Severe Malnutrition and Reductive Adaptation

The acute phase response to an infection is muted in severe protein-energy malnutrition in part of a process referred to as 'reductive adaptation,' whereby the structure and function of cells or tissues cannot be maintained due to the limited supply of energy resulting from decreased nutritional intake. Protein synthesis from amino acids is highly energy-dependent and proteins have a wide variety of structural and functional roles in the body, including the cytokines that initiate the acute phase reaction (IL-1, Il-6, tumor necrosis factor (TNF-a)). Severely malnourished individuals are therefore immunocompromised, in that they cannot produce an adequate immune response to infection. The generalized responses to infection such as fever and increased pulse, as well as localized responses such as inflammation and delayed cutaneous hyper-sensitivity, may also not manifest. Silent infections must therefore always be suspected and treated in severe malnutrition.

Table 1 Major infections: their effect on nutritional status and ways in which these infections may be modulated by nutrition

Nutritional modulation Infection Nutritional effects

Table 1 Major infections: their effect on nutritional status and ways in which these infections may be modulated by nutrition

Nutritional modulation Infection Nutritional effects

Zinc: # incidence and morbidity

Acute Respiratory


Ascorbic acid: may have protective effect

infections (ARI)


(conflicting results)

Vitamin A: # incidence of diarrhea

Diarrheal diseases

Nutrient losses

Breast feeding: ^incidence of diarrhea

Intestinal damage and malabsorption

Malnutrition ! # epithelial integrity and


" diarrhea

Electrolyte imbalance

Zinc: # duration and mortality

Nutrient deficiencies (e.g., vitamin A)

Vitamin A: # morbidity and mortality in



HIV + children


Wasting syndrome

# plasma selenium associated with " HIV

virus (HIV)

When treated with HAARTb can lead to metabolic


changes and lipodystrophy

Ascorbic acid: may # HIV viral load

Zinc supplementation ! conflicting results in


Vitamin A: in lactation may " MTCTa

Intestinal parasites

Nutrient losses



Anemia (in hookworm and Trichuris)

Impaired growth and weight loss

Vitamin A: # malaria-anemia



Iron: # malaria-anemia but may " morbidity

" Protein metabolism


Fever ! " energy needs

# Plasma retinol

Malaria in pregnancy ! low-birth-weight baby

Vitamin A: " measles specific Ab in response



to measles vaccination

Buccal mucosal lesions ! # intake

Vitamin A: # morbidity

" Catabolism ! growth faltering and weight loss

# Plasma retinol

Tuberculosis (TB)

" Energy metabolism

" Protein breakdown



aMTCT: mother to child transmission. bHAART: highly active anti-retroviral therapy.

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  • bellisima
    How reductive adaptation during malnutrition affect our body?
    3 years ago
  • Kaelyn
    How does reductive adaptation affects the body's system?
    3 years ago
  • liberata
    What are the causes of reductive adaptive in children?
    3 years ago
  • jean
    What are the phases of reductive adaptation?
    3 years ago
  • kelsey
    What is reductive adoptation?
    3 years ago
  • segan
    What is reductive adaptation in a child with severe malnutrition?
    3 years ago
  • Arsi
    What is reductive adaption?
    3 years ago
    What is reductive afaptation?
    3 years ago
  • doreen
    What is redutive adaptation?
    3 years ago
  • massawa
    How couse redactive adaption couse malnutraiton?
    3 years ago
  • Holly Watt
    What is reductive adaptation in undernutrition kenya?
    3 years ago
  • stephen
    What is redactive adaption malnutrition?
    3 years ago
  • Girma
    What is reduction adaptative in malnutrition?
    3 years ago
  • wiktor
    How does reductive adaptaion work?
    2 years ago
  • Gorhendad Maggot
    What is reductive adaptation as used in nutrition crisis?
    2 years ago
  • Aurelio Toscani
    What is redactive adaptation?
    2 years ago
  • yemane
    What is reductive adaptation Its effects?
    9 months ago
  • maciej
    What is reductive adaptation and important?
    9 months ago
  • ariam yohannes
    What is the reductive adaptation in nervous system?
    8 months ago
  • Ulrich
    What is redactive addactive mechanism in malnutrition?
    8 months ago
  • robinia
    What is reductive addaptation in SAM.?
    7 months ago

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