessment, nutrition diagnosis, intervention, routine monitoring and evaluation. In applying our Medical Nutrition Therapy we assure the quality outcome of our nutrition care. We design an eating plan based on an individual’s preferences and special health needs. Furthermore, we educate the public on healthy lifestyle choices with the right information on diet and nutrition. To attain good nutrition status and to aim prevention or treatment of malnutrition and other related non-communicable diseases. We share the right information based on scientific-based recommendations to protect the public against misleading advertisements and pieces of advice by non-registered or non-licensed nutritionist-dietitians.”
As the country faces worsening nutrition-related issues while trying to survive this pandemic, Juvy Sy, who was an ABBOTT Malnutrition 2020 Awardee by the Academy of Nutrition and Dietetics Foundation in the US, shares practical tips on how to prevent and correct malnutrition.
“Identifying the right macronutrients and micronutrient requirements to supply into our body must be based on our daily lifestyle or clinical condition. We must know and practice the basics of nutrition: Your plate must have carbohydrates (rice, noodles, root crops); protein (fish, meat, plant-based protein); fats (margarine, vegetable oils, avocado); vitamins and minerals (fruits, vegetables, nuts, beans); water (drinks or healthy beverages); adding prebiotics, probiotics, and plant stanols as well in our daily eating habits. Practice food variation by imagining and following the rainbow colors. Eat and drink in moderation while enjoying your day. Engage in physical activity e.g. 20-minute walking or any floor exercise three times a week. Learn how to read food labels and finally free ourselves from daily stress within our environment.”
The Philippine and US registered dietitian also reminds the public to be well informed based on facts by the duly licensed nutrition and dietetics professionals. “Rely only on our registered nutritionist-dietitians in the field for proper guidance on your nutritional needs,” said Sy.