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Malnutrition and gastrointestinal and respiratory infections in children: a public health problem.

Rodríguez L, Cervantes E, Ortiz R - Int J Environ Res Public Health (2011)

Bottom Line: Infectious disease is the major cause of morbidity and mortality in developing countries, particularly in children.Moreover, certain infectious diseases also cause malnutrition, which can result in a vicious cycle.In this review, we analyze the cyclical relationship between malnutrition, immune response dysfunction, increased susceptibility to infectious disease, and metabolic responses that further alter nutritional status.

View Article: PubMed Central - PubMed

Affiliation: Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana-Iztapalapa, Avenida San Rafael Atlixco 186, CP 09340, México, DF, México. leor@xanum.uam.mx

ABSTRACT
Infectious disease is the major cause of morbidity and mortality in developing countries, particularly in children. Increasing evidence suggests that protein-calorie malnutrition is the underlying reason for the increased susceptibility to infections observed in these areas. Moreover, certain infectious diseases also cause malnutrition, which can result in a vicious cycle. Malnutrition and bacterial gastrointestinal and respiratory infections represent a serious public health problem. The increased incidence and severity of infections in malnourished children is largely due to the deterioration of immune function; limited production and/or diminished functional capacity of all cellular components of the immune system have been reported in malnutrition. In this review, we analyze the cyclical relationship between malnutrition, immune response dysfunction, increased susceptibility to infectious disease, and metabolic responses that further alter nutritional status. The consequences of malnutrition are diverse and included: increased susceptibility to infection, impaired child development, increased mortality rate and individuals who come to function in suboptimal ways.

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Related in: MedlinePlus

Protein Energy Malnutrition Increases Prevalence of Infection, Leading to Energy loss for the Individual. Adapted from Schaible et al. [16].
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f4-ijerph-08-01174: Protein Energy Malnutrition Increases Prevalence of Infection, Leading to Energy loss for the Individual. Adapted from Schaible et al. [16].

Mentions: There are multiple mechanisms of action in the relationship between malnutrition and susceptibility to bacterial infections diseases. For instance, PCM impairs normal immune system development [26]. Stimulation of an immune response by infection increases the demand for metabolically derived anabolic energy, leading to a synergistic vicious cycle of adverse nutritional status and increased susceptibility to infection (Figure 4). Infection itself can cause a loss of critical body stores of protein, energy, minerals and vitamins. During an immune response, energy expenditure increases at the same time that the infected host experiences a decrease in nutrient intake [38]. The metabolic response to infection includes hypermetabolism, a negative nitrogen balance, increased gluconeogenesis and increased fat oxidation, which is modulated by hormones, cytokines and other pro-inflammatory mediators [39]. During an infection, a negative nitrogen balance occurs after fever induction and then it increases and persists for days to weeks after the febrile phase. Additionally, negative nitrogen balance appears to correlate with net loss in body weight; both conditions are the result of reduced food intake and infection induced-increased nitrogen excretion [40,41].


Malnutrition and gastrointestinal and respiratory infections in children: a public health problem.

Rodríguez L, Cervantes E, Ortiz R - Int J Environ Res Public Health (2011)

Protein Energy Malnutrition Increases Prevalence of Infection, Leading to Energy loss for the Individual. Adapted from Schaible et al. [16].
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3118884&req=5

f4-ijerph-08-01174: Protein Energy Malnutrition Increases Prevalence of Infection, Leading to Energy loss for the Individual. Adapted from Schaible et al. [16].
Mentions: There are multiple mechanisms of action in the relationship between malnutrition and susceptibility to bacterial infections diseases. For instance, PCM impairs normal immune system development [26]. Stimulation of an immune response by infection increases the demand for metabolically derived anabolic energy, leading to a synergistic vicious cycle of adverse nutritional status and increased susceptibility to infection (Figure 4). Infection itself can cause a loss of critical body stores of protein, energy, minerals and vitamins. During an immune response, energy expenditure increases at the same time that the infected host experiences a decrease in nutrient intake [38]. The metabolic response to infection includes hypermetabolism, a negative nitrogen balance, increased gluconeogenesis and increased fat oxidation, which is modulated by hormones, cytokines and other pro-inflammatory mediators [39]. During an infection, a negative nitrogen balance occurs after fever induction and then it increases and persists for days to weeks after the febrile phase. Additionally, negative nitrogen balance appears to correlate with net loss in body weight; both conditions are the result of reduced food intake and infection induced-increased nitrogen excretion [40,41].

Bottom Line: Infectious disease is the major cause of morbidity and mortality in developing countries, particularly in children.Moreover, certain infectious diseases also cause malnutrition, which can result in a vicious cycle.In this review, we analyze the cyclical relationship between malnutrition, immune response dysfunction, increased susceptibility to infectious disease, and metabolic responses that further alter nutritional status.

View Article: PubMed Central - PubMed

Affiliation: Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana-Iztapalapa, Avenida San Rafael Atlixco 186, CP 09340, México, DF, México. leor@xanum.uam.mx

ABSTRACT
Infectious disease is the major cause of morbidity and mortality in developing countries, particularly in children. Increasing evidence suggests that protein-calorie malnutrition is the underlying reason for the increased susceptibility to infections observed in these areas. Moreover, certain infectious diseases also cause malnutrition, which can result in a vicious cycle. Malnutrition and bacterial gastrointestinal and respiratory infections represent a serious public health problem. The increased incidence and severity of infections in malnourished children is largely due to the deterioration of immune function; limited production and/or diminished functional capacity of all cellular components of the immune system have been reported in malnutrition. In this review, we analyze the cyclical relationship between malnutrition, immune response dysfunction, increased susceptibility to infectious disease, and metabolic responses that further alter nutritional status. The consequences of malnutrition are diverse and included: increased susceptibility to infection, impaired child development, increased mortality rate and individuals who come to function in suboptimal ways.

Show MeSH
Related in: MedlinePlus