How Time Has Changed the Definition of “Malnourished”

If you were asked to describe the term “malnourished”, what would you say? How would this person look? Are you yourself malnourished? More than likely, images of starved children in poor economic countries come to mind. But the question is, “what exactly defines the term malnourished?”

There used to be 2 terms that referred to malnourished: kwashiorkor and marasmus. Kwashiorkor refers to not eating enough protein while marasmus is traditional starvation. However, now malnourishment has a set of criteria composed of 6 characteristics of a person:

  • Weight loss
  • Reduced functional strength
  • Not eating enough calories to support the body
  • Swelling
  • Loss of fat under the skin
  • Loss of muscle mass

Notice that nowhere in these 6 factors is overall body weight or BMI mentioned. This means that even someone who is overweight or obese can be malnourished. It does not say that a person has to be less than 100 pounds or have bones prominently showing.

“Nourish” is defined as “to sustain with food or nutriment; to supply what is necessary for life, health, and growth.” Even when not referring to food, someone could say, “This lotion left my hands feeling nourished and smooth.”

Why do dietitians push for vegetables over candy? The nutrients. They both provide energy, but they don’t provide the same profile of nutrients. Calories are essential, but nutrients nourish. For example, if someone was overweight, we regularly don’t describe them as malnourished…but let’s say they were only consuming Cheetos, donuts, and Coke for their meals. This type of diet can lead to malnutrition because while calories might be sufficient, nutrients to help the body repair itself and keep things functioning properly are lacking.

Any size of person can be malnourished. Malnourishment often becomes apparent in the context of a medical diagnosis. This is not to say that everyone who is overweight/obese is malnourished, but the premise is that malnourished isn’t always what we have seen historically when food wasn’t as abundant as it is now. The bottom line: eating a diet focused on nutrient-rich foods helps prevent malnourishment. Choose nutrients over calories.


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