If you're raising a picky eater, you may worry that
your child isn't getting the nutrients necessary for
proper growth and development. But you probably don't need
to worry unless your doctor tells you that your child isn't
growing at the normal rate for that age range. Over time, most
finicky eaters do get enough calories and nutrients to meet their
What Are Hunger and Malnutrition?
Everyone feels hungry at times. Hunger is the body's signal
that it needs food. Once we've eaten enough food to satisfy our
bodies' needs, hunger goes away until our stomachs are empty
Malnutrition is not the same thing as hunger, although they
often go together. People who are malnourished lack the nutrients
needed for proper health and development. Someone can be
malnourished for a long or short period of time, and the condition
may be mild or severe. People who are malnourished are more likely
to get sick and, in severe cases, may even die.
Unfortunately, there are millions of people in the world
who don't get enough to eat most of the time and are at risk
Chronic hunger and malnutrition can cause significant health
problems. People who go hungry all the time are likely to be
underweight, weighing significantly less than an average person of
their size. Their growth may also be stunted, making them much
shorter than average. (Of course, people can also be underweight or
short because they have an illness or because of their genetic
makeup.) Worldwide, as many as 27% of children younger than age 5
What Causes Hunger and Malnutrition?
People who don't get enough food often experience hunger,
and hunger can lead to malnutrition over the long term. But someone
can become malnourished for reasons that have nothing to do with
hunger. Even people who have plenty to eat may be malnourished if
they don't eat food that provides the right nutrients,
vitamins, and minerals.
Some diseases and conditions prevent people from digesting or
absorbing their food properly. For example:
- Someone with
has intestinal problems that are triggered by a protein called
gluten, which is found in wheat, rye, barley, and oats.
- Kids with
have trouble absorbing nutrients because the disease affects the
pancreas, an organ that normally produces enzymes necessary for
- Kids who are
have difficulty digesting milk and other dairy products. By
avoiding dairy products, they're at higher risk of
malnutrition because milk and dairy products provide 75% of the
calcium in America's food supply.
If a person doesn't get enough of one specific nutrient,
that's a form of malnutrition (although it doesn't
necessarily mean the person will become seriously ill). The most
common form of malnutrition in the world is iron deficiency, which
affects up to 80% of the world's population - as many as 4 to 5
is found in foods like red meat, egg yolks, and fortified flour,
bread, and cereal.
Who Is at Risk for Malnutrition?
All over the world, people who are poor or who live in
poverty-stricken areas are at the greatest risk for hunger and
malnutrition. In poor countries, wars and natural disasters such as
droughts and earthquakes may also contribute to hunger and
malnutrition by disrupting normal food production and
In the United States, food manufacturers fortify some common
foods with vitamins and minerals to prevent certain nutritional
deficiencies. For example, the addition of iodine to salt helps
prevent some thyroid gland problems (such as goiter), folic acid
added to foods can help prevent certain birth defects, and added
iron can help prevent iron-deficiency anemia.
Malnutrition affects people of every age, although infants,
children, and adolescents may suffer the most because many
nutrients are critical for growth and development. Older people may
develop malnutrition because aging, illness, and other factors can
lead to a poor appetite, so they may not eat enough.
Alcohol can interfere with nutrient absorption, so alcoholics
might not benefit from the vitamins and minerals they consume.
People who abuse drugs or alcohol can be malnourished or
underweight if they don't eat properly.
Children and teens on special diets - such as vegetarians - need
to eat balanced meals and a variety of foods to get the right
nutrients. Vegetarians and vegans should make sure they get enough
protein and vitamins like B12.
Symptoms and Effects of Malnutrition
Malnutrition harms both the body and the mind. The more
malnourished someone is - in other words, the more nutrients that
are missing - the more likely he or she is to have physical
problems. A child who is slightly to moderately malnourished may
show no outward physical symptoms.
Indications of malnutrition depend on which nutritional
deficiencies a child has, although they can include:
- fatigue and low energy
- poor immune function (which can hamper the body's
ability to fight off infections)
- dry, scaly skin
- swollen and bleeding gums
- decaying teeth
- slowed reaction times and trouble paying attention
- poor growth
- muscle weakness
- bloated stomach
- osteoporosis, or fragile bones that break easily
- problems with organ function
If a pregnant woman is malnourished, her child may weigh less at
birth and have a lower chance of survival. Vitamin A deficiency
from malnutrition is the chief cause of preventable blindness in
the developing world, and kids with severe vitamin A
deficiency have a greater chance of getting sick or dying from
infections such as diarrhea or measles. Iodine deficiency, another
form of malnutrition, can cause mental retardation and delayed
development. Iron deficiency can make kids less active and
less able to concentrate. Teens who are malnourished often have
trouble keeping up in school.
Treating Children Who Are Malnourished
Fortunately, many of the harmful effects of malnutrition can be
reversed, especially if a child is only mildly or briefly
If you think your child isn't getting enough of the right
nutrients, talk to your doctor, who may perform a physical exam and
ask about the types and amounts of food your child eats. The doctor
- measure height, weight, and
body mass index (BMI)
to see if they're within a healthy range for your
- order blood tests to check for abnormalities
- use X-rays or CT scans to look for signs of malnutrition in
organs and bones
- check for underlying conditions that could cause
Treatment for malnutrition depends on its cause. A doctor or
dietitian might recommend specific changes in the types and
quantities of foods your child eats, and may prescribe dietary
supplements, such as vitamins and minerals. If there's an
underlying problem causing the malnutrition, the doctor will help
you find ways to ensure your child gets the necessary
Can a Picky Eater Become Malnourished?
Parents often worry that kids who seem to live on peanut
butter sandwiches or hide at the sight of vegetables might
not eat enough to stay healthy. Few kids in the United States
and other developed nations experience severe malnutrition like
that seen in Third World countries. Even finicky eaters usually
get adequate calories and nutrients.
The best way for parents to ensure that kids
are properly nourished is to serve a variety of healthy foods
and limit unhealthy snacks. If you're concerned that your
child's energy level is lagging or that he or she isn't
growing as fast as other kids of the same age, share your concerns
with your doctor.
Larissa Hirsch, MD
Date reviewed: January 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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