II.6.1.1. Balanced diet for children
To avoid malnutrition, a balanced diet is one that has
adequate daily servings from each of the food groups (energy giving food,
protein giving food, vitamin and mineral giving food) and provides adequate
nutrition for growth, and good health, both physical and mental. The source of
energy includes mainly rice, wheat, cassava, bananas, sweet potatoes, bread to
supply metabolic demands. The source of proteins include beans, cassava
leaves, meat, fish and eggs and contain all essential amino acids to build
organism such as in muscles. The source of essential fatty acids include the
vegetable seed oils to protect organism against diseases. The source of
micronutrients (vitamins and mineral elements) includes the dark green leaves,
red and white meats for many biochemical reactions in the body. These groups
of food must be found in the daily diet of children. The age of child is the
determining factor in portion sizes and amount of each food group recommended
(RIDHS, 2005). Breastfeeding a baby for at least six months is considered the
best way to prevent early-childhood malnutrition.
Talking to a doctor before putting a child on any kind of
diet, such as vegan, vegetarian, or low-carbohydrate, can help assure that the
child gets the full supply of nutrients that he or she needs (Brookes, 1999).
In society where the prevalence of malnutrition is high, sugar, cooking oil,
maize flour and wheat flour could be potential vehicles for delivering vitamins
and minerals.
ll.6.2. How malnutrition
decrease immune system and lead to gastrointestinal infections?
The first line of defense against these types of infection is
the innate (non specific) immune response, particularly epithelial barriers and
the mucosal immune response. Protein Malnutrition (PM) significantly
compromises mucosal epithelial barriers in the gastrointestinal, respiratory
and urogenital tracts. For example, vitamin A, protein,
micronutrients deficiencies induce the loss of mucus-producing cells. This
loss of the protective mucus blanket increases susceptibility to infection by
pathogens that would ordinarily be trapped in the mucus and swept away by the
cleansing flow of mucus out of the body. Malnourished children suffer in
greater proportion from bacterial gastrointestinal and respiratory infections
(Chandra, 1999).
The human body requires a balanced diet that provides
nutrients, minerals, and vitamins for a functional and effective immune
response. Immune function is impacted by factors including hormonal status,
age, and nutritional status. Malnutrition results in a depressed immune system
that raises the risk of infections (Hedlund, 1995).
Severe PM in newborns and small children has been shown to
cause atrophy of the thymus with reduced cell numbers and subsequently
ill-developed peripheral lymphoid organs, i.e., lymph nodes and spleen.
Malnourished children suffer in greater proportion from respiratory infections,
infectious diarrhea, and malaria, characterized by a protracted course and
exacerbated disease. These malnourished children present with diminished
functional T cell counts, increased undifferentiated lymphocyte numbers, and
depressed serum complement activity (Savino, 2002).
Several studies on the effects of malnutrition at the
immunological level have been conducted in humans and in experimental animal
models. Multiple immune system abnormalities, including lymphoid organ
atrophy, profound T-cell deficiency, altered ratios of T-cell subsets, and
decreased natural killer (NK) cell activity and cytokine production have been
described in individuals. In addition, these studies indicate that malnutrition
decreases T-cell function, cytokine production and the ability of lymphocytes
to respond appropriately to cytokines (Bhaskaram, 1992).
As shown in figure 2, nutritional deficiencies can affect
immune response and increase susceptibility to infections. In turn, infection
further aggravates nutritional deficiencies by increasing metabolic demands,
decreasing nutrient intake, or blocking absorption from the gut (Calder et al.,
2002). Nutritional and dietary supplements stimulate immune response and may
result in fewer infections, particularly in the elderly and in malnourished,
critically ill individuals (Chandra, 1999).
Figure 2: Relationship
between nutrition and infection. Adapted from (Brown, 2003).
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