EPIDEMIOLOGY OF

MALNUTRITION
Group Member :
Almira Dianti 6411416094
Hendri Haryanto 6411416132

Department of Public Health, Faculty of Sport Science, UNNES

 DEFINITION

• Malnutrition, in all its forms, includes undernutrition (wasting,

stunting, underweight), inadequate vitamins or minerals, overweight,
obesity, and resulting diet-related noncommunicable diseases.
• Undernutrition,
• Wasting (low weight-for-height),
• Stunting (low height-for-age),
• And underweight (low weight-for-age);
• Micronutrient-related malnutrition.
• Overweight, obesity and diet-related noncommunicable diseases .
2
 CLASSIFICATION

1. Undernutrition
• Low weight-for-height is known as wasting.
It usually indicates recent and severe weight loss, because a person has not had
enough food to eat and/or they have had an infectious disease, such as
diarrhoea, which has caused them to lose weight.

• Low height-for-age is known as stunting.

It is the result of chronic or recurrent undernutrition.

• Children with low weight-for-age are known as underweight.

A child who is underweight may be stunted, wasted, or both.
3
 CLASSIFICATION

2. Micronutrient-related malnutrition
• Inadequacies in intake of vitamins and minerals, often referred to as
micronutrients, can also be grouped together.
• Micronutrients enable the body to produce enzymes, hormones, and
other substances that are essential for proper growth and
development.
• Iodine, vitamin A, and iron are the most important in global public
health terms; their deficiency represents a major threat to the health
and development of populations worldwide, particularly children and
pregnant women in low-income countries.
4
 CLASSIFICATION

3. Overweight and obesity

• Body mass index (BMI) is an index of weight-for-height commonly used
to classify overweight and obesity.
• It is defined as a person’s weight in kilograms divided by the square of
his/her height in meters (kg/m²).
• In adults, overweight is defined as a BMI of 25 or more, whereas
obesity is a BMI of 30 or more.
• Overweight and obesity result from an imbalance between energy
consumed (too much) and energy expended (too little).
5
 EPIDEMIOLOGY

• In 2014, approximately 462 million adults worldwide were underweight,

while 1.9 billion were either overweight or obese.
• In 2016, an estimated 155 million children under the age of 5 years were
suffering from stunting, while 41 million were overweight or obese.
• The Basic Health Research in 2018 has shown an improvement in the
nutritional status of children in Indonesia.
• The proportion of very short and short nutritional status decreased from
37.2% (2013) to 30.8% (2018).
• The proportion of malnutrition and under-nutrition status decreased from
19.6% (2013) to 17.7% (2018).
• Baseline data on stunting prevalence, a target of 2019 of 28.0%. 6
Source : Basic Health Research 2018, MoH.
Source : Basic Health Research 2018, MoH.
Source : Basic Health Research 2018, MoH.
 SIGN AND SYMPTOMS

• For determining the health center level PEM conducted by weighing the
child BB compared to age and use of KMS and Table W / Baku Median
WHO-NCHS
• PEM light when the result of weighing in KMS is located on a yellow
ribbon
• PEM was when the results weighing on KMS is located in the Lower Red
Line (BGM).
• Severe PEM / malnutrition when the weighing result W / A <60%
standard WHO-NCHS median. At KMS no dividing line severe PEM /
Malnutrition and PEM medium, so as to determine the weight PEM /
malnutrition used Table W / Baku Median WHO-NCHS. 10
WHO-NCHS
KMS BALITA
 RISK FACTOR

• Women, infants, children and adolescents are at particular risk of

malnutrition.
• Poverty amplifies risks for malnutrition. People who are poor are more
likely to be affected by different forms of malnutrition.
• Basic Health Research (2010), the problem of lack of energy and protein
consumption mainly occurred in school-age children (6-12 years),
prepubescent age (13-15 years), and adolescents (16-18 years).
• For example, around 44.4 percent of children aged 7-12 years consume
less than 70 percent based on the nutrition adequacy table.
• The 59.7 percent of children of that age consume less than 80 percent
13
based on the nutritional adequacy table.
 WHO RESPONSE

• Actions to end malnutrition are also vital for achieving the diet-related
targets of the Global action plan for the prevention and control of
noncommunicable diseases 2013–2020, the Global strategy for
women’s, children’s, and adolescent’s health 2016–2030, and the 2030
Agenda for sustainable development.
• WHO uses its convening power to help set, align and advocate for
priorities and policies that move nutrition forward globally; develops
evidence-informed guidance based on robust scientific and ethical
frameworks; supports the adoption of guidance and implementation of
effective nutrition actions; and monitors and evaluates policy and
programme implementation and nutrition outcomes.
14
 INDONESIAN GOV POLICY

• The government has proposed the location of integrated nutrition

interventions in the 100 districts / cities that have been identified.
• Location criteria are a composite of indicators of high stunting
prevalence, high number of children under five, high poverty rates, and
availability of nutritional packages from ministries such as PKH, STBM,
Pamsimas, Sanimas, and PAUD.
• Meanwhile, the main goal of the intervention was a reduction in
stunting in the first 1,000 days of life.
• The first thousand days of life is a golden period in a child's growth and
development.
15
THANK YOU