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Malnutrition Sources: The World Food Problem Leathers & Foster, 2004 The Omnivore’s Dilemma Michael Pollan, 2006 http://www.lastfirst.net/images/product/R004548.jpg Malnutrition • Undernutrition – Lack of nutrients • Calories • Protein • Micronutrients – Low income countries • Overnutrition – Obesity • Too many calories – High and middle income countries http://i105.photobucket.com/albums/m203/sspasha/Malnutrition.jpg Undernutrition • Undernutrition – Secondary Malnutrition – Micronutrient Malnutrition – Protein Energy Malnutrition • Most important Severe Protein Energy Malnutrition http://www.bio.davidson.edu/people/kabernd/seminar/2002/tech/ma lnutrition.jpg Global Undernutrition http://paperdreamer.files.wordpress.com/2008/04/world_hunger_map.jpg Secondary Malnutrition • Diet normal • Food not digested or absorbed – Diarrhea – Parasites Tapeworm Micronutrient Malnutrition • Deficiency in: – – – – – – – – Rickets (Vitamin D deficiency) http://www.talkorigins.org/faqs/homs/rickets.jpg Vitamin A Iodine Iron Zinc Calcium Vitamin D B Vitamins Vitamin C Vitamin A Deficiency • Night Blindness – 500,000 children/year – xerophthalmia • Half of these will die – within a year of becoming blind • Rice diet lacking green vegetables xerophthalmia http://www.vitaminsdiary.com/UserFiles/Image/keratomalacia.jpg – Vitamin supplements help: cost $3/year – Golden Rice could help Vitamin A Deficiency http://upload.wikimedia.org/wikipedia/commons/thumb/7/7d/Vitamin_A_deficiency.PNG/800px-Vitamin_A_deficiency.PNG Iodine Deficiency • Iodine deficiency Goiter (thyroid enlargement) http://www.voanews.com/english/images/emory_edu_goiter_Iodine_Deficiency_Disorder _195_eng_11may06_0.jpg – affects 740 million people worldwide – single greatest cause of preventable brain damage in babies – Goiter – Stillbirth – Miscarriages – Mental Retardation • Prevented by iodized salt • Best sources of natural iodine – Sea weed – Sea food 38 million newborns are not protected from iodine deficiency http://images.google.com/imgres?imgurl=http://www.unicef.org/progressforchildren/2007n6/images/pfc6_sources_of_data_used_in_unicef_analysis_20002006.gif&imgrefurl=http://www.unicef.org/progressforchildren/2007n6/index_41796.htm&h=361&w=600&sz=20&hl=en&start=75&sig2=xIUDzxMbqzKvhSoLjqx6cw&um=1&tbnid=AHRtpUj1tsOS5M:&tbnh=81&t bnw=135&ei=AptlSJ6DD6fuigHGy4y7Cw&prev=/images%3Fq%3Dunicef%26start%3D60%26ndsp%3D20%26um%3D1%26hl%3Den%26rlz%3D1B3GGGL_enUS240US242%26sa%3DN Iron Deficiency Anemia • Affects 2 billion people, • 90% live in developing countries – 39% of preschool children – 52% of pregnant women • Reduced – physical activity – mental activity • Increased http://www.micronutrient.org/reports/images/Page16Image.jpg – – – – birth mortality Worms Malaria HIV • High iron rice could help Other Deficiencies • Zinc – – – – Growth retardation delayed sexual maturation skin and eye lesions 48% of world at risk for zinc deficiency • Calcium – Osteoporosis: bone loss Swaddled babies at risk for Rickets: not enough sunlight • Vitamin D – Rickets: bone malformation • Not enough sunlight exposure: – Swaddled babies http://www.ulanbatoronline.org/cammp_section/article_images_lamc_lati mes/scans/latimes_images/thumbnails/babyswaddle.jpg Other Deficiencies • Vitamin C – Causes Scurvy: problem in refugee camps • Niacin – Causes Pellagra: dermatitis, diarrhea, dementia – Due to diet high in maize (low in tryptophan) • Thiamin Scurvy – Causes Beriberi – Due to diet high in polished rice • Folate http://www.athropolis.com/arctic-facts/misc/scurvy.jpg – Birth defects: Anancephaly and Spina Bifida Protein Energy Malnutrition (PEM) • Underconsumption of calories or protein • Most important form of malnutrition • Associated with poverty – Not enough food – Poor quality food • Kwashiorkor – Extreme protein deficiency Kwashiorkor • Marasmus – Extreme calorie deficiency Kwashiorkor • Protein deficiency often associated with weaning onto thin cereal gruels. – Cassava – Plantains • Bloating of the stomach due to edema – Fluid leaking into body – Wasted muscles • Antibodies degraded to provide protein to body http://www.imageenvision.com/md2/sym_0004-0703-14222622_nurse_standing_with_a_group_of_african_children_showing_symptoms_of_the_protein -deficiency_disease_kwashiorkor.jpg – Infection – Dysentery – Death Marasmus • Calorie deficiency – Lack of food – Poorest populations – Neglected • Infants • children • Protein used for energy • Results in wasting – Deterioration of tissues • Brain development impaired Overnutrition • Consumption of too many calories – Obesity • Medical problems – Heart disease – Diabetes – Cancer http://www.mercola.com/images/blog/2005/01.01.junkfood.gif Overnutrition • Global problem – Overnutrition has surpassed undernutrition • Worst in middle and high income countries • Rising in low income countries – Can co-exist with undernutrition • Same country • Same household – Projected to get worse as incomes rise • Industrial food – High in calories http://i.dailymail.co.uk/i/pix/2008/05/16/article-0-064EFCA50000044D-848_468x296.jpg Industrial Food • Economies of scale – Industrial agriculture • Commodity grains – Factory farm animals • Confinement • Processing – White flour – Corn and soy ingredients • Low Prices – Must sell more • Supersizing • Fat and sugar added • New products http://www.salembargains.com/Images/Cereal-Aisle2.jpg Global Overnutrition http://news.bbc.co.uk/nolpda/ukfs_news/hi/newsid_7151000/7151813.stm Global Overnutrition http://www.fao.org/FOCUS/E/obesity/obes3.htm http://www.fao.org/FOCUS/E/obesity/obes1.htm Overnutrition in the USA • Overweight population – 2/3 of adults – 1/3 of children • Reasons – Excess fat, sugar in diet – Not enough fiber – Sedentary lifestyle • Poor are overweight – Industrial food inexpensive • Fast food • Processed • Energy dense – Fruits, vegetables more expensive http://www.epidemiologic.org/obesity/obesity-epidemic2004-msn-small.JPG http://www.geographyalltheway.com/ib_geography/ib_resources/imagesetc/obesity_poverty.jpg Overnutrition rising in developing countries • Increase in global food market – Industrial food • Urbanization – Fast Food • Diet change – Decline in traditional diet – Increased meat http://www.fao.org/FOCUS/E/obesity/obes2.htm Calorie consumption Balanced Protein • Protein are made of amino acids • Essential amino acids – Body cannot make – Required in diet • Animal proteins have perfect balance of amino acids – Meat – Milk – Eggs http://www.ibabuzz.com/allyoucaneat/wp-content/uploads/2007/09/eggs.jpg Complementing Proteins • Plant proteins – are deficient in different essential amino acids • Cereals – Low in lysine • Beans – Low in methionine • Must eat both cereal and beans together – To get balanced amino acids – Complementing proteins Rice and Beans http://www.d16acbl.org/U174/black%20beans.jpg Calorie Deficiency • Most widespread problem among poor • Cannot get enough calories (energy) in diet – Most get enough protein • Calorie requirements vary – – – – Age Sex Pregnancy Lactation Nutritional Needs • RDA – Recommended Daily Allowance – Level of nutrients adequate for 97-98% of the group – Good target for individuals • EAR – Estimated Average Requirement http://www.fda.gov/diabetes/pyramid.gif – Level of nutrients adequate for ½ individuals in group – Always lower than RDA – Good target for average intake of a group
