Thursday, 11 August 2016

Undernutrition And Diminished Immunity: Breaking The Lethal Cycle


Healthy children are the bedrock of a healthy society. Good nutrition is the core pillar for healthy and productive communities and nations. The benefits of good nutrition are carried across generations, binding and supporting various facets of nation’s development. Hence it is in a nation’s best interest to safeguard its children’s health. As per UNICEF, around 3 million children die due to undernutrition every year. Asia alone is believed to be home to approximately 70% of the world's malnourished children, while India has the highest percentage of undernourished children in the world. Ironically when the economic development of India is growing at nearly 10% annually, the rate of undernourished children remain very high. As per the third National Family Health Survey (NFHS) India, 48% of children under the age of five are stunted due to chronic undernutrition. Undernutrition, often referred to as “hidden hunger”, is a form of malnutrition. It has long been a sore point for India, adversely impacting the overall social and economic development.

Without aggressive efforts, the undernutrition issue in India is escalating with devastating consequences on children’s development-physical growth retardation, increased susceptibility to diseases, hampered cognitive development.

Undernutrition issues among the age of under-five children is an important concern for the health authorities in India. It is acknowledged widely that infections are as much a cause of malnutrition as they are a consequence. Malnourished children have increased risk of mortality from infectious diseases. Investing in elevating maternal and child nutritional status is a long-term investment that will benefit the present generation and their children as well.
The nutrition of mothers and children is closely linked. When malnutrition starts at conception, most of the damage is already done as the child enters the second year of life. The first 1000 days of a child’s life is a critical window and represents the most vulnerable period to the impact of poor nutrition. Deficits during this period can have irreversible consequences for the child. Other than adversely impacting the cognitive ability, a child’s nutritional status also influences the immune responses in varied and complex ways. A common thread links nutrition, immunity and infections. Nutritional deficiencies are known to affect various components of the immune system putting a child at a greater risk of developing a disease. The severity of malnutrition and the age of onset of nutritional deprivation often decide the extent of immunological impairment. A stunted, undernourished child is at a greater risk of various diseases. Infection and malnutrition overlap and interact; infact they form a vicious cycle. Undernutrition weakens the immune system, putting children at higher risk of more severe, frequent and prolonged bouts of illness. Looking at this from other end of the spectrum, undernutrition appears to be a consequence of repeated infections, which can further worsen the child’s nutritional status. Thus recurrent infections contribute to pathogenesis of malnutrition. This interaction between under nutrition and infection creates a potentially lethal cycle of worsening illness and deteriorating nutritional status. Critical nutrition interventions have the potential to break this cycle and are important for accelerating progress. Scrimshaw et al (1968) first described this vicious cycle of infection and under nutrition. His research stated that infections predispose to malnutrition, through reduced intake and absorption and diversion of nutrients away from growth, while malnutrition reduces immune function and increases the risk and/or severity of infections.

Immunization and improved nutrition are among the key factors in a multi-sectoral package of interventions for reducing childhood mortality and feature prominently in the Gates Grand Challenges in Global Health. Vaccination programs also stand to hugely benefit the malnourished population as well. Vaccination programs are particularly valuable health resource for settings that are in high-disease environment. Reforming children’s health status translates into higher worker productivity promoting economic success and poverty reduction for a nation. Improving nutritional status will further add to the overall success of the multi sectoral interventions that include immunization and vaccination programs undertaken by the government.


It is reassuring that the enormity of the adverse impacts of poor nutrition on a child’s growth and development are being recognized and acted upon aggressively. Entities such as Hilleman Laboratories understand and recognize the interplaying role of nutrition and immunity in improving child health and development and its impact on the economic sustainability of our nation and are looking ahead and promoting actions for transforming lives.


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