MALNUTRITION IN

ADOLESCENTS AND
PREGNANT WOMAN
GROUP MEMBERS
Arooj Malik
Bushra Malik
Mahnoor Fatima
Maryam Tariq
Tareem Akram
•Outlines
-Introdution
-Malnutrition in adolescents
-Control of malnutrition in
adolesents
-Malnutrition in pregnant women
-Control of malnutrition in pregnant
women
-Conclusion
-References
•INTRODUCTION
Malnutrition is an important public health
problem that is caused by a deficient or
excess intake of nutrients in relation to
requirements.
Under nutrient is the prevalent type of
malnutrition in tropic developing countries.
At most risk are the poor and disadvantaged,
particularly women of reproductive age and
young children.
The nutritional status of woman before and during
pregnany is important for a health pregnancy
outcome.
Maternal malnutrition is a key contributor to poor
fetal growth, low bodyweight (LWB) and infant
morbidity and mortality ,and cause long- term
irreversible and detrimental cognitive , motor and
health impairments.
Under nutrition in females may occur during
childhood , adolescence and pregnancy, and has a
cumulative adverse impact on birth weight of future
babies and later developmental milestones.
MALNUTRITION IN ADOLESCENTS
Adolescent , defined by World Health Organization (WHO)
as individuals between the ages 10 and 19 years.
Adolescents make up approximately 20% of the world’s
population.
WHO acknowledges that adolescents remain “a neglected
difficult-to –measure and hard-to-reach population.
There have been few population based studies examining
the prevalence of under nutrition(defined as body mass
index for age, less than the 5th percentile of WHO/NCHS
(National Center for Health Statistics) among adolescents
and in turn, fewer examinations with prevalence
disaggregated by region or socio-economic status.
 ADOLESCENT GROWTH
Adolescence is a time of intense growth , second only to infancy. It is
only period in individual’s life when growth velocity increases.
During adolescence, individuals can gain 15% of for two years after
menarche their ultimate adult height and 50% of their adult weight.
This rapid growth is accompanied by an increase in nutrient demand,
which also significantly influenced by infection and energy
expenditure.
Adolescents boys generally build more muscle mass ,gain weight at a
faster rate and deposits less fat than girls.
For adolescents girls, the greatest gain in height and weight normally
occurs in the year preceding menarche , and the growth spurts
continues.
 MEASUREMENT OF ADOLESCENTS NUTRITIONAL
STATUS AND GROWTH
WHO recommends standards using National Center for Health
Statistics(NCHS) data on US adolescents as reference population.
Both NCHS and WHO use BMI as a proxy measure for nutritional status of
adolescents. BMI and height for age below 5th percentile are used as the
reference data for determining under nutrition.
RECOMMENDED DIETARY
ALLOWANCE
Based on our review and other documents dealing with
nutrition in adolescence(Gillespie 1997;Chungong 1998 ;
Treffers 1998), the following are seen as the main
nutritional issues of adolescence in low-and middle-income
countries.
Under nutrition and associated deficiencies, are often
originating earlier in life;
Iron deficiency anemia and other micronutrient
deficiencies;
obesity and associated cardiovascular disease risk markers;
Early pregnancy;
Inadequate or unhealthy diets and lifestyle.
ANEMIA AND IRON DEFICIENCY
Anemia ,whether or not the primary cause of iron deficiency, is
generally recognized as the main nutritional problem in adolescents.
Heavy menstrual blood loss may be an important factor of iron
deficiency anemia, Menorrhagia was suspected to be an important
contributor to high rate of anemia (40%).
Iron deficiency and anemia may be common among young athletes
,owing to chronic urinary and gastro intestine blood loss and to
intravascular hemolysis that are associated with strenuous exercise
combined with endurance events (Raunklar and sabio,1992)
Because of muscles mass development , boys have high iron
requirements, although girls usually expected to have high anemia
rate due to onset of menarche. However , as the growth of
adolescents slows down , boys iron status improve.
MICRONUTRIENTS DEFICIENCY
The relationship of serum retinol binding protein and
retinol with puberty level suggests an important role of
vitamin A in sexual maturation.
Iodine deficiency affects all ages groups , but goiter
primarily affects people aged 15-45 years, in particular
women.
While adolescence is a high time of calcium
requirements , surveys suggest that adolescent diets are
often inadequate in calcium.
Quite a few micronutrients are suspected to be in short
supply in adolescence at least in certain population
groups.
 OBESITY
Globally, it is estimated that at least half a billion
adolescents have the most severe form of
overweight, with a BMI of 30 +, obesity. While
highest prevalence is observed in countries with
higher income.
CARDIOVASCULAR DISEASE RISKS
 Atherosclerosis and blood lipids; measuring waist
circumference of adolescents, in addition to BMI, could
help identify those who likely have adverse lipid and
insulin concentration, and who should be targeted for
weight reduction and risk-factor .
Hypertension: high blood pressure in childhood and
adolescents may be associated with impaired fetal
growth evidence by low birth weight, and this was also
observed in Africa.
Other nutrition-related chronic diseases such as CVD,
NIDDM and certain types of cancer may only appear in
adult life, but are associated with dietary and lifestyle
risk factor at adolescence many of which are associated
with obesity.
EFFECTS OF MALNUTRITION IN
ADOLESCENTS
-Impairs immune
-Delay physical growth and mental
maturation
-Reduce work capacity
-Obesity
-High maternal mortality and morbidity
-low birth weight and prematurity
-Poor lactation performance of adolescence
mother.
MALNUTRITION IN PREGNANT
WOMEN
Implication of poor nutrition in women include poor
pregnancy outcomes, highly susceptibility to disease with
slow recovery rates and reduce productivity.
Among pregnant women in particular, malnutrition can
increase the risk of obstructed labor, cause poor fetal
development, and prevent production of high quality of
breast-milk.
It can also increase the risk of death due to post-partum
hemorrhage and overall morbidity and mortality in both the
mother and child;
Therefore maintaining a healthy nutrition among pregnant
women is of utmost importance.
Both obesity and under nutrition have severe
consequences on the health of women. Some of these
include increased rate of infection, lethargy and general
body weakness leading to reduced productivity,
increased risk of maternal complication and death.
Obesity in particular increase the risk of developing
cardiovascular disease in women and In pregnancy it
induces gestational diabetes and hypertension.
Micronutrients are only needed in small amount;
however; any form of their deficiency can be severe.
COMMON PROBLEM ASSOCIATED
WITH PREGNANCY
Nausea and vomiting: up to 80% of pregnant women
experience this at some point, usually beginning between
the 4th and 7th weeks after their last period and ending
for most women by the 20th week.
Craving and aversions
Heartburn
Morning sickness: comes from hormonal changes in early
pregnancy. Smells often trigger it.
Gestational diabetes
Hypertension
pica
preeclampsia
LIFE-STYLE INTERACTION AND
PREGNANCY
The American College of Obstetrician and
Gynecologist(ACOG) recommends that pregnant
women without medical or more of moderate
exercise a day in a week if not everyday
Women who maintain high level of physical
activity during pregnancy will have relative caloric
needs higher than less-active women who are in
the same age of pregnancy induced
hypertension, preterm rupture of membranes,
preterm labor, incompetent cervix.
Avoid Cigarette Smoking
AND Drinking of alcohol CAUSE
PROBLEM LIKE:
Irreversible brain damage
mental retardation
Nicotine & cyanide are toxic to a fetus
Second hand smoke is also problematic
blood flow is restricted
Slow fetal growth
Low birth weight
CONCLUSION
The severe consequences of poor nutrition on
adolescents and pregnant women health cannot
be over emphasized and households that are poor
are particularly at risks.
Nutrition promotion should be campaigned
among the adolescents, in school, community and
society at large.
Prevention of early pregnancy and other
preventable diseases association with
malnutrition, particularly, micronutrient
deficiency.