Water's Role and Consequences of Deficiency: Water is vital for virtually all bodily processes. It acts as a solvent, transporting nutrients and removing waste. It helps regulate body temperature through sweating and respiration. A lack of water leads to dehydration, causing symptoms like fatigue, headaches, dizziness, and impaired cognitive function. Chronic dehydration can strain the kidneys and increase the risk of kidney stones. It also affects skin health, leading to dryness and reduced elasticity.

Dietary Fibre's Role and Consequences of Inadequate Intake: Dietary fibre is crucial for digestive health. It promotes regular bowel movements by adding bulk to the stool, preventing constipation. It also feeds beneficial gut bacteria, contributing to a healthy gut microbiome. Furthermore, fibre helps regulate blood sugar levels by slowing down the absorption of glucose and can lower cholesterol levels by binding to cholesterol in the digestive system. A diet low in fibre can result in constipation, diverticular disease (inflammation of pouches in the colon), and an increased risk of developing colon cancer. It can also negatively impact blood sugar control and increase the risk of heart disease.

Malnutrition significantly increases the risk of developing coronary heart disease (CHD), a condition where the arteries supplying blood to the heart become narrowed or blocked. Several mechanisms link malnutrition to CHD, primarily through the disruption of metabolic processes and the promotion of atherosclerosis (the build-up of plaque in the arteries).

Mechanisms:

• Lipid Metabolism: Nutritional deficiencies can impair lipid metabolism, leading to elevated levels of low-density lipoprotein (LDL) cholesterol ("bad" cholesterol) and triglycerides in the blood. High LDL cholesterol contributes to plaque formation.
• Inflammation: Malnutrition can trigger chronic inflammation throughout the body. Inflammation plays a key role in the development and progression of atherosclerosis.
• Endothelial Dysfunction: Impaired endothelial function (the inner lining of blood vessels) is a hallmark of CHD. Nutritional deficiencies can damage the endothelium, making it more susceptible to plaque formation.
• Oxidative Stress: Malnutrition can increase oxidative stress, which damages cells and contributes to the development of atherosclerosis.

Nutrient Deficiencies and their Impact:

• Vitamin D Deficiency: Vitamin D deficiency is associated with increased risk of hypertension (high blood pressure), a major risk factor for CHD. Vitamin D also plays a role in regulating inflammation.
• Folate Deficiency: Folate deficiency leads to elevated levels of homocysteine, an amino acid linked to an increased risk of heart disease.
• Potassium Deficiency: Potassium helps regulate blood pressure. Low potassium levels can increase blood pressure and the risk of heart problems.
• Omega-3 Fatty Acid Deficiency: Omega-3 fatty acids (found in fish oil) have anti-inflammatory properties and can help lower triglycerides. A deficiency increases the risk of CHD.
• Fiber Deficiency: Low fiber intake contributes to high cholesterol levels and increases the risk of CHD. Fiber helps bind cholesterol in the digestive system, preventing its absorption.

In summary, malnutrition disrupts metabolic pathways, promotes inflammation, damages blood vessel linings, and elevates risk factors for CHD. Addressing nutritional deficiencies through a balanced diet is crucial for preventing and managing this condition.

Causes of PEM: PEM occurs when a child doesn't consume enough protein and calories. This can be due to poverty, food scarcity, infections (like measles or diarrhoea), or poor dietary choices. It's often a combination of factors.

Kwashiorkor: Kwashiorkor is primarily caused by a deficiency in protein, even if calorie intake is adequate. It's more common in areas where carbohydrate-rich foods are the staple diet and protein sources are limited.

Symptoms of Kwashiorkor:

• Edema: Swelling, particularly in the abdomen (causing a pot-belly), feet, and ankles. This is due to a low concentration of albumin in the blood, which prevents fluid from staying in the blood vessels.
• Skin Problems: Dermatitis (skin inflammation), often with lesions and discoloration.
• Hair Changes: Hair becomes thin, brittle, and may lose its normal pigmentation (often appearing reddish or yellowish).
• Growth Retardation: Stunted growth and development.
• Poor Immune System: Increased susceptibility to infections.
• Irritability and Lethargy: General lack of energy and difficulty concentrating.

Marasmus: Marasmus is caused by a deficiency in both protein and calories. It's a more severe form of malnutrition.

Symptoms of Marasmus:

• Severe Weight Loss: Extreme weight loss and emaciation (being very thin).
• Muscle Wasting: Loss of muscle mass, giving a skeletal appearance.
• Growth Retardation: Significant stunted growth.
• Dry Skin: Skin becomes dry and wrinkled.
• Reduced Body Fat: Very little subcutaneous fat.
• Weakness and Lethargy: Extreme weakness and lack of energy.

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