Disorders related to nutritional imbalance cvd diabetes cancers hypertension

1. DISORDERS RELATED TO NUTRITIONAL IMBALANCE
Nutritional imbalance:
Nutritional imbalance can be caused by an inability of the body to absorb certain nutrients or
result from a poor diet. Depending on the nutrients in short or excess supply, imbalances create
unpleasant side effects and conditions that could lead to serious disease.
Malnutrition:
Malnutrition is a state with lack of nutrients or specific nutrients that are required for growth,
maintenance, and proper mechanism of body functions. Malnutrition is the name given to such
situations that describe over or under consumption of food.
The World Health Organization (WHO) defines malnutrition as "the cellular imbalance between
the supply of nutrients and energy and the body's demand for them to ensure growth,
maintenance, and specific functions."
This state is a nutritional imbalance which shows the difference between nutrients that our body
needs and nutrients that our body gets. This might happen because of majorly three reasons:
 Imbalanced Nutrition (Unbalanced Consumption)
Imbalanced nutrition refers to improper ratio of nutrients. When we intake certain
nutrients more and more everyday for a longer period of time and simultaneously keep
avoiding the consumption of other important nutrients, such a diet is said to be improper,
unhealthy and unbalanced.
 Over Nutrition (Excessive Consumption)
Over-nutrition, that is, too much consumption of calories or nutrients that are used by
organism in expending (absorbing) or expelling (removing). The excessive consumption
of sustenance ultimately leads to poor health and obesity. Other results can cause brittle
nails, hair loss and irregular premenstrual cycle in females.
 Under Nutrition (Insufficient Consumption)
Under-nutrition, that is, less consumption of calories or specific nutrients that are used for
fulfilling the energy need of body for organism absorption, expels and expends. The
insufficient consumption of sustenance leads to poor health, diseases and disorders.
Nutrients playing role in nutritional imbalance:
Various nutrients such as simple carbohydrates, complex carbohydrates, saturated fat,
unsaturated fat, trans fat, fats, omega-3 fats, omega-6 fats, cholesterol, protein, sodium, iron,
iodine, Vitamin A, B1, B2, B12 and Vitamin C, D, E, K, calcium, magnesium and potassium
play vital role in nutritional imbalance.

2. Disorders caused by nutritional imbalance:
Following are some disorders caused by nutritional imbalance.
 Overweight and obesity
 Diabetes mellitus
 Protein energy malnutrition (Marasmus, Kwashiorkor)
 Cardiovascular diseases
 Cancers (lung cancer, liver cancer, breast cancer, oropharyngeal cancers)
 Other diseases or disorders (Hypertension, Arthritis, Osteomalacia, Osteoporosis,
Rickets, Scurvy, Anemia, Goitre)
Overweight and Obesity
Overweight and obesity are defined as the medical condition in which excess body fat has
accumulated to an extent that it may have negative effects on health.
Overweight and obesity is a major contributor in reducing life expectancy. It is linked with the
development of coronary heart disease, diabetes, gallbladder, hypertension, respiratory ailments
and certain types of cancers.
Body mass index
Body mass index (BMI) is a simple index of weight-for-height that is commonly used to classify
overweight and obesity in adults. It is defined as a person’s weight in kilograms divided by the
square of his height in meters (kg/m2).
WHO recommended BMI
Classification BMI (kg/m2)
Underweight <18.5
Normal range 18.5–24.9
Overweight >25.0
Pre-obese 25–29.9
Mildly increased obese ≥30.0
Class I obese 30.0–34.9
Moderate Class II obese 35.0–39.9
Severe Class III obese ≥40.0

3. Causes of overweight and obesity
 Most common cause of overweight and obesity is the intake of high levels of fatty foods,
high calorie food, and high carbohydrate intake
 Other causes include inherited trait, excessive fat cells (depending on dietary habits) and
underactive thyroid gland (that produces a hormone to regulate metabolism).
Symptoms of overweight and obesity
 Breathlessness
 Increased sweating
 High BMI (Body Mass Index)
Prevention and Treatment for overweight and obese persons
 Low carbohydrate and fat diet (low calorie intake i.e. 800-1500 calories)
 Lifestyle changing such as increased exercise and physical activity
 Increased intake of water.
 Medication (vitamin and mineral supplements) and surgery for extremely obese people.
 Intake of fruits and vegetables high in fiber, vitamins and minerals but low in calorie,
whole legumes, lean meat, protein rich foods and skim milk.
Diabetes mellitus
The term ‘diabetes mellitus’ is used to describe a group of conditions characterized by raised
blood glucose levels resulting from an absolute or relative deficiency of insulin.
 In insulin-dependent diabetes (IDDM) now known as type1 diabetes, there is destruction
of the pancreatic islet beta cells usually resulting from an autoimmune process and
insulin treatment is essential to maintain life.
 In non-insulin-dependent diabetes (NIDDM), type 2 diabetes, a key abnormality is
resistance to the action of insulin and in the early stages of the disease insulin levels may
actually be raised.
Causes of diabetes mellitus
 High intake of dietary sugar and carbohydrate rich foods, overweight and obesity
 Insulin resistance by the body because of genetics and lifestyle.
 Lack of awareness because many people are diagnosed with diabetes only after they have
developed serious complication, such as heart attack, kidney disease, impaired eyesight.

4. Symptoms of diabetes mellitus
 Fatigue and frequent urination
 Extreme thirst and hunger
 Slow wound healing and blurry vision
Prevention and Treatment for type 2 diabetic persons
 Intake of low glycaemic foods rich in soluble fibre
 Exercise and weight loss
 Table sugar (sucrose) should be replaced with raw sugar (jaggery) in minute quantity.
 Medications as prescribed by the doctor.
Normal blood glucose levels
Time of Check
Goal plasma blood
glucose ranges
for people without diabetes
(mg/dl)
Goal plasma blood
glucose ranges
for people with diabetes
(mg/dl)
Before breakfast (fasting) < 100 70 – 130
Before lunch, supper and snack < 110 70 – 130
Two hours after meals < 140 < 180
Bedtime < 120 90- 150
Protein energymalnutrition
The human body can become deficient of protein due to low intake of protein in diet. Due to
protein deficiency children are highly affected and suffer from PEM (Protein Energy
Malnutrition). PEM also occur in individuals who are unable to absorb vital nutrients and also
incapable of energy generation required for proper functioning of body organs and tissues. PEM
develops gradually in children suffering from chronic illness while it develops suddenly in
children suffering from acute illness.
There are two form of severe PEM which are
 Marasmus
 Kwashiorkor

5. Marasmus
The term marasmus, derived from Greek word marasmos, means withering or wasting.
Marasmus is the form of PEM in developing countries. It is the child equivalent of starvation.
Infants from six months to one year are more susceptible to marasmus who is weaned from
breast milk.
Causes of Marasmus
 Improper supply of nutrients to the child and inability of the child to absorb nutrients.
 Also caused by infections such as syphilis or tuberculosis.
 Chronic diseases in children such as chronic diarrhea.
 Unhygienic conditions spread infections and diseases.
Symptoms of Marasmus
 Thin face, sunken eyes, ribs and shoulder bones are visible.
 Stomach may be swollen and diarrhoea develops.
 Lethargic and less resistant to infections.
 Stunted growth and intellectual disabilities.
Prevention and treatment of Marasmus
 Mothers should breast feed their new born to prevent malnourishment i.e. marasmus.
 Good sanitation and hygienic condition should be maintained.
 A well-balanced diet should be followed which contains essential proteins,
carbohydrates, fats, minerals, vitamins and clean water.
 Treatment prescribed by the doctor in case of severe marasmus should be followed.
Kwashiorkor
The term kwashiorkor is taken from the Ga language of Ghana and means “the sickness of the
weaning.” Kwashiorkor is usually common in children which are weaned from protein rich
breast milk to a very low protein diet. It occurs in children from one to five years.
Causes of Kwashiorkor
 Famine, natural disaster i.e. floods, earthquakes etc
 Limited food supply especially protein, carbohydrates and fats essential for body health
 Lack of awareness i.e. people don’t know to take proper diet.
 Parasites and infection that interfere with nutritional status.

6. Symptoms of Kwashiorkor
 Change in skin and hair colour to rust colour
 Fatigue
 Loss of muscle mass and failure to grow and gain weight
 Swelling of ankles, feet and belly (edema)
 Damaged immune system
Prevention and treatment of Kwashiorkor
 Immunization to infectious diseases
 Intake of well-balanced diet consisting of all essential proteins, carbohydrates, fats,
water, vitamins and minerals.
 Treatment prescribed by the doctor in case of severe kwashiorkor should be followed
otherwise death may occur.
Difference between Marasmus and Kwashiorkor
Features Kwashiorkor Marasmus
Definition
Kwashiorkor is a kind of
malnutrition. It is primarily caused
due to insufficient intake of
proteins.
Marasmus is a kind of malnutrition
that occurs due to deficiency of
proteins, carbohydrates and fats in
the diet.
Symptoms
Large belly sticking out, diarrhea,
change in skin pigment, decreased
muscle mass, diarrhea, failure to
gain weight and grow, fatigue, hair
changes, etc.
Peeling and alternately pigmented
skin, hair loss, edema or swelling,
skin folds are formed, etc.
Affecting Generally children of age 1-5 years Generally children under the age 1
Main causes
Weaned from mother’s milk to a
diet low in protein
Failed breastfeeding, feeding
inadequate infant formula or
suffering from some disease like
diarrhea
Wasting of
muscles
Not evident Quite evident
Bloated belly Yes, due to retention of fluids No
Treatment
Providing carbohydrates followed
by high protein foods. Dried milk
specially.
Providing a nutritious, well-
balanced diet with lots of fresh
fruits and vegetables, grains, and
protein.

7. Cardiovasculardiseases CVD
Cardiovascular disease is usually assumed to include coronary heart disease (CHD) (also referred
to as coronary artery disease (CAD) or ischemic heart disease (IHD)), cerebrovascular disease
and peripheral arterial disease. Inappropriate nutrition has most consistently been linked with
CHD. Cardiovascular diseases affect the heart and blood vessels. A group of risk factors of CVD
are known as the metabolic syndrome, previously known as Syndrome X. These risk factors
which are applicable to both children and adults are abdominal obesity, high blood lipids such as
triglycerides, low HDL, high LDL, high blood pressure, insulin resistance and elevated highly
sensitive C-reactive protein in the blood.
Coronary heart disease CHD
When a waxy substance, plaque builds up inside the coronary arteries, which supply oxygen-rich
blood to the heart from the lungs, coronary heart disease CHD or coronary artery disease CAD
may occurs. Plaque can harden or rupture. If the plaque hardens, coronary arteries become
narrow causing difficulty in providing heart oxygenated blood. If the plaque ruptures, blood
clotting may occur. Depending on the size of blood clot, the coronary artery may be completely
or partially blocked.
Causes of Coronary heart disease
 Overweight and obesity, sedentary lifestyle
 Smoking
 High blood pressure and high cholesterol
 Diabetes or insulin resistance
 Family history or genetics
Symptoms of Coronary heart disease
 Chest pain (angina)
 Shortness of breath
 Heart attack or myocardial infarction
 Increased sweating
Prevention and treatment of Coronary heart disease
 Controlling blood cholesterol level and blood pressure
 Intake of monounsaturated and polyunsaturated fatty acids rather than saturated fatty
acids and consuming a well-balanced diet with reduced sugar and salt.
 Lifestyle changes from sedentary to active, reducing obesity.
 Medication and surgery (Laser, Coronary bypass, Angioplasty and stent placement)

8. Cancers
An abnormal growth of cells which tend to proliferate in an uncontrolled way and, in some cases,
to metastasize (spread). Cancer is a class of diseases characterized by out-of-control cell growth.
There are two types of tumors i.e. benign tumor and malignant tumor. Tumors which remain at
their original location are called benign tumors. Tumors which invade other tissues are called
malignant or cancerous tumors. Such tumors spread cancer cells to other parts of the body where
new tumor may form. This phenomenon is called metastasis (spreading of disease).
Types of cancers
There are many different types of cancers i.e. oropharyngeal cancers, oesophageal cancer,
stomach cancer, large bowel cancer (colorectal cancer), breast cancer, lung cancer, liver cancer,
prostate cancer etc.
Cancers like breast cancer, lung cancer, liver cancer, colorectal cancer, prostate cancer are most
commonly diagnosed in Pakistan.
Types of
cancer
Causes Symptoms
Prevention and
treatment
Oropharyng
eal cancers
 Excessive
smoking
 Excessive
consumption of
tobacco and
alcohol
 Family history
 Human
papillomavirus
(HPV)
 Poor Oral hygiene
 Sore throat
 Pain and difficulty
in swallowing
 Sudden weight
loss
 Ear pain
 Changes in voice
 Lump in the neck,
back of throat and
mouth
 Avoid smoking
and consumption
of tobacco and
alcohol
 Vaccination of
HPV (Human
papillomavirus)
 Surgery,
radiotherapy and
chemotherapy
according to the
stage of cancer
Lung cancer
 Smoking
 Passive smoking
 Family history
 High indoor
levels of radon (a
radioactive gas
emitted by soil)
 Asbestos (a
material used for
insulation and fire
proofing)
 Persistent cough
with bloody
sputum
 Sudden weight
loss
 Shortness of breath
 Stridor (harsh
noise when breath
in)
 Chest pain
 Family history
 Quit smoking and
passive smoking
 Use radon
mitigation systems
 Diet rich in
vegetables and
fruits
 Surgery,
radiotherapy and
chemotherapy
according to the

9.  Air pollution  Loss of appetite
 Severe infections
such as bronchitis
and pneumonia
stage of cancer
Breast
cancer
 Family history or
inheritance
 Chances of breast
cancer increase
with age
 Early menses and
late menopause
 Exposure to
radioactive rays
and microwaves
 Hormone
replacement
therapy (HRT).
 Obesity.
 Alcohol
consumption.
 High fat diet in
adult’s life.
 Breast lumps
formation is the
first symptom.
 Armpit swelling.
 Pain and
tenderness in the
breast.
 Unusual discharge
from the breast
that may be clear,
bloody or another
colour.
 Change in contour,
texture and
temperature of the
breast.
 Intake of fruits and
vegetables.
 Low intake of fats
 Avoid alcohol
consumption.
 Avoid the use of
microwave oven
 Surgery,
radiotherapy,
chemotherapy and
hormone therapy
according to the
stage or severity of
cancer.
Liver cancer
 Excessive
consumption of
alcohol
 Long-term
hepatitis B and
hepatitis C
 Non alcoholic
fatty liver disease
 Obesity
 Family history
 Impure water
intake
 Unintentional
weight loss
 Loss of appetite
 Pain or swelling in
lower abdomen
 Feeling of fullness
after very small
meals
 Nausea
 Jaundice
 Itchy skin
 Avoid the
consumption of
alcohol
 Avoid fatty foods
 Intake of boiled or
pure water
 Surgery,
radiotherapy,
chemotherapy and
liver transplant
according to the
severity or stage of
cancer.
Other disorders or diseases
Hypertension, osteoporosis, osteomalacia, rickets, arthritis, scurvy, anemia, night blindness,
colour blindness, edema, eczema, dementia, alopecia, anorexia, paralysis, headaches, insomnia,
hypochloremia, hypoglycemia, goiter etc are some other diseases and disorders caused by
nutritional imbalance.

10. The causes, symptoms, prevention and treatment of some common diseases are given below.
Diseases or disorders Causes Symptoms
Prevention and
treatment
Hypertension
(a silent killer)
 Heavy alcohol
consumption
and smoking
 Stress, aging
 Sedentary
lifestyle
 Intake of
excess salt or
sodium and low
potassium.
 Family history
 Harden and
inelastic blood
vessels
 Overweight and
obesity
 Headaches
 Shortness of
breath
 Nose bleeding
 Blurry vision
 Palpitation
 Anxiety
 Intake of low
sodium in diet
 Intake of
unsaturated
fatty acid (olive
oil, fish oil and
fish fat)
 Exercise
regularly
 Reduce
smoking and
alcohol
consumption
 Medications
prescribed by
the doctor i.e.
diuretics
Osteoporosis
 Low estrogen
level in women
and low
testosterone
level in men
but more
common in
women
 Lack of
calcium and
vitamin D
 Lack of
exercise
 Family history
 Fractures of
hipbone, wrist
and spines
 Chronic back
pain
 Loss of height
gradually due
to stooped
posture
 Intake of
calcium rich
foods (low-fat
milk, yogurt,
cheese)
 Vitamin D from
sunlight or
supplements
 Exercise
regularly
 Medications
prescribed by
the doctor if
needed
Rickets
 Mother
deficient of
vitamin D
during
pregnancy
 Dark skin
colour
 Age factor
 Delayed growth
 Pain in spine,
pelvis and legs
 Muscle
weakness
 Skeletal
deformities i.e.
bowing of legs,
 Intake of
calcium rich
food (milk,
cheese, yogurt)
 Exposure to
sunlight for
vitamin D and
vitamin D

11. (common in
children from
6-36 months)
 Lack of
calcium,
phosphate and
vitamin D
thickened wrist
and ankles,
breastbone
projection
 Muscle cramps
 Fractured bones
supplements
 Food items rich
in vitamin D
(fish, eggs,
milk, liver)
Iron deficiency
Anemia
 Low iron intake
and decreased
ability to
absorb iron
 Menstrual cycle
in women and
teenage girls.
 Frequent
donation of
blood
 Internal
bleeding
 Weakness and
fatigue
 Shortness of
breath
 Pale skin
colour
 Easily broken
and brittle nails
 Headaches
 Cold hand and
feet
 Poor appetite
 Intake of iron
and vitamin C
rich foods
(beans, red
meat, citrus
fruits, leafy
green
vegetables)
 Intake of iron
supplements as
prescribed by
the doctor.

12. References
http://www.briskpost.com/2017/02/malnutrition-nutritional-imbalance.html
https://www.mayoclinic.org/diseases-conditions/obesity/basics/prevention/con-20014834
http://www.cadiresearch.org/topic/obesity/global-obesity/obesity-prevention-and-control
http://www.joslin.org/info/Goals-for-Blood-Glucose-Control.html
https://www.webmd.com/diabetes/guide/types-of-diabetes-mellitus
https://emedicine.medscape.com/article/1104623-overview
http://www.healthofchildren.com/P/Protein-Energy-Malnutrition.html
https://www.medicalnewstoday.com/articles/313185.php
https://www.healthline.com/health/marasmus#risk-factors4
https://medlineplus.gov/ency/article/001604.htm
http://www.nytimes.com/health/guides/disease/kwashiorkor/overview.html
https://www.nhs.uk/conditions/kwashiorkor/Pages/Introduction.aspx
http://www.differencebetween.info/difference-between-kwashiorkor-and-marasmus
https://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/symptoms-causes/syc-
20350613
https://www.webmd.com/osteoporosis/guide/understanding-osteoporosis-symptoms
http://www.healthguidance.org/entry/4667/1/Hypertension---Causes-Prevention-and-
Treatment.html
https://www.medicinenet.com/liver_cancer_hepatocellular_carcinoma/article.htm
https://www.medicinenet.com/breast_cancer_facts_stages/article.htm
https://www.medicalnewstoday.com/articles/37136.php
https://www.cancer.org/cancer/lung-cancer/prevention-and-early-detection/signs-and-
symptoms.html
Essentials of human nutrition, Second edition, Oxford University Press