Severe Malnutrition and Reductive Adaptation

Last Updated on Wed, 25 Sep 2019 | Human Nutrition

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	•	Anorexia
•	Ascorbic acid: may have protective effect	infections (ARI)	•	Dysphagia
	(conflicting results)
•	Vitamin A: # incidence of diarrhea	Diarrheal diseases	•	Nutrient losses
•	Breast feeding: ^incidence of diarrhea		•	Intestinal damage and malabsorption
•	Malnutrition ! # epithelial integrity and		•	Dehydration
	" diarrhea		•	Electrolyte imbalance
•	Zinc: # duration and mortality		•	Nutrient deficiencies (e.g., vitamin A)
•	Vitamin A: # morbidity and mortality in	Human	•	Anorexia
	HIV + children	immunodeficiency	•	Wasting syndrome
•	# plasma selenium associated with " HIV	virus (HIV)	•	When treated with HAARTb can lead to metabolic
	severity			changes and lipodystrophy
•	Ascorbic acid: may # HIV viral load
•	Zinc supplementation ! conflicting results in
	HIV
•	Vitamin A: in lactation may " MTCTa
		Intestinal parasites	•	Nutrient losses
			•	Malabsorption
			•	Anorexia
			•	Anemia (in hookworm and Trichuris)
			•	Impaired growth and weight loss
•	Vitamin A: # malaria-anemia	Malaria	•	Anemia
•	Iron: # malaria-anemia but may " morbidity		•	" Protein metabolism
			•	Anorexia
			•	Fever ! " energy needs
			•	# Plasma retinol
			•	Malaria in pregnancy ! low-birth-weight baby
•	Vitamin A: " measles specific Ab in response	Measles	•	Anorexia
	to measles vaccination		•	Buccal mucosal lesions ! # intake
•	Vitamin A: # morbidity		•	" Catabolism ! growth faltering and weight loss
			•	# Plasma retinol
		Tuberculosis (TB)	•	" Energy metabolism
			•	" Protein breakdown
			•	Anorexia
			•	Anemia

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
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Kaelyn
How does reductive adaptation affects the body's system?

3 years ago
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liberata
What are the causes of reductive adaptive in children?

3 years ago
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jean
What are the phases of reductive adaptation?

3 years ago
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kelsey
What is reductive adoptation?

3 years ago
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segan
What is reductive adaptation in a child with severe malnutrition?

3 years ago
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Arsi
What is reductive adaption?

3 years ago
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KIRSTI
What is reductive afaptation?

3 years ago
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doreen
What is redutive adaptation?

3 years ago
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massawa
How couse redactive adaption couse malnutraiton?

3 years ago
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Holly Watt
What is reductive adaptation in undernutrition kenya?

2 years ago
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stephen
What is redactive adaption malnutrition?

2 years ago
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Girma
What is reduction adaptative in malnutrition?

2 years ago
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wiktor
How does reductive adaptaion work?

2 years ago
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Gorhendad Maggot
What is reductive adaptation as used in nutrition crisis?

1 year ago
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Aurelio Toscani
What is redactive adaptation?

1 year ago
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yemane
What is reductive adaptation Its effects?

3 months ago
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maciej
What is reductive adaptation and important?

3 months ago
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ariam yohannes
What is the reductive adaptation in nervous system?

2 months ago
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Ulrich
What is redactive addactive mechanism in malnutrition?

2 months ago
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robinia
What is reductive addaptation in SAM.?

25 days ago
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