As mentioned earlier, under-nutrition is the result of deficiency of one or more of the essential nutrients in the diet. The scope of under­ nutrition can be general or partial. General under-nutrition implies a total reduction in food intake (hollow hunger) while partial under nutrition results from a deficiency of one or several nutrients (hidden hunger). Primary under-nutrition results from a poor dietary intake, whereas secondary under-nutrition is caused by some disease process in body which interferes with the normal utilization and assimilation of the nutrients. Under-nutrition may be termed ‘mild’, ‘moderate’, or ‘severe’ depending on the degree of the problem.

Under-nutrition is the form of malnutrition which is wide spread in the developing countries with large population and low economic strata. Nearly two thirds of the total world population suffers from the varying degrees of malnutrition. In India poor growth and other manifestations of under-nutrition can be seen among its population.

Causes of Under-nutrition

1. Ignorance

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Lack of knowledge about the kinds and amounts of food needed for good nutrition is one of the main causes of inadequate food intake and consequent under nutrition. The specific growth requirements of children, increased nutritional needs of women during pregnancy and lactation are examples where such knowledge is required. Wrong ways of weaning the child often lead to infant malnutrition.

2. Poverty

Poor economic conditions which reduce the purchasing power of an individual constitute one of the major reasons for inadequate food intake among the poorer sections of the society. This, in the long run, results in deficiency diseases. Low-income groups resort to cheaper foods of low nutritive value. Poverty, together with ignorance, precipitates a condition of under nutrition among individu­als. An example is given on the next page.

Infants of mothers from low economic strata suffer in two ways. Firstly; they are weaned off without suitable alternative foods. Sec­ondly, the breast milk may be substituted by other milk given in diluted forms under poor hygienic conditions. The under-nutrition thus resulting can be seen in the chart on the next page.

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3. Individual Factors

Individuals may be undernourished due to their socio-cultural and religious values that force them to stick to old beliefs about food habits. Personal food fads and the desire to look slim may also deprive an individual of adequate nourishment.

4. Accidents and ill-health

Prolonged and acute illness like anae­mia, diarrhea, uncontrolled diabetes, trauma from bums, fractures, profuse bleeding due to accidents and operations and resultant mal­absorption may also lead to under-nutrition.

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5. Alcoholism and Drug-Addiction

Excessive intake of alcohol and drugs interferes with normal food consumption and digestion.

Psychological factors lead to lack of appetite. Inability to eat foods or allergy may also contribute to under-nutrition.

6. Environmental Factors

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The home environment is an important factor in developing proper nutritional habits. Faulty meal-timings, over-fatigue before taking food, over-emphasis on table manners among children, etc., often interfere with satisfactory food intake. These factors affect the normal feeding habits of children leading to malnutrition. Natural calamities such a famine, floods and droughts cause acute shortage and non-availability of food resulting in starvation.

Sometimes certain locally available food may be deficient in normal nutrient composition. For example, foods grown in the iodine-deficient soil of the sub-Himalayan regions lack iodine (responsible for the proper functioning of the thyroid glands) leading to deficiency symptoms in people of that region.

Certain food may have adverse effects on the absorption of other nutrients. For example, cabbage contains goitrogenic factors which increase iodine requirement by blocking the uptake of iodine by thyroid glands.

A judicious combination of various food groups is required to ensure that nutrient demands of individuals are fully met.

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It is a common misconception that under-nutrition is found only among the poor. Instances of under-nutrition among affluent groups of people are not uncommon.

Dieting is yet another cause of poor nutrition. Rich ladies and young adolescent girls often succumb to fancy ideas of dieting gathered from unreliable and unauthentic sources. Dieting by exclusion of essential nutrients and skipping of meals often leads to under- nutrition.

Young working house holders also end up having some effects of poor nutrition in case they do not pay adequate attention to the foods they need to consume.

Eating high calorie snacks like chocolates, pastries and other sweets in between the meals is a bad habit. Habitual consumption of ‘fast-foods’, processed and tinned food often paves the way to the wrong eating habits.