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Unformatted text preview: Community Nutrition GCH 421 World Hunger and Food Insecurity: World Challenges and Opportunities. Chapter 14 Chapter Today: Review Chapter 14. (World Hunger and Review Food Insecurity: Challenges and Opportunities.) Opportunities.) Statistics on Global Undernutrition More than 6 billion people in the world More suffer from chronic severe undernutrition. suffer Over 200 million children under 5 years Over suffer from PEM. suffer Approximately 2 billion people, mostly Approximately women and children, suffer from micronutrient deficiencies. Concepts Concerning Undernutrition in Developing Countries Food Shortage – When total food supplies within Food a geographic area are insufficient to meet the needs of the populations living in an area. needs Food Poverty – Situation in which households Food cannot obtain enough food to meet the needs of all their members. their Food Deprivation – Refers to inadequate Food individual consumption or absorption of food energy or of specific nutrients, the form of malnutrition known as undernutrition. malnutrition Food Shortage Worldwide there is actually enough food supply to meet the Worldwide world’s needs. There is enough food to feed approximately 20% more people than the actual world’s population since the 1970’s. Yet only 60% of the world’s population can be fed with Yet existing food production. existing Many countries have had national food shortages which are Many due to the fact that countries cannot produce enough or cannot afford imported food. afford In 1997, 29 countries worldwide had food shortages or famine. Refugees and internally displaced people are among the Refugees world’s most food insecure people. world’s In 1992, 16 million people were refugees. Food Poverty Food poverty is due to inadequate income, poor Food access to productive resources, inability to benefit from private or public food transfers, or lack of other entitlements to food. other In 1996, 840 million people were malnourished In and it is projected this will decline to 680 million by 2010. 30% of the world’s population still experiences some form of malnutrition experiences Much of the problems of food poverty occur in Much Sub-Saharan Africa. By 2010, it is estimated that 1/3 of the population will be food insecure. 1/3 It is estimated that 29% of all children under 5 It years are underweight. years Many are also at risk of micronutrient Many deficiencies. 29% are at risk of goiter and 79% of all pregnant women are at risk for iron deficiency. deficiency. Much progress has been made to eradicate Much Vitamin A deficiency, yet very little has worked in Africa. in Food Deprivation Food Security Access by all people at all times to enough Access food for an active and healthy life. food Ensures adequate food supplies are Ensures available. available. Ensures that households whose members Ensures suffer from undernutrition have the ability to acquire food. ability Mapping Poverty and Undernutrition Food insecurity and hunger is spread into Food about 86 countries known as low-income food deficit countries (LFDCs). food Half of these countries are in Africa. The Gap between Developed and Developing Nations GNP ($261 vs. $26,157) Infant mortality rate (104/1000 vs. 6/1000) Life expectancy (51 years vs. 78 years) Literacy rate (53/100 vs. 96/100) Safe water supply (61% vs. 100%) Children under 5 mortality rate (164/1000 Children vs. 6/1000) vs. Malnutrition and Health Worldwide Many children in developing countries die from Many diseases that are not common in the developed world: dysentery, whooping cough, measles, tuberculosis, cholera, and malaria. For children who are malnourished, they cannot often recover from these diseases. from The top 5 child killers include: Perinatal conditions (20%) Respiratory infections (18%) Diarrheal disease (17%) Vaccine preventable disease (15%) Malaria (7%) PEM (Protein-Energy Malnutrition) Defined as a deficiency of protein and food Defined energy; the world’s most widespread malnutrition problems including marasmus and kwashiorkor. and Kwashiorkor and Marasmus Kwashiorkor No major losses in No skeletal muscle. skeletal Serum proteins Serum significantly decreased. significantly Adipose tissue Adipose preserved. preserved. Body weight is Body relatively normal. relatively Pitting edema is Pitting common. (often in feet and legs and in upper extremities and face in severe cases) severe Ample energy with little or no protein. no Marasmus Significant losses in Significant skeletal muscle. skeletal Serum proteins are Serum relatively normal. relatively Significant loss of Significant adipose tissue. adipose No edema. Starvation: lack of both Starvation: protein and total energy. energy Kwashiorkor Marasmus kwashiorkor General Clinical Signs of PEM Hair can become dry, brittle, dull, and Hair easily pulled without pain. easily “Flag Sign”- Traverse depigmentation of Flag hair. hair. Traverse ridging of nails. Cracking of skin. (like flaky paint) Cellophane appearance. Growth Failure. Where does PEM occur? Very few actually suffer from severe PEM, most people Very suffer from mild to moderate PEM, which may show little signs. signs. PEM occurs in the developed world as well as the PEM developing world. developing In the U.S. it occurs in economically deprived areas. One recent CDC report, noted 3 infants suffering from One protein energy malnutrition because they were fed rice water rather than breast milk or formula. water Also in developed countries, PEM occurs among Also people suffering from wasting diseases (I.e. cancer, HIV/AIDS). HIV/AIDS). PEM is more common in economically depressed areas. In many countries, diets consist of a single high starch In food that is low in protein. Ex: cassava, rice, potatoes.. food 3 Major Micronutrient Deficiencies Vitamin A Iron Deficiency Iodine Deficiency Vitamin A 750 million people are affected by vitamin A globally. 750 5-10 million children develop xeropthalmia of whom 25 to 5-10 50% go blind. 50% Methods of prevention include: Programs aimed to increase intake of dietary sources of Programs vitamin A vitamin Administration of large doses of vitamin A (give pills Administration or injections that will provide enough for 4-6 months) or Dietary fortification and enrichment Fortification is addition of vitamin A in the food in Fortification which the vitamin is absent (skim milk) which Enrichment is addition of vitamin A to a food which Enrichment the vitamin is present in small amounts (margarine) the Supplementation Symptoms of Iron Deficiency Anemia Feeling weak or tired Headaches Hair loss Feeling out of breath after physical activity Upset stomach Pale skin Rapid pulse Loss of sexual desire Loss of appetite Iodine Deficiency Approximately 30% of the world’s Approximately population are at risk from iodine deficiency and 750 million people have goiters. goiters. Found more commonly in Syria, India, and Found China, but also a problem in Europe. China, Children at Risk The first to show signs of undernutrition The include pregnant and lactating women, infants, and children. infants, In developing countries, the average weight In gain among pregnant women is 11 to 15 pounds (in developed countries it is 27 pounds). pounds). Children at Risk Low birth weight babies (less than 2500 Low grams or 5.5 pounds) are common in developing countries. Being of low birth weight has future ramifications: weight More likely to experience complications More during delivery during More likely to have physical and mental More birth defects birth More likely to contract diseases and die More early early Low birth weight contributes to more Low than half of the deaths of children under 5 years of age. years Breastfeeding in the World Most women throughout the world breastfeed, primarily Most because it is inexpensive. Unfortunately there is a rising trend in many developing Unfortunately countries in which mothers choose formula over breast milk, because formula carries more status. milk, Only about half of all infants exclusively breastfeed to the Only age of 4 months. age The global recommendation is now for exclusive The breastfeeding for 6 months accompanied by timely complementary feeding at 6 to 9 months along with continued breastfeeding well into the second year. continued WHO estimates that more than 1.5 million children’s lives WHO could be saved if all mothers gave their babies nothing but breast milk for the first 4-6 months of life. breast Women will often water down formula with unclean water Women so that they can conserve the formula and this can lead to diarrhea and put the infant in severe risk for malnutrition. diarrhea However, in southern Africa, where HIV/AIDS is However, common, women are afraid to use formula, because they can be stigmatized as having HIV/AIDS. In the developed world, it is recommended that women In who have HIV/AIDS use formula, because most research suggests that HIV can be carried to the infant via breast milk. However the WHO recommends breastfeeding under all circumstances. Breastfeeding in the World Breastfeeding provides all the nutrients Breastfeeding needed for first 4 months of life and at least for 6 months of life. Up to 2 years or more breast milk continues to provide high quality nutrients. Nutrients not in formulas include: include: High quality protein Long chain PUFA (essential FA) Micronutrients: iron in a form that is Micronutrients: efficiently absorbed efficiently Value of Breastfeeding Here are some advantages to breast feeding. Advantages to baby: Improved mental development Less diarrhea and less severe diarrhea Fewer lower respiratory infections Fewer urinary tract infections Less bacterial meningitis Fewer ear infections Possibly less risk of sudden infant death syndrome Possibly (SIDS) (SIDS) Possibly less risk of diabetes Type I Possibly less risk of allergic diseases Formula Feeding versus Breastfeeding Advantages to mother: Less bleeding after giving birth Reduced risk of ovarian cancer Reduced risk of breast cancer Reduced risk of anemia Reduced risk of osteoporosis Quicker weight loss after giving birth Less bone decay and fewer hip fractures in Less old age old Less expensive Women at Risk Childbearing Cultural values of women Food Insecurity in Developing Countries Role of colonialism Many countries started plantations to produce Many products that could be sold to other nations. These displaced indigenous crops and took up land. land. International trade and debt Many countries need to purchase items from Many abroad and often need to borrow to do it. abroad Food Insecurity in Developing Countries North-South Dialogue – Discussions between North-South developed countries and developing countries to achieve global economic change and address the economic imbalance in international trade experienced by developing countries. experienced Role of multinational corporations Multinational corporations – Transnational Multinational companies with direct investments and or operative facilities in more than one country. operative These corporations hire cheap local labor and These export what is produced (bananas, coffee, textiles, oil, etc..). textiles, Role of overpopulation The current world population is 6 billion and is The projected to be 7.8 billion by 2025. projected Low income countries have typically high birth Low rates, death rates, and low standards of living. rates, With improved standard of living, the death With rates and birth rates decline. rates Distribution of resources Agricultural technology (use of appropriate Agricultural technologies) technologies) People-centered Development Development enables people to meet their Development essential needs, extends beyond food aid and emergency relief, reverses the process of impoverishment, enhances democracy, and makes possible a balance between populations and resources. resources. Development cannot be measured by economic Development development, but it should serve the people and requires ongoing community involvement. requires Nutrition and Development The U.N. views a healthy nutritious diet as The a basic human right. basic Achieving this worldwide requires the Achieving following: following: Ensuring adequate access to food Preventing and controlling infectious Preventing diseases by providing clean water and basic sanitation basic Promoting healthy diets and lifestyles Nutrition and Development quality and safety quality Preventing micronutrient deficiencies Assessing, analyzing, and global Assessing, monitoring of nutrition status of populations at risk populations Incorporating nutrition objectives into Incorporating development policies and programs development Protecting consumers through improved food Protecting Progress and setbacks in meeting Progress Millennium Development Goals (MDG) p 485 485 Look at Progress and Setbacks to meeting Look the World Summit for Children Goals, 2001-2008, p 490-491 2001-2008, Agenda for Action Focus on children GOBI- UNICEF’s Child survival campaign: GOBIGrowth charts, oral rehydration therapy (ORT), breast milk, and immunization (ORT), ORT – Easily made formulas that can ORT increase the absorption of fluid by 25 fold. increase Oral Rehydration Drink With sugar and salt To one liter of clean water, add half of a To level teaspoon of salt, and 8 level teaspoons of sugar. of With powdered cereal and salt To one liter of clean water, add a half of a To teaspoon of salt and 8 heaping teaspoons (or 2 handfuls) of powdered cereal. handfuls) Oral Rehydration Drink Boil for 5 to 7 minutes to form a watery Boil porridge, cool and serve. porridge, Note that the cereal drinks can spoil in just a Note couple of hours in hot weather. couple To either drink add half a cup of fruit juice, To coconut water, or mashed ripe banana, if available. These foods can add needed potassium and will help a child accept more food and drink. food Focus on Women Remove barriers to financial credit so Remove women can obtain loans for raw material and equipment to enhance their role in food production. production. Provide access to time saving technologies. Provide Provide appropriate training to make Provide women self-reliant. women Teaching management and marketing skills Teaching to help women avoid exploitation. to Focus on Women Making health and day care services Making available to provide a healthy environment for women’s children. for Forming women’s support groups to foster Forming strength through cooperative efforts. strength Providing information and technology to Providing promote planned pregnancies. promote Personal action Our choices have impact on the rest of the Our world’s people world’s Demands we in developed world place on Demands finite natural resources finite We have freedom and means to choose our We lifestyle; people in poor nations do not lifestyle; People in other societies cannot secure People enough clean water; bottle of diet soda with artificial sweetners has 12 oz water, cost 800 Kcal to produce. 800 Personal action in US billions $$ spent annually to lower in calorie consumption while 850 million people can’t find enough calories to consume consume Choosing a diet of necessity rather than Choosing excess would lower demands on agriculture excess PERSONAL CHOICES DO MATTER!!! ...
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