Malnutrition in Obesity: Is It Possible?

Abstract

<b><i>Background:</i></b> The World Health Organization (WHO) classifies malnutrition as the biggest threat to public health worldwide, and this condition is observed in 20–60% of hospitalized patients. Malnutrition is a state of the body in which due to insufficient supply or incorrect absorption of essential nutrients, the body composition changes and the body’s functions are impaired. Malnutrition is associated not only with reduced body mass index but also with obesity. <b><i>Summary:</i></b> Obesity is defined as a paradoxical state of malnutrition, which despite excessive energy consumption is associated with a shortage of individual microelements. Deficiency or lack of homeostasis of essential micronutrients can significantly affect daily performance, intellectual and emotional state, but also the physical state of the body. Food deficiency can also contribute to further weight gain or the development of other metabolic diseases. Micronutrient deficiency may include not only incorrect dietary choices and insufficient access to nutrient-rich foods but also changes in the absorption, distribution or excretion of nutrients, and altered micronutrient metabolism resulting from systemic inflammation caused by obesity. An effective therapy method recommended for people with morbid obesity is bariatric surgery aimed at both weight loss and improving quality of life. Unfortunately, the effects of these treatments are often medium- and long-term complications associated with micronutrient deficiency as a result of reduced consumption or absorption. Therefore, the use of bariatric surgery in patients with extreme obesity can affect the metabolism of microelements and increase the risk of nutritional deficiencies. <b><i>Key Messages:</i></b> Studies by many authors indicate a higher incidence of food deficiency among people with excessive body weight, than in people with normal body weight of the same age and same sex. Monitoring the concentration of minerals and vitamins in blood serum is a good practice in the treatment of obesity. The proper nutritional status of the body affects not only the state of health but also the effectiveness of therapy. The aim of the review was to present the issue of malnutrition in the context of obesity.

Micronutrients Deficiencies in Candidates of Bariatric Surgery: Results from a Single Institution over a 1-Year Period

“…The reasons for micronutrient deficiency in severe obesity are not fully understood. In a recent review [21], several mechanisms have been proposed, such as overconsumption of foods with high calories but low nutrient densities, diets with a high-fat content associated with lower intake of vitamins, increased storage of vitamin D in adipose tissue in patients with increased body fat, and possible relation to microbiota dysfunction. Some authors have also correlated malnutrition to low levels of newly discovered hormones like fibroblast growth factor 23 (FGF 23) [22].…”

HPA-Axis Activity and Nutritional Status Correlation in Individuals with Alcohol Use Disorder

“…In the AUD group, thiamine and folic acid intake was lower when compared to the non-AUD group; however, both groups had sufficient thiamine and insufficient folic acid intake (according to RDA). The relation of alcohol intake to folic acid is well studied and folic acid deficiency can lead to serious clinical consequences [ 42 ]; it should therefore be taken into consideration.…”

Fighting Obesity-Related Micronutrient Deficiencies through Biofortification of Agri-Food Crops with Sustainable Fertilization Practices

“…A poor diet quality mainly causes the occurrence of nutritional deficiencies in obesity based on the overconsumption of processed foods that are calorie-dense and have a low nutrient density, which is generally accompanied by a decreased consumption of fruits and vegetables, being two of the primary sources of vitamins and minerals [2,9,37]. The NOVA food classification has established food processing as an important indicator of food quality.…”

“…Obese people are now facing a complex nutritional challenge characterized by the coexistence of under-and overnutrition. This concept has been recently defined as a "double burden of malnutrition", involving an excessive consumption of calories associated with a shortage of certain microelements [5,9,10]. Several studies have reported a direct and clear link between obesity and various micronutrient deficiencies, including iron, zinc, magnesium, potassium, selenium, and vitamins A, C, E, and D [2,6,[11][12][13].…”

“…In addition to bad dietary choices and alterations in the metabolism of nutrients as causes of obesity-related micronutrient deficiencies, insufficient access to nutrient-rich foods, which is closely related to modern agricultural practices and the current agrifood system, also contributes significantly to the prevalence of these conditions in obese subjects [6,9,14]. However, modern agriculture faces critical challenges in solving health and environmental issues associated with macro and micronutrient deficiencies, food insecurity, low fertilizer-use efficiency, overfertilization, climate change, water scarcity, a reduction in agricultural lands, and soil degradation [15][16][17][18][19][20][21].…”