5.

5 Deficiency diseases

Balanced Diet and Deficiency Diseases

• The human body requires a balanced diet for normal functioning.
• Inadequate intake of carbohydrates, proteins, minerals, or vitamins causes deficiency
diseases.
• A deficiency disease occurs when the body lacks a specific nutrient, leading to health
problems.
• Common examples of deficiency diseases:
o Kwashiorkor
o Marasmus
o Anemia
o Rickets
o Scurvy

Marasmus
• Caused by inadequate carbohydrate intake, especially in children.
• Symptoms:
o Very thin arms and legs
o Little muscle
o Old-looking face
o Thin skin hanging in folds
• Effects:
o Reduced fat and muscle tissue
• Treatment:
o Energy-rich, balanced diet

Kwashiorkor
• Caused by inadequate protein intake, mainly in children.
• Symptoms:
o Dry or flaky skin
o Swelling of legs and abdomen
o Change in hair color
o Weakness and irritability
• Treatment:
o Protein-rich diet
Anemia
• Caused by iron deficiency.
• Importance of Iron:

1
 Needed to produce haemoglobin in the blood
o
o Helps transport oxygen
• Consequences of Deficiency:
o Low haemoglobin → Less oxygen → Less respiration → Less energy
• Symptoms:
o Feeling weak, tired, and irritable
• Treatment/Prevention:
o Iron capsules
o Iron-rich foods
Rickets
• Caused by vitamin D deficiency.
• Effects:
o Deformed bones in children, especially legs
• Sources of Vitamin D:
o Morning and evening sunlight
o Oily fish, butter, milk, cheese, egg yolk
• Function:
o Helps absorb calcium and phosphorus
o Important for strong bones and teeth

Scurvy
• Caused by vitamin C (ascorbic acid) deficiency.
• Effects:
o Improper formation of connective tissue and blood vessel fibers
• Symptoms:
o Bleeding under the skin (especially joints)
o Bleeding gums
o Poor wound healing
• Prevention:
o Daily intake of vitamin C (since it cannot be stored in the body)
• Sources:
o Oranges, lemons, grapefruit, tomatoes, fresh green vegetables
• Table 5.3: Summary of Major Nutrients and Their Deficiency Diseases
Deficiency Disease /
Nutrient Rich Food Sources Use in the Body
Effects
Builds cell structure;
Meat, fish, eggs, soya,
Protein important for growth and Kwashiorkor
groundnuts, milk
repair

2
 Barley, wheat, potatoes,
Carbohydrate bread, sugary foods like Provides energy Marasmus
honey
Oranges, lemons, other Helps in tissue repair and
Vitamin C Bleeding gums, Scurvy
citrus fruits boosts disease resistance
Strengthens bones and
Fish oil, milk, butter, also Soft bones, bowed legs,
Vitamin D teeth; helps in calcium
made by skin in sunlight Rickets
absorption
Forms hemoglobin in red
Tiredness, low energy,
Iron Liver, meat, cocoa, eggs blood cells for oxygen
Anemia
transport
Strengthens bones and Weak bones and teeth,
Calcium Milk, fish, green vegetables teeth; important for muscle cramps, Rickets, muscle
function weakness

Vitamin D:
• Role: Helps the body absorb calcium and phosphorus from the diet.
• Deficiency Effect: Without enough Vitamin D, even if you eat foods rich in calcium, your
body cannot absorb it properly.
• Result: Bones become soft and weak, leading to rickets, with symptoms like bowed legs,
bone pain, and delayed growth.
• Sources: Sunlight (main source), fish oil, milk, butter, egg yolk.

Calcium:
• Role: Main building block of bones and teeth.
• Deficiency Effect: If there's not enough calcium in the diet, bones cannot grow or
strengthen properly, even if you have enough Vitamin D.
• Result: Weak bones, poor tooth development, muscle cramps, and rickets-like symptoms.
• Sources: Milk, cheese, green vegetables, fish.

In Summary:
• Vitamin D helps your body use calcium.
• Calcium builds bones and teeth.
• A lack of either one can cause rickets, but for different reasons.

5.6 Malnutrition
• Malnutrition is the insufficient, excessive, or imbalanced consumption of nutrients,
leading to health problems.
• Causes of malnutrition include:

3
 o Poverty
o Famine due to drought or flood
o Soil erosion
o Wars
o Too little land for too many people
o Ignorance of proper nutritional requirements
• The dual burden of malnutrition includes:
o Undernutrition
o Overweight and obesity
o Diet-related non-communicable diseases
• Effects of malnutrition:
o Tissue damage
o Growth retardation
o Disorderly differentiation
o Reduced brain development in children
o Negative behavioral issues
o Poor intellectual capacity
o Class repetition
o Reduced productivity

Undernutrition
• Most common form of malnutrition, caused by lack of protein and dietary energy
(carbohydrates and lipids).
• If food intake is insufficient:
o Leads to weight loss
o Muscle wastage
o Weakness
o Starvation
• Extreme reduction in carbohydrates can cause marasmus.
• Malnutrition victims have low resistance to diseases.

Forms of Undernutrition:
• Wasting (low weight-for-height):
o Indicates recent/severe weight loss
o Caused by poor quality or quantity of food, or frequent illness
o Associated with high risk of death in children if untreated
• Stunting (low height-for-age):
o Caused by chronic or repeated undernutrition
o Linked to poverty, poor maternal health/nutrition, illness, and poor feeding
practices

4
 o Prevents physical and cognitive development
• Underweight (low weight-for-age)
• Micronutrient deficiencies:
o Lack of essential vitamins and minerals
o Affects enzyme, hormone, and other substance production necessary for growth
and development

Overnutrition (Excess Nutrition)

• Too much fat in the diet can lead to:
o Coronary heart disease
o Fat buildup in arteries
o Reduced blood vessel diameter
o Blood clots and heart attacks

Obesity (Overweight)
• Caused by eating more food than needed, leading to fat storage
• Common in people consuming:
o High-fat foods
o Sugary foods
• To prevent malnutrition:
o Consume diverse, nutrient-dense food
o Avoid junk and sugary foods
o Do regular physical exercise
• Obesity is caused by:
o Imbalance between stored energy and energy release
o Increased high-energy food intake with low physical activity
o Decreased levels of physical activity
• Health risks of obesity:
o Heart disease
o High blood pressure
o Diabetes
o Arthritis (worn joints)
• Ways to control obesity:
o Eat less high-energy foods (lower energy intake)
o Do more exercise (increase energy output)
o Eat a balanced diet with lower energy intake

5.7. Substance abuse

5
Drugs
• A drug is any substance taken into the body that alters or affects chemical reactions.
• Drugs can be:
o Medicinal drugs – taken legally to reduce symptoms (e.g., headaches) or treat
infections.
o Recreational drugs – often taken illegally to stimulate, induce sleep, or cause
hallucinations.

Drugs in Food
• Drugs are present in some common foods and drinks such as:
o Tea
o Coffee
o Energy drinks
o Alcoholic beverages
• These contain substances like caffeine, which can be addictive due to their stimulant
effects.

Substance Abuse
• Definition: Using legal or illegal substances in the wrong way or in excessive amounts.
• Includes both medical and non-medical substances.
Examples of legal substances often misused:
• Caffeine – found in tea, coffee, energy drinks
• Nicotine – found in tobacco
• Alcohol – found in various alcoholic drinks
• While legal, excessive use of these substances can lead to serious health issues.
Examples of illegal/recreational drug use:
• Alcohol, tobacco, khat, heroin – used for pleasure, relaxation, or stimulation.

Commonly Abused Drugs in Our Country

1. Cigarettes
• Made from the tobacco plant (Nicotiana tabacum).
• People smoke for stimulation or due to addiction.
Harmful Components:
1. Tar
o A sticky black substance.
o Accumulates in the lungs and causes:
▪ Chronic bronchitis: Excess mucus production, damaged cilia, blocked
bronchioles.
▪ Lung cancer: Carcinogens in tar cause tumor formation.
2. Emphysema

6
 o Caused by alveoli damage and bursting due to coughing.
o Reduces oxygen absorption.
o Leads to breathlessness and exhaustion.
3. Carbon Monoxide
o A poisonous gas in smoke.
o Binds with hemoglobin (forms carboxyhemoglobin), reducing oxygen supply.
o Increases heart rate, causes blood vessel damage, and raises risk of:
▪ Coronary Heart Disease (CHD)
▪ Stroke
4. Nicotine
o Stimulates and relaxes the nervous system.
o Causes addiction by increasing dopamine in the brain.
o Long-term use leads to:
▪ Dependency
▪ Increased heart rate and blood pressure
▪ Narrowing of blood vessels
▪ Blood clot formation

2. Alcohol
• Widely accepted in many societies, including Ethiopia.
• Local alcoholic drinks include Tella, Arekie (Katicala), Beer, Wine.
Absorption:
• Absorbed through the stomach and small intestine into the bloodstream.
• Broken down by liver enzymes.
WHO Guidelines:
• One standard drink = 10g pure ethanol.
• Recommended: No more than 2 drinks/day for both men and women.
Effects:
• Depressant – slows brain activity and nerve impulse transmission.
• High consumption causes:
o Loss of coordination
o Poor judgment
o Slowed reaction time
o Loss of self-control
Addiction (Alcoholism):
• Leads to dependency and tolerance.
• Causes family, financial, and social problems.
• May result in:
o Violence
o Crime

7
 oMarital problems
o Child neglect
o Absenteeism from work
Long-term Effects:
• Stomach ulcers
• Heart disease
• Brain damage
• Cirrhosis – liver tissue replaced by scar tissue, potentially fatal

3. Heroin
• A powerful depressant that slows the nervous system.
• Chemically similar to endorphins (natural pain-relievers in the brain).
Effects:
• Binds to endorphin receptors, blocking pain.
• Produces a sense of euphoria.
• Leads to:
o Addiction
o Tolerance – more heroin is needed over time to feel the same effects
4. Cannabis
• Most commonly used illegal drug globally.
• Derived from the Cannabis plant, mainly the flower, which is harvested and dried.
• Common names: weed, pot, marijuana.
• Used for both recreational and traditional medicinal purposes.
• Contains Tetrahydrocannabinol (THC) – a stimulant/psychoactive component.
• Methods of use:
o Smoking
o Vaporizing
o Mixing with food
o Extract form
Effects:
• Sense of enjoyment
• Altered mind and time perception
• Difficulty concentrating
• Short-term memory loss
• Body relaxation
• Increased appetite
• Duration: 2 to 6 hours depending on dose
High-dose effects:
• Nervousness
• Panic

8
 • Hallucinations
• False beliefs
• Suspicion
• Psychosis

5. Chewing Khat
• Plant: Catha edulis
• Chewed for its stimulant effect
• Grown in Ethiopia, Somalia, Kenya, and southern Arabia
• Supplied as fresh leaves wrapped in false banana leaves
• Contains Cathinone – active chemical affecting the central nervous system (CNS)
• Only fresh leaves used (cathinone breaks down in dry leaves)
• Common use: chewing; sometimes tea from dried leaves
Effects and consequences:
• Initially causes:
o Joy
o Increased alertness
o Stimulation
• Later effects:
o Depressed mood
o Irritability
o Loss of appetite
o Gastritis and peptic ulcer
o Difficulty sleeping
Social problems:
• Family fragmentation
• Multiple sexual partners
• Spread of sexually transmitted infections (STIs)
• Early sexual activity reported among chewers

6. Doping
• Doping: Use of banned drugs/treatments to enhance athletic performance
• Common in competitive sports
• Performance Enhancing Drugs (PEDs) are used to boost performance
• World Anti-Doping Agency (WADA) oversees testing using blood and urine tests
• Biological passport tracks long-term biological data
Why doping is a concern:
1. Health Risks:
o Cardiovascular: High blood pressure, heart attack, sudden death
o CNS: Anxiety, depression, addiction, psychosis, stroke

9
 o Respiratory: Nose bleeds, sinusitis
o Hormonal: Infertility, enlarged breasts (males), cancer, etc.
2. Moral Issues:
o Unfair advantage
o Diminishes spirit of fair competition

Banned Substances & Methods:

• Always banned: Anabolic agents, peptide hormones, gene doping, diuretics, masking
agents, etc.
• Banned in competition: Stimulants, narcotics, cannabinoids, glucocorticoids
• Sport-specific bans: Beta blockers (e.g., archery, shooting)
Therapeutic Use Exemption (TUE):
• Athletes with medical needs can apply for a TUE
• Must be approved by a medical committee

Consequences of Doping
1. Physical Health:
o Steroids: Liver disease, heart problems, baldness, sexual issues
o EPO: Blood clotting, stroke, heart attack
o Human Growth Hormone: Vision loss, heart failure, deformities
2. Mental Health:
o Anxiety, mood swings, aggression, psychological dependence
3. Social Impact:
o Ruined reputation, isolation, media scrutiny
4. Financial Losses:
o Loss of income and sponsorship
o Career suspension or ban
5. Sporting Impact:
o Disqualification
o Loss of rankings and medals
o Team consequences
6. Legal Consequences:
o Suspensions
o Ban from sports and official training

Problems of Using Drugs

• Reasons for use:
o Stimulation
o Recreation
o Peer pressure

10
 •Over time:
o Users may need more to feel the same effects
o Leads to addiction
Common problems faced by users:
• Eating or sleeping disorders
• Changing social circles
• Neglecting personal care
• Loss of interest
• Family and work issues
• Financial struggles
• Isolation from society

Recovery from Drug Addiction

Steps for Recovery:
• Acknowledge the problem
• Seek support from others
• Adjust daily habits
• Celebrate small victories
• Avoid relapse
• Strive for lasting freedom

11