Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
TODAY • Irish famine example • The Nutrition Transition © T. M. Whitmore Questions? • Synergy between nutrition and disease • • • continued Especially vulnerable populations Four faces of hunger Global Hunger © T. M. Whitmore Irish “hunger” of 1846-51 an example of Underlying Processes & background • • • • • Surplus production and appropriation & resource competition The potato Population growth Crop failures and subsistence crisis throughout the nineteenth century Racist views toward the Irish (probably delayed help) © T. M. Whitmore Irish “hunger” an example of Immediate/Proximate Causes & Processes • • • Environmental Fluctuation – infection of potato crop with Phytophthora infestons a fungal infection (late potato blight) spread by the wind Socio-Economic policies that deprived millions of entitlements to food A process – not a single event © T. M. Whitmore • • • • Irish “hunger” Process Blight 1845 => 40% loss and famine in 1846 1846 => near 100% loss + severe winter => severe famine & disease in 1847 1847 - 1850 potato crop not blighted but output low due to small planting (people expected blight) Entitlements Crops failed => loss of production entitlement ~ 500,000 people were evicted (could not pay rent) => lost production entitlement Food prices soared => income entitlement problems even for urban poor © T. M. Whitmore • • • • Irish “hunger” Responses Slow British govt. responses (the Irish exaggerate) First relief = imported maize from north America – not well tolerated Eventually British govt. relief schemes Workhouses (housing workers on public works such as roads, canals, etc.) became centers of contagion Duke of Norfolk suggested that the Irish should substitute curry powder for the potato and nourish themselves on curry powder mixed with water. © T. M. Whitmore • • • Irish “hunger” Responses II Corn laws repealed 1846 Little heal since the Irish had no cash regardless of grain prices Late in 1846 a Whig administration dedicated to a laissez-faire policy Extension of poor laws (that denied aid to most) Wheat, oats, barley, butter, eggs, beef and pork were exported from the large estates Ireland in large quantities - as many as eight ships left Ireland daily carrying foodstuffs © T. M. Whitmore • • • Irish “hunger” commentary A “blame the victim” mentality: the Irish were at fault for over-dependence on potatoes and high fertility (too many kids) The British also saw it as a “natural disaster” Charles Trevelyn (oversaw relief for Whig govt.) “…the problem of Ireland being altogether beyond the power of man, the cure has been applied by all-wise Providence…” All the while – food was exported from the large estates Ireland in large quantities - as many as eight ships left Ireland daily carrying wheat, oats, barley, butter, eggs, beef ©and T. M. Whitmore pork • • • Irish “hunger” Consequences Starvation and disease became epidemic More died of disease than of starvation. Most were weakened from long starvation when they finally succumbed to typhus, cholera, dysentery, and scurvy. At least 1 million perished 1 – 2 + million emigrated during the hunger (mostly to US and England) Population of Ireland 1850 = 6.5 m (down from 8.5m 5 yrs earlier) 1900 4.5 m => longer-term emigration, much to US © T. M. Whitmore • Related historic processes of change Interconnected “Transitions” Demographic Transition (DT) Stages of change in mortality and fertility => population growth over time Regional differences-geography Epidemiologic Transition (ET) Shift in the patterns of causes of death over time Regional differences-geography Nutrition Transition Shifts in dietary and physical activityinactivity patterns © T. M. Whitmore Regional differences-geography • The Nutrition Transition’s “Stage 1: “Collecting Food” Hunter gatherers High in carbohydrates and fiber and low in fat, especially saturated fat Activity patterns are very high with little obesity Stages 1-2 of DT First phase in ET © T. M. Whitmore • The Nutrition Transition’s “Stage 2: “Famine” Early agriculture and contemporary least developed areas generally Diet becomes much less varied and subject to larger variations and periods of acute scarcity of food Little change in activity levels Stages 1-2 of DT First-Second phases in ET © T. M. Whitmore • The Nutrition Transition’s “Stage 3: “Receding Famine” Scientific agriculture, early industrialization, and contemporary developing areas Consumption of fruits, vegetables, and animal protein increases, and starchy staples become less important in the diet Activity patterns start to shift and inactivity and leisure becomes a part of the lives of more people Stages 2-3 in DT Second/Third Phases of ET © T. M. Whitmore • The Nutrition Transition’s “Stage 4: “Nutrition-related Non-communicable Disease (NR-NCD)” Associated with “modern” industrial lifestyles A diet high in total fat, cholesterol, sugar, and other refined carbohydrates and low in polyunsaturated fatty acids and fiber Often accompanied by an increasingly sedentary life Stage 4 in DT Third Phase of ET © T. M. Whitmore The Nutrition Transition’s “Stage 5: “Behavioral Change” • “Post-modern” industrial lifestyles A new dietary pattern => changes in diet associated with the desire to prevent or delay degenerative diseases and prolong health May be associated with increased “recreational” or health related exercise Stage 4 in DT Third Phase of ET © T. M. Whitmore Demographic Transition Model Nutrition Patterns 1 & 2 Nutrition Patterns 3, 4, & 5 Nutrition Patterns 1 & 2 Nutrition Patterns 3, 4, & 5 New York Times New York Times Stages of Health, Nutritional, and Demographic Change Demographic Transition Epidemiologic Transition Nutrition Transition High fertility/mortality High prevalence infectious disease High prevalence undernutrition Reduced mortality, changing age structure Receding pestilence, poor environmental conditions Receding famine Focus on family planning, infectious disease control Reduced fertility, aging Focus on healthy aging spatial redistribution Focus on famine alleviation/prevention Chronic diseases predominate Diet-related noncommmucable diseases predominate Focus on medical intervention, policy initiatives, behavioral change Source: Popkin, Barry M. ( 2002) Public Health Nutrition 5:93-103. Stages of the Nutrition Transition Urbanization, economic growth, technological changes for work, leisure, & food processing, mass media growth Pattern 3 Receding Famine • starchy, low variety, low fat,high fiber • labor-intensive work/leisure MCH deficiencies, weaning disease, stunting Slow mortality decline Pattern 4 Degenerative Disease • increased fat, sugar, processed foods • shift in technology of work and leisure obesity emerges, bone density problems accelerated life expectancy, shift to increased DR-NCD, increased disability period Source: Popkin, Barry M. ( 2002) Public Health Nutrition 5:93-103. Pattern 5 Behavioral Change • reduced fat, increased fruit, veg,CHO,fiber • replace sedentarianism with purposeful changes in recreation, other activity reduced body fatness, improved bone health extended health aging, reduced DR-NCD 4,500 Average caloric intake in USA: 1909-2004 4,000 3,500 3,000 2,500 1900 1920 1940 1960 1980 2000 Source: USDA/Center for Nutrition Policy and Promotion, March 3, 2006 200 Average total fat (grams) in USA diet: 1909-2004 180 160 140 120 100 80 60 40 20 0 1900 1920 1940 1960 1980 2000 Source: USDA/Center for Nutrition Policy and Promotion, March 3, 2006 700 600 500 400 Average daily caloric intake of added fats and sugars in the USA 300 200 100 0 1965 1970 1975 1980 1985 1990 1995 Source: Source: USDA/Economic Research Service 2000 2005 2010 New York Times 400 Avearge daily caloric intake of sugar and corn sweetners in the USA 350 300 250 200 150 100 50 0 1965 1970 1975 1980 1985 1990 1995 Source: Source: USDA/Economic Research Service 2000 2005 2010 160 140 120 100 Average per capita daily calories (net) from fruits and vegetables in US 80 60 40 20 0 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 250 200 150 Average daily calorie intake of red meat and chicken in USA 100 50 0 1965 1970 1975 1980 1985 1990 1995 Source: Source: USDA/Economic Research Service 2000 2005 2010