Being underweight can signify as many health concerns to an individual just as being overweight can. Doctors emphasise that if a person is underweight, their body may not be receiving the nutrients it needs to build healthy bones, skin, and hair. Dieudonné Bukaba, a private nutritionist at Avega Clinic Remera, says an underweight person is one whose body weight is considered too low to be healthy. Underweight people have a body mass index (BMI) of under 18.5 or a weight 15 per cent to 20 per cent below that is normal for their age and height group. He points out that risks of underweight persons include; malnutrition, vitamin deficiencies, or anaemia, osteoporosis from too little vitamin D and calcium, decreased immune function, increased risk for complications from surgery, fertility issues caused by irregular menstrual cycles, growth and development issues, especially in children and teenagers. WHEN IS ONE UNDERWEIGHT? Private Kamanzi, a dietician at Amazon Wellness Centre, Remera-Gasabo District, says underweight is the case where people don’t have appropriate weight due to inadequate nutrients. Underweight is categorised according to age group. He says there is underweight at birth. According to World Health Organization (WHO) cut points, when a baby born with less than 2.5 Kgs is considered underweight, and the cause could be due to inadequate nutrition intake by the mother during pregnancy. “From birth to five years, a child is considered underweight if measured for weight for age. That weight is compared to the age of the child. When you have negative two Z score and above (this is a standard deviation), that shows that the child is underweight. There is a software used to measure this,” Kamanzi notes. However, he says, there are also filed standard forms if one doesn’t have that software. Measure if the weight of the child lines in the ranges that are mentioned by WHO according to the reference population. Kamanzi explains, underweight during childhood can be severe (here, a child is measured having negative three and above standard deviation) and moderate (when a child lies between negative two and negative three), if the child has severe underweight, they need a transfer to the district hospital. He notes, there are other complications associated to underweight, for instance; nausea, low metabolic rate, these complications can be treated. However, other foods are introduced to the severely underweight children, some of this food includes; therapeutic milk, among others. “From 5 to 19 years, we don’t consider weight for age to know whether someone is underweight. Here we use body mass index for age. If a person in this age bracket has above negative two standard deviation, then they are considered underweight. “From 20 years and above, body mass index is reflected as an indicator. If a person has less than 14.4 body mass index, they are underweight,” Kamanzi states. He also mentions that being underweight is caused by inadequate food intake, if a person eats less food compared to their dietary needs, automatically they would be underweight, regardless of the age. RISKS Kamanzi explains that when a person is suffering from a certain disease, their dietary needs increase, for example, if a person is suffering from cancer and has been undergoing chemotherapy or radiotherapy, the body uses a lot of energy which needs them to increase the energy intake to recompense the energy lost, during the treatment. “If you don’t increase the dietary intake yet undergoing a certain treatment, this lowers your energy, thus creating a high possibility of losing weight,” he notes. The dietician further notes that vulnerable diseases like HIV require extra nutrients to compensate the energy lost by the infection. If the appetite has been lost, energy will be lost. This results in loss of weight. Kamanzi says being underweight can cause complications, it weakens the immune system. That is to say, a child born with low birth weight is at great risk of diseases due to a low immune system. Low birth weight goes hand-in-hand with premature birth. Such children are always sick. “Infertility could be a consequence of being underweight. If adolescents are poorly fed, they might be underweight which can lead to infertility at a later age in life. Being underweight is a sign that the uterus of a girl during adolescence doesn’t develop adequately and some reproductive hormones are affected as well,” he says. He adds, for males who have been underweight during adolescence, their sperm production is very low. Kamanzi calls upon underweight patients to consume high protein and carbohydrates intake. Medics say, exercise, especially strength training, can help one gain weight by building up the muscles. It may also stimulate the appetite. Bukaba elucidates that underweight people should eat five to six smaller meals during the day, rather than two or three large meals. Choose nutrient-rich foods. As part of an overall healthy diet, choose whole-grain breads, pastas and cereals, fruits and vegetables, dairy products, lean protein sources, nuts and seeds. Try smoothies and shakes too. Kamanzi adds that underweight people should take thick porridge and bread in the morning. Lunch should be taken on time, for example; at about noon. They should focus more on carbohydrates and protein food. He says, from lunch, underweight people have to snack (they can take samosas, yoghurt, juice, biscuits, among others). They should take dinner a bit early, like at 8pm. editorial@newtimesrwanda.com
