Stages of Nutritional Injury


Stage O – Healthy, or Possible Risk of Nutritional Injury

Example: Genetics:Genotype,Phenotype, Environment: Agents – family history of alcoholism or habit of excessive alcohol intake, bipolar disorder, celiac disease, diabetes

Stage I – Diminishing Reserves/Building Excess

Example: Omits food groups due to allergies and/or preferences, eats 1 meal/day, used mega-doses of supplements, follows fad diets

Potential nutrients affected*:  Protein, Carbohydrate, Vitamins A, C, D, E, Folic acid, Iron, Calcium

Stage II. –  Reserves Exhausted, Excesses Accumulated

Stage III.- Physiologic and Metabolic Changes

Examples:  Weight gain / loss, elevated Lipids, Glucose, Homocysteine; Meaningful Scores on Eating Disorder evaluations

Potential nutrients affected*: Low vitamin B-12 and C, Folic acid, Iron, Essential fatty acids, Elevated Cholesterol, Triglycerides, Homocysteine

Stage IV. – Non-specific Signs and Symptoms

Examples:  Fatigue, Headaches, Irritability, Trouble concentrating, Poor appetite, Nausea, Diarrhea, Nutrient-based lesions

Potential nutrients affected*:  Vitamin deficiency, low carbohydrate intake, Excess or Inadequate calorie intake; symptoms related to  environmental toxins

Stage V. – Illness, Condition, Medical diagnosis

Examples: Metabolic syndrome, Bulimia, Anorexia Nervosa, Gestational diabetes, Alcohol dependence, Medications with Nutrient-Drug Interactions

Potential Nutrients Involved*:  MAOI/Tyramine interaction, Lactose intolerance, Vitamin/Mineral deficiency; Gluten sensitivity

Stage VI. – Permanent Damage

Examples: Dementia, Bariatric / gastric bypass surgery, Pernicious anemia, Phenylketonuria, Dementia, Xerosis with ulcerations, Blindness r/t lack of Vitamin A . . . . . . . . . . . . . . . . Potential Death

Potential Nutrients involved*: Vitamin A, B-12, phenylalanine

*including, but not limited to . . .

Arroyave G. Genetic and Biologic Variability in Human Nutrient Requirements. Young R & Scrimshaw NS. American Journal of Clinical Nutrition, 1979; 32:486-500.  Adapted with permission from Guillermo Arroyave.