Malnutrition has been defined as “a pathological state resulting from a relative or absolute defi­ciency or excess of one or more essential nutrients”. It comprises four forms: Under nutrition, Over nutrition, Imbalance and Specific deficiency.

Under nutrition is the condition which results when insufficient food is eaten over extended period of time. In extreme cases it is called starva­tion. Over nutrition is the pathological state resulting from the consumption of excessive quantity of food over an extended period of time, Imbalance is the pathological state resulting from a disproportion among essential nutrients with or without the absolute deficiency of any nutrient.

Specific deficiency is the pathological state resulting from a relative or absolute lack of an individual nutrient.

The effects of malnutrition are different in poor and rich communities. India is an example of a poor country where malnutrition is endemic.

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Diet survey carried out in India has shown that the average Indian diet is ill balanced with an excess of carbohydrate and very little protec­tive foods like milk, meat, fish, eggs, fruit and leafy vege­tables. While under nutrition is the pressing problem in India, the major nutritional problems in many western countries today centre round over nutrition.

Factors Related to Malnutrition:

Malnutrition makes the individual more susceptible to infection and infection in turn is one of the principal con­tributory factors of malnutrition. Infection such as diarrheas dysenteries, intestinal parasites and worms are caused due to malnutrition. But malnutrition is not always due to shortage of foods.

Too often there is starvation in the midst of plenty. People choose poor diets when good ones are available because of cultural influences the family plays an important role in shaping the food habits and these habits are passed from one generation to another. Many customs and beliefs are based on false ideas and ignorance

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Religion has also a powerful influence on the food habits of people. Certain religions or castes in India do not take meat, fish and eggs. Same people do not even eat certain vegetables like onions on religious grounds Fasting is prescribed by certain religions Prolonged fasts weaken the individual’s resistance. Thus religion is an important factor responsible for a certain amount of malnutrition in India.

Food is a purchasable commodity, it can be held only for a price. The poor people cannot afford for relatively costly and protective food such as eggs, meat, fish, milk and fruits. Therefore, the poor purchasing capacity is a very important factor in the prevalence of malnutrition.

There are several other factors such as ignorance of the people, prices of foods, population increase and urbaniza­tion contributes considerably for malnutrition.

Symptoms of Malnutrition:

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The consequences of malnutrition are (i) retarded physical and mental develop­ment (ii) lowered productivity in adulthood and (iii) occurrence of a wide range of nutritional deficiency diseases etc. The diseases arising out of over nutrition are diabetes, arterial hypertension and diseases of the gall bladder. Physical ailments and deformities, rough and wrinkled skin, anemia, sleeplessness, mental indifference, absence of alertness, fatigue, rickets etc. are some of the symptoms of malnutrition.

Preventive Measures:

Since malnutrition is the outcome of several factors social, economic, cultural and psychological the problem can be solved only by taking action simultaneously at various levels family, community, national and inter­national levels.

The problem of the in a equate nutrition can only be adequately tackled by the close co-operation and co-ordination of effort between administrators, elected representatives of the people, voluntary organizations, international bodies and ultimately by the people them­selves.

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People should be educated about the requirement of nutrition and food and arrangements should be made for the medical examination of the children by the doctors. As a precautionary measure provision should be made for crèches and children homes and students should be provided with meals in the schools.

However, the long range objective of the overall programme will be the improvement of the health of the community.