World View of Nutrition

Chapter

18

The Tragic Facts

• ~12mill children under 5 YOA die each year – 55% are from undernutrition

• 1/10 US households have issues with hunger

• 1/6 worldwide are chronically undernourished

• 2/3 undernourished live in Asia

• Problem growing at the fastest rate are in Africa - Ethiopia, Sudan, Rwanda, Burundi, Kenya, Somalia, Tanzania

• Problem is getting WORSE, not better

Common Maladiesfrom Undernutrition

• Vit A: Xerophthalmia (eye dries out)

• Vit D: Rickets• B’s: Rickets, Beriberi,

Pellagra• Vit C: Scurvy• Iron: Anemia• Iodide: Goiter• Zinc: All areas of growth

A few definitions…• Hunger

• Uneasy or painful sensation caused by a lack of food (acute) May in time, lead to malnutrition

• Malnutrition• Failure to achieve nutrient requirements (chronic)• Results: discomfort, weakness -> mental retardation, chronic

diseases, death

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

• Food security• Assess to enough food

Malnutrition in the U.S.

Prevalence and distribution• Linked with economic and social factors

Reflects10.4% of UShouseholds

Malnutrition in the U.S.: Groups at Risk

• Working poor• May or may not qualify for food assistance• Can’t get to proper facilities

• Isolated• Lack access to food resources

• Elders• Economic difficulties• Physical ailments• Nursing home settings

Malnutrition in the U.S.: Groups at Risk

• Homeless• Lack consistent cooking facilities• Limited income, if any• ~30% are substance abusers

• Children Dependent on family circumstances• Hunger affects school performance

• Eating Disorders

Malnutrition in the U.S.

• Attacking hunger in America• The Food Stamp program

• Extends food buying power

• Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

• Food, nutrition services for pregnant and lactating women, and children to age 5

• National School Lunch Program• Free and reduced price meals

• Child and Adult Care Food Program

Malnutrition in the U.S.

• Attacking hunger in America (Government programs)• School Breakfast Program• Summer Food Service Program• Special milk program• Commodity Supplemental Food Program• Food Distribution Program on Indian Reservations• Older Americans Act Nutrition Program• Disaster Feeding Program• The Emergency Food Assistance Program (TEFAP)• Others• Non-government (food pantries, rescue missions, etc.)

Malnutrition in the Developing World

Concern: Supply vs Demand

Demand:• In 1800 world population was 1 bill• By 2000 world population was 6 bill• By 2050 some estimates are as high as 8 – 12 bill, but AIDS might

take it down to 7-9 bill.• Increases mostly coastal and river basin areasSupply:• Green Revolution of 1960’s introduced high-yielding, disease

resistant rice, wheat, corn, greater use of fertilizers, water, cultivation practices. Green revolution might be at capacity because remaining lands largely unsuitable for farming.

• Currently, problem is food distribution, not food production• Soon, it will be BOTH!

Concern: Supply vs Demand

Solution: Control demand side to 2:1 (birth control)Birth control shown effective in developed countries, but not in undeveloped countries. Why?

In undeveloped countries, surviving children care for parents in their later years! Only when people have enough to eat and are financially secure will they have fewer children.

Education is the long term solution: Proven effective in Brazil, Egypt, India and Mexico

Why Hunger??

Why Hunger??• Poverty is #1 reason

• Limits access to food• Limits purchase of farm

equipment/supplies, boats, etc• Discourages education

• Population growth• Parent’s source of security• No access to birth control

• Infection and Disease• Limited immunizations, limited hygiene

and sanitation, poor drinking water, limited access to medical care

• HIV – June 2000 = 34.3 mill (90+% in developing countries, 2/3 in Africa)

• Currently 42 mill, -> 3.7 mill orphans• Poor diet accelerates AIDS infection

Why Hunger??• Politics and Natural Disasters

• War diverts resources away from needed food (military spending has doubled in last 20 years), working class goes into the Army.

• Currently 1% of world’s goods = economic development, whereas

6% = military expenditures.• Refugees• Sanctions• Floods, droughts, mudslides, hurricanes

• Inequitable Food Distribution• Enough food is now being produced,

problems with distribution to areas of greatest need. Social structure prioritizes father having the greatest need, then older boys, then women, then children

Why Hunger??• Agriculture and Environment

• Need irrigation, pesticides, fertilizers – most can’t afford

• Environment - competition bet. Farmland and urbanization

• Clear-cutting and over irrigation produces deserts

• Over-fishing depletes another renewable resource

• In 1975 38% lived in cities, now 50%; 70% by 2050

• Inadequate or deteriorating shelters

• Lack proper food storage – leads to 40% loss of perishable foods

Why Hunger??

General Effects of Semistarvation

Critical Phases of Undernutrition?• Pregnancy

• Risk to both mother and fetus• Africa has 1/20 chance of mother dye from pregnancy

related problems (US = 1/8,000)

• Fetal and Infant Stages• Often born prematurely -> weakened immune sys., 5-10X

chance of dying before 1 YOA• Many nutrients needed for proper brain development

• Childhood• Rapid growth phase. Most vulnerable = brain, inc. illness,

stunted growth, anemia, many learning problems

• Later years• Greater medical costs = less spent on proper nutrition• Unable to take care of themselves

Malnutrition in the Developing World(micronutrients)

• Iodine deficiency disorders

• Most common cause of preventable brain damage

Malnutrition in the Developing World (micronutrients, cont)

• Vitamin A deficiency• Leading cause of preventable blindness

• Iron-deficiency anemia• Limits productivity of population

• World Bank suggests:• Increase diversity of the food supply• Fortify specific foods• Provide supplementation when necessary

Reducing Undernutrition

• Short Run• Aid must be given – people are starving

• Long Run• Improving the infrastructure for poor people• Currently rely on outside sources for basic needs• Focus on local conditions (Peace Corps)

• Help people meet their own needs• Requires training, storage facilities, marketing and credit• Need greater focus on impoverished women (end cycle of

female neglect)

Reducing Undernutrition

• Long Run• Appropriate technologies for processing,

preserving, marketing, distributing food• Education on proper diets, sanitation, cooking, birth

control, AIDS prevention, infant/child rearing• Employment training

“The world has both the food and the technical expertise to end hunger. What is lacking is the political will to do so.”

Resources• World Health Organization (WHO) – coordinates

international health work.• www.who.int/nut

• Food and Agriculture Organization (FAO) – A UN agency – promotes agricultural development, improved nutrition and food security.• www.fao.org

• World Bank. A development Bank which provides loans, policy advice, technical assistance and knowledge sharing services to low and middle income countries to reduce poverty.• www.worldbank.org

Resources

• Peace Corps: education, youth outreach, and community development; health and HIV/AIDS; agriculture and environment; business development; and information technology.

• www.peacecorps.gov

• Samaritan’s Purse: nondenominational evangelical Christian organization providing spiritual and physical aid to hurting people around the world. Focus = victims of war, poverty, natural disasters, disease, and famine with the purpose of sharing God's love through His Son, Jesus Christ.

www.samaritanspurse.org

Resources

• Food for the Hungry International: long-term development among the extremely poor, recognizing their dignity, creativity, and ability to solve their own problems. We focus on:

• Sustainable Food Production, including agricultural training and assistance, agro-forestry, reforestation, and land conservation

• Water Resource Development for both drinking and irrigation • Primary Health Care

• Income Enhancement, including micro-enterprise development

and skills training. • www.fhi.net