World View of Nutrition: The Faces of Global

Malnutrition

Chapter

19

A Few Definitions…• Hunger: Uneasy or painful

sensation caused by lack of food

• Malnutrition: Failure to achieve nutrient requirements

• Food insecurity: Limited or uncertain availability of nutrients/food

• Food security: Assess to enough food

Malnutrition in the United States• The Face of American Malnutrition• Prevalence and distribution

• Linked with economic and social factors

Malnutrition in the United States: Groups at Risk

• Working Poor• May or may not qualify for food

assistance• Food Deserts

• Lack access to food resources• Older Adults

• Economic difficulties• Physical ailments

Malnutrition in the United States: Groups at Risk

• Homeless or Inadequately Housed• Lack consistent cooking facilities• Limited income, if any

• Children• Dependent on family circumstances• Hunger affects school performance

Malnutrition in the United States

• Attacking Hunger in America• The Supplemental Nutrition Assistance

Program• Special Supplemental Nutrition Programs

for Women, Infants, and Children (WIC)• National School Lunch Program• The Child and Adult Care Food Program• Feeding America

Malnutrition in the Developing World

Malnutrition in the Developing World

• The World Food Equation• Global Economic Boom• Oil Prices and Biofuels• Global Climate Change and Severe

Weather Events• The Fight Against Global Hunger

Malnutrition in the Developing World

• Social and Economic Factors• Poverty• Population Growth• Urbanization

• Infection and Disease• Political Disruptions

• War• Refugees• Sanctions• Floods, Droughts, Mudslides, Hurricanes

Malnutrition in the Developing World

• Agriculture and environment: A tricky balance• Environmental degradation

• Reduced food production• Nutritional consequences

Malnutrition in the Developing World

• Malnutrition: Its Nature, Its Victims, and Its Eradication• Protein-Energy Malnutrition

• Kwashiorkor• Marasmus

Malnutrition in the Developing World

• Protein Energy Malnutrition• In kwashiorkor, the body and face swell

with excess fluid, the hair turns wispy and red, and a terrible rash develops; without treatment, the person dies.

• Marasmus paints an even more dramatic picture of sunken eyes, shriveled limbs, and a clearly visible outline of the skeleton; it is as deadly as kwashiorkor.

Malnutrition in the Developing World

• Iodine deficiency disorders

• Most common cause of preventable brain damage

Malnutrition in the Developing World

• Vitamin A deficiency• Leading cause of preventable blindness

• Iron-deficiency anemia• Limits productivity of population

Malnutrition in the Developing World

• Deficiencies of other micronutrients • Overweight and obesity

• Differing cultural attitudes• High-calorie, low-nutrient dense foods

Addressing World Hunger, Malnutrition and Food Insecurity

• It is the position of the AND that access to adequate amounts of safe, nutritious, and culturally appropriate food at all times is a fundamental human right. Hunger continues to be a worldwide problem of staggering proportions.

• The AND supports programs and encourages practices that combat hunger and malnutrition, produce food security, promote self-sufficiency, and are environmentally and economically sustainable.

AIDS and Malnutrition

• It is the position of the Academy of Nutrition and Dietetics and Dietitians of Canada that efforts to optimize nutritional status, including medical nutrition therapy, assurance of food and nutrition security, and nutrition education, are essential components of the total health care available to people with human immunodeficiency virus infection throughout the continuum of care.

Malnutrition in the Developing World

• Despite gains in eradicating malnutrition, 30 percent of the global population—especially people in the developing world—continue to suffer from chronic hunger.

• Although world food supplies are adequate, factors that allow hunger to continue include poverty, poor sanitation, urbanization, and inefficient food distribution.

• Infection (especially AIDS) rapid population growth, wars, and environmental degradation threaten to reverse hard-won gains.

Inequitable Food Distribution • Advances in agriculture have increased food production

worldwide. Enough calories are now produced to supply the energy needs of every person on Earth. But distribution of these calories is uneven: among the continents, among nations, within nations, and even within families.

• In some societies the father of the family may be wrongly perceived as having the greatest nutrition needs and will be given priority for the most nutritious, high-protein foods.

• In those societies, older boys will have second priority; pregnant and breastfeeding women, women in general, and small children will have the lowest priority. Nations may follow a similar pattern, ensuring that their soldiers or men of fighting age receive scarce foodstuffs.

Nutritional Deficiencies

• The most critical nutritional deficiencies in today’s developing world are deficiencies of protein, calories, iodine, vitamin A, and iron. There have been gains in reducing the severity and prevalence of protein-energy malnutrition, through breastfeeding promotion, nutrition education, and improvements in food supplies.

• Fortification and supplementation programs are effectively attacking iodine and vitamin A deficiencies but have had less success in overcoming iron deficiency. All of the underlying causes of malnutrition must be addressed to reduce and eliminate these and other deficiencies.

Hungry and Homeless

• A major public health concern for homeless people is not only whether they are getting enough to eat but also the nutritional quality of their diet.

• This concern in complicated by the special needs of infants, children, and women, especially pregnant women.

Malnutrition in the United States

• Overt malnutrition in the United States is uncommon. Food insecurity and hunger are interlinked with poverty. Groups at risk include the working poor, the isolated, the homeless, children, and elders.

• A large network of individual volunteers, nonprofit agencies, and charities, together with major government programs such as Food Stamps, WIC, and School Lunch, have done much to reduce hunger.

• However, food insecurity, which continues among an unacceptably large number of people, must be overcome by social and economic improvements.

Environmental Degradation• Environmental degradation is a growing concern in both

the developing and the industrialized world. In developing countries, there is pressure for more land to support rapidly expanding populations. In industrialized countries, there is pressure from the affluent for more land, more houses, larger properties, more recreation areas, and so on.

• Residents of the industrialized world consume vast amounts of resources (e.g., water, fuel, wood, paper, textiles, food) without a thought and often without making the small effort to conserve or recycle.

• Residents of the developing world consume much less per person, but the impact of their numbers is greater.

Blame Undernutrition?

• In all populations in the developing world, low weight- and height-for-age affect 10 to 15 percent of preschool and school-aged children.

• Most experts attribute this shortfall to insufficiency of food.

• A study of African schoolchildren, however, found no significant difference between well-fed and underfed pupils on measures such as their class position, aptitude for games, and interest in education.