Malnutrition is a condition that results from eating a diet in which one or more nutrients are either not enough or are too much such that the diet causes health problems. It may involve calories, protein, carbohydrates, fat, vitamins or minerals. Not enough nutrients is called undernutrition or undernourishment while too much is called overnutrition. Malnutrition is often used to specifically refer to undernutrition where an individual is not getting enough calories, protein, or micronutrients. If undernutrition occurs during pregnancy, or before two years of age, it may result in permanent problems with physical and mental development. Extreme undernourishment, known as starvation, may have symptoms that include: a short height, thin body, very poor energy levels, and swollen legs and abdomen. People also often get infections and are frequently cold. The symptoms of micronutrient deficiencies depend on the micronutrient that is lacking.
Undernourishment is most often due to not enough high-quality food being available to eat. This is often related to high food prices and poverty. A lack of breastfeeding may contribute, as may a number of infectious diseases such as: gastroenteritis, pneumonia, malaria, and measles, which increase nutrient requirements. There are two main types of undernutrition: protein-energy malnutrition and dietary deficiencies. Protein-energy malnutrition has two severe forms: marasmus (a lack of protein and calories) and kwashiorkor (a lack of just protein). Common micronutrient deficiencies include: a lack of iron, iodine, and vitamin A. During pregnancy, due to the body's increased need, deficiencies may become more common. In some developing countries, overnutrition in the form of obesity is beginning to present within the same communities as undernutrition. Other causes of malnutrition include anorexia nervosa and bariatric surgery.
Efforts to improve nutrition are some of the most effective forms of development aid. Breastfeeding can reduce rates of malnutrition and death in children, and efforts to promote the practice increase the rates of breastfeeding. In young children, providing food (in addition to breastmilk) between six months and two years of age improves outcomes. There is also good evidence supporting the supplementation of a number of micronutrients to women during pregnancy and among young children in the developing world. To get food to people who need it most, both delivering food and providing money so people can buy food within local markets are effective. Simply feeding students at school is insufficient. Management of severe malnutrition within the person's home with ready-to-use therapeutic foods is possible much of the time. In those who have severe malnutrition complicated by other health problems, treatment in a hospital setting is recommended. This often involves managing low blood sugar and body temperature, addressing dehydration, and gradual feeding. Routine antibiotics are usually recommended due to the high risk of infection. Longer-term measures include: improving agricultural practices, reducing poverty, improving sanitation, and the empowerment of women.
There were 821 million undernourished people in the world in 2018 (10.8% of the total population). This is a reduction of about 176 million people since 1990 when 23% were undernourished, but an increase of about 36 million since 2015, when 10.6% were undernourished. In 2012, it was estimated that another billion people had a lack of vitamins, and minerals. In 2015, protein-energy malnutrition was estimated to have resulted in 323,000 deaths—down from 510,000 deaths in 1990. Other nutritional deficiencies, which include iodine deficiency and iron deficiency anemia, result in another 83,000 deaths. In 2010, malnutrition was the cause of 1.4% of all disability adjusted life years. About a third of deaths in children are believed to be due to undernutrition, although the deaths are rarely labelled as such. In 2010, it was estimated to have contributed to about 1.5 million deaths in women and children, though some estimate the number may be greater than 3 million. An additional 165 million children were estimated to have stunted growth from malnutrition in 2013. Undernutrition is more common in developing countries. Certain groups have higher rates of undernutrition, including women—in particular while pregnant or breastfeeding—children under five years of age, and the elderly. In the elderly, undernutrition becomes more common due to physical, psychological, and social factors.
The majority of the 40,000 deaths every day, or 6 million a year, among the developing world's infants and children are caused by infection as a result of malnutrition. A typical three-year-old in a developing country has one illness every three weeks. Between 1975 and 1990, the number of malnourished children aged four or younger declined in Southeast Asia and Latin America. However in sub-Saharan Africa the number rose from 18 to 30 million, and in South Asia (India, Pakistan, Sri Lanka, Bangladesh and Nepal) the number increased from 90 to 101 million. In 1993, an estimated 120 million of the 190 million underweight children in the world live in four countries: China, India, Pakistan and Bangladesh. Probably as many as 60% of the children in India and Bangladesh are malnourished, a rate twice as high as in sub-Saharan Africa.
Projections to the year 2000 suggest that while the prevalence of malnutrition will probably go down overall, the number of children who are underweight for their age will increase, particularly in sub-Saharan Africa and South Asia; in these latter two regions, a satisfactory nutrition situation is not currently in sight.