ETIOLOGY OF UNDERNUTRITION /
MALNOURISHMENT
It is a multistep interconnected process, which can be
put as a vicious cycle. It begins with a chronic inflammatory
state, which leads to increased expenditure of energy
and diminishes nutritional reserves faster than they can be
replenished. Certain lifestyles and conditions, like drug
abuse, homelessness, psychiatric conditions, can also use
up the reserves or hinder their replenishment (Table 1). As
the reserves are being used up, oxidative stress becomes
more pronounced and immune suppression ensues. Qualitative
changes in immune functions among HIV infected
individuals very closely resemble changes seen in malnourished
patients. In both groups numbers of CD4 and CD8
cells fall down as well as does their ratio. Late phase skin
hypersensitivity reactions, vaccination response and bactericidal
properties are also adversely influenced. Synthesis
of cytokines, complement proteins, mucous and cell membranes
is hindered due to scarcity of proteins and microelements,
which results in debilitation of the non-specific barriers