IMAGINE how health would be affected by economic devastation in a world already reeling from a pandemic.
Tumbling purchasing power would leave many families and nations hungry. Inadequate or improper diets would push many more to the brink of malnutrition, which is an urgent global problem.
For a child, the precious first 1,000 days is crucial for lifelong health, and should be capitalised on to ensure good growth. Scarce nutrition at this time may set the stage for long-term diseases. For a pregnant woman, malnutrition can affect her unborn child, and even impact generations to come.
What exactly is malnutrition?
Do we realise that malnutrition includes not only a state of deficiency, but also a state of excess or imbalance?
Being underweight (wasted, stunted, or both); being overweight or obese; and, having an excess or deficiency of vitamins and minerals are all types of malnutrition.
Nutrition and immunity
The importance of nutrition is such that it influences a network linking our immunity, metabolism and hormones.
A malnourished child has to cope with an initially increased metabolism. So, the focus of food energy is to survive. There is very little extra energy to fight infections. Immune-system cells are, after all, just like any other cells in the body, and need energy to function.
When a malnourished person has to fight off an infection, the body doesn’t do it right because there are a lot of unnecessary inflammatory processes. So, the person is really in a state of immune deficiency, and this is only the tip of the iceberg because nutrition functions in so many ways.
When protein, an extremely important nutrient in diet, is reduced, infections occur frequently because immune cells contain proteins. Malnourished individuals also suffer because their intestinal barriers, which keep infections within the gut, don’t function properly. There is not only the risk of frequent infections, but also the risk of a dangerous spread of infections.
It’s important to get micronutrients in a balanced diet. An iron deficiency increases the risk of infections, but too much of it can predispose one to infections. Therefore, popping iron tablets without getting medical advice is dangerous.
Vitamin A and iodine deficiencies may be more subtle in the early stages, but can also increase infection risks.
Obesity, at the other end of the malnutrition spectrum, is a risk factor in H1N1 and Covid-19 cases.
Not always aware
The face of malnutrition is so varied today that many people are actually suffering from one deficiency or another without knowing it.
Since nutrition is so important to fight infections, how we respond to infections really depends on our holistic nutrition. For example, although we know some of the underlying health issues that put a Covid-19 patient’s life at bigger risk, there are still victims without such issues who have succumbed to the disease.
Hence, having a balanced diet, immunising against diseases with vaccines, and being up to date on new, approved vaccines are necessary.
Vaccination and malnutrition
Since malnutrition causes so many problems, one may wonder if undernourished children can respond well to vaccines.
The best strategy is to do both – improve their nutrition and vaccinate them.
Fortunately, even malnourished children can respond well to vaccination, although how severely malnourished they are may result in some differences in their response.
These children are important target groups for vaccination because of their risk of severe infections. Infections can tip the balance of nutrition in any child, but vaccinations work by protecting them. Studies have indicated that even when children suffer stunting and wasting, vaccines can normalise growth in a number of them.
Vaccinations allow an undernourished child to use their precious calories for growth and development of the body and brain, instead of simply fighting infections. Also, let’s not overlook the fact that by vaccinating children, the number of vaccinated individuals in a population increases, and that’s important for herd immunity. – April 28, 2020.
* Dr Prameela Kannan Kutty is professor of paediatrics at Universiti Pertahanan Nasional Malaysia.
* This is the opinion of the writer or publication and does not necessarily represent the views of The Malaysian Insight. Article may be edited for brevity and clarity.
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