1. The Physical Side of Hunger
Concepts & Measurements

2. First Steps: Define Interrelationships
Food Insecurity
Hunger
Under-nutrition

3. Three Nested Concepts
Food Insecurity
Hunger
Under-nutrition

5. Food Insecurity

6. Food Security vs. Food INsecurity
Food security: A condition that exists when all people at all times are free from hunger.
It has four elements:
- Availability
- Access
- Utilization
Vulnerability
Food insecurity = absence of food security

7. Food Security Framework
Hunger status
Inadequate food
Availability
Inadequate food
access
Inappropriate food
utilization
Elements of vulnerability
• Physical and environmental risks
• Economic and market risks
• Social and health risks

9. Hunger

10. Hunger A condition in which people lack the required nutrients, both:
Macronutrients (protein, carbohydrates, & fats)
AND
Micronutrients (vitamins & minerals), for fully productive, active, & healthy lives

11. Hunger Short term Chronic, Acute, or Hidden
Physical & Mental Hunger Sensation

12. Short-term Hunger
A transitory, mild form of hunger that temporarily affects mental and physical capacity (i.e. school children)

13. Chronic, Acute, & Hidden Hunger
Chronic Hunger
Occurs when people suffer from hunger for long periods. Hunger becomes their normal condition.

14. Chronic, Acute, & Hidden Hunger
Acute Hunger
Occurs when people suffer from hunger for short periods, usually due to shocks such as drought or conflict

15. Chronic, Acute, & Hidden Hunger
Occurs when people lack essential micronutrients, even if the consume adequate amounts of calories and protein

16. Physical Side of the Hunger Sensation
5. Hypothalamus
creates satiation
sensation
2. Hypothalamus
creates hunger
sensation
1. Gherlin
released in
stomach and/or
glycogen levels in
blood go down
3. You eat food
4. Leptin and
other
hormones
released in
stomach

17. Gherlin Helps Trigger Hunger Sensation
Gherlin levels rise before meals, but fall after them
Gherlin has been called the ‘hunger hormone,’ but in fact, a number of hormones are involved

18. Mental Side of the Hunger Sensation
Cultural/Societal Factors
Meal times
Preferred foods
Appropriate color of food
Emotional Factors
Stress
Repulsion
Anger

20. Under-Nutrition

21. Malnutrition vs. Under-Nutrition
Often used loosely & Interchangeably
Malnutrition refers to all deviations from adequate and optimal nutritional status, including energy under-nutrition and over-nutrition (obesity is a form of malnutrition)

22. Malnutrition vs. Under-Nutrition
Under-nutrition is used to refer to generally poor nutritional status, but also implies underfeeding

23. Malnutrition Nutritional deficiencies (under-nutrition) OR
An excess of certain nutrients (over-nutrition)

24. Under-Nutrition
A form of hunger that results from serious deficiencies in one or more essential nutrients and that can have lasting mental and physical impacts
Mild
Moderate
Severe

25. Under-Nutrition Two Principal Types
Protein Energy Malnutrition (PEM)
A result of deficiencies in any or all nutrients (in particular macronutrients)
Micronutrient Deficiency Diseases (MDD’s)
A result of deficiencies in specific micronutrients (such as vitamins or minerals)

26. Measurements of Under-Nutrition
STUNTING
(shortness – height for age)
CHRONIC UNDER-NUTRITION
Occurs as a result of
inadequate nutrition over a long period of time
WASTING (thinness – weight for height) ACUTE UNDER-NUTRITION
Occurs as a result of
recent rapid weight loss
or a failure to gain weight
UNDER-WEIGHT
(thinness/shortness
– weight for age)
Occurs as a result of
weight loss
or inadequate nutrition
over a long period of time

27. Who is stunted & who is wasted?
A B C D
A: Healthy B: Stunted C: Wasted D: Stunted & Wasted

29. Malnutrition

30. Forms of Protein Energy Malnutrition (PEM)
Marasmus
Severe loss of body weight
Kwashiorkor
Swelling (oedema)
Marasmic Kwashiorkor
Combines symptoms of Marasmus & Kwashiorkor

31. Marasmus

32. Marasmus
Marasmic child
Same child
after refeeding

33. Kwashiorkor
Note the peeling
of the skin around
The stomach area

34. Kwashiorkor
Kwashiorkor
Same child after refeeding

35. Kwashiorkor

37. Three Most Common Micronutrient Deficiency Diseases
Iron Deficiency
Anemia
Vitamin A Deficiency
VAD
Iodine Deficiency
Goitre

38. Iron Deficiency Iron is essential for transport of oxygen in blood
Iron deficiency leads to poor cognitive development of children, contributes to maternal death, & causes fatigue

39. Iron Deficiency
3 to 5 billion people are affected by this disease in the world, particularly:
Pregnant women
Children 5-14 years and pre-school age
Older adults

40. Symptoms of Iron Deficiency

41. Approaches to Anemia
Access to fortified foods (e.g. cereal-legume blends, wheat, maize flour, etc.)
Access to dietary sources of iron & Vitamin C

42. Approaches to Anemia
Iron/folate supplements for pregnant & lactating women, infants (especially with low birth weight), and young children
Control of infections (such as malaria, worms, etc.)

43. Vitamin A Deficiency (VAD)
VAD is the leading cause of preventable blindness among pre-school children
VAD weakens the immune system and increases clinical severity and mortality risk from measles and diarrhea

44. Vitamin A Deficiency (VAD)
WHO estimates that 21% of all children suffer from VAD, mostly in Africa & Asia

45. Symptoms of Vitamin A Deficiency

46. Approaches to Address Vitamin A Deficiency
Vitamin A supplements for children 6 months to 5 years and women after delivery
Access to dietary sources of Vitamin A (orange and red fruits & vegetables)

47. Approaches to Address Vitamin A Deficiency
Promotion and support of breastfeeding
Access to fortified commodities: oil, cereal-legume blends

48. Iodine Deficiency
Single most common preventable cause of mental retardation and brain damage

49. Iodine Deficiency
1 billion people are estimated to have some degree of goitre (mostly in Africa, Middle-East and Asia, but also in Europe)

50. Symptoms of Iodine Deficiency

51. Approaches to Address Iodine Deficiency
Fortification (iodization of salt)
Access to iodine rich foods (seafish, seaweed, etc.)

52. Conclusion: Three Nested Concepts
No current hunger, but vulnerability to it It can take many forms, including Protein Energy Malnutrition and micronutrient deficiencies
Food Insecurity
Hunger
Under-nutrition