Nutrition And Infections

Patient Education

Interactions of Nutrition and Infection in children:

Data from national surveys have shown that in India nearly half the preschool children are underweight or stunted and nearly a fifth are wasted.^1,2,3,4 Data from NFHS-3⁵ indicate that majority of infants age 0-2 months are exclusively breastfed. Exclusive breastfeeding protects these babies from undernutrition. Undernutrition in 1st 3 months of life seems to be related to low birth weight. Low birth weight rates in India are about 30%. Between 3-6 months of age, the prevalence of undernutrition rises due to early weaning and the introduction of milk substitutes which may be inadequate for the child. In fact, exclusive breastfeeding until 6 months of age is enough to maintain nutrition in the child. Between 6-12 months of age, complementary feeds introduced may be an inadequate increasing prevalence of undernutrition in this age group. Further increase in undernutrition between 12-23 months is due to low-calorie food intake due to lesser quantity, the poor nutrient value of food leading to Micronutrient deficiency, and unbalanced food leading to rising prevalence of undernutrition in these young children.⁶

Between 20-30% of preschool children are suffering from morbidity due to infections.⁵ Diarrhea and fever are the most common infections in preschoolers.⁶ Undernutrition is associated with impaired immune function and consequent increased susceptibility to infections; infections aggravate undernutrition - thus a vicious cycle sets in.⁶ Stunting and wasting are significant effects of malnutrition. Stunting is seen with chronic malnutrition whereas wasting is seen with acute malnutrition. Malnutrition affects the epithelial and mucosal integrity, mucociliary clearance, immunoglobulin synthesis, lymphocyte differentiation and thus leads to impaired immunity which leads to recurrent infections.⁷ Stunting has an inverse correlation with intellectual development in children and adults whereas wasting is closely linked to child mortality. In fact, the relative risk of morbidity due to infections is higher in children with low BMI and in children with wasting. The small group of children who have to stunt with wasting has the highest relative risk of morbidity due to infection.⁶

There are several nutrients that have a role in maintaining health and preventing disease. Thus the balanced supply of both macronutrients and micronutrients is essential to prevent wasting and thus the risk of infection.