1. Nutrition and Global Health
Chapter Eight
Nutrition and Global Health

2. The Importance of Nutrition
Nutritional status is intimately linked with health status
Nutrition is the leading risk factor for loss of health in low- and middle-income countries
Low-cost, highly effective interventions are available to improve nutrition status

3. Definitions and Key Terms
Malnutrition - refers to those who do not get proper nutrition, whether too little, too much, or the wrong kind
Undernourished - refers to those who lack sufficient energy or nutrients
Underweight - refers to those who have low weight for their height or age
Overweight or obese - refers to those who are nourished to the point of being too heavy for their height or age

4. Table 8.3: Key Terms and Definitions
Source: Adapted with permission from The World Bank. Repositioning Nutrition as Central to Development. Washington, DC: The World Bank;
2006:xvii.

5. Table 8.3: Key Terms and Definitions (cont.)
Source: Adapted with permission from The World Bank. Repositioning Nutrition as Central to Development. Washington, DC: The World Bank;
2006:xvii.

6. The Determinants of Nutritional Status
Immediate causes of malnutrition:
Inadequate dietary intake- weakens the body and opens it up to infection
Illness- makes it harder for people to eat, absorb the nutrients they take in, and raises the need for some nutrients
Relationship creates a cycle of illness and infection

7. Figure 8.1: The Determinants of Nutritional Status: The UNICEF Framework

8. Gauging Nutritional Status
Nutritional status of infants and children is gauged by measuring and weighing them, then plotting weight and height on a growth chart
Child’s position on growth curve indicates if they are developing normally
Large share of nutritional deficits are mild, but still have negative consequences on development

9. Key Nutritional Needs Undernutrition
Outcome of insufficient food intake and repeated infectious disease
Includes underweight, stunted, wasted, and micronutrient malnutrition
Raises risk of illness and decreased intellectual capacity in children
Raises risk of pregnancy-related death and delivering prematurely in women

10. Key Nutritional Needs Vitamin A
Deficiency associated with night blindness and eventually, permanent blindness
Important to growth and the proper functioning of the immune system
Impact on severity of illness and chance of survival from several causes, including diarrhea, malaria, and pneumonia

11. Key Nutritional Needs Iodine
Deficiency associated with a growth on the thyroid called a goiter and the failure to develop full intellectual potential
Occurs in people who live in mountainous regions where less seafood is consumed and the soil is deficient in iodine

12. Key Nutritional Needs Iron
Deficiency causes iron deficiency anemia which is associated with fatigue and weakness
Iron-deficient pregnant women have an increased risk of giving birth to a premature or low birthweight baby or hemorrhaging and dying in child birth

13. Key Nutritional Needs Zinc
Deficiency is associated with growth retardation, impaired immune function, skin disorders, hypogonadism, and cognitive dysfunction
Deficiency is a major risk factor for morbidity and mortality from diarrhea, pneumonia, and malaria

14. Nutritional Needs Throughout the Life Cycle
Pregnancy and Birthweight
Pregnant women need a sufficient amount of protein and energy as well as iron, iodine, folate, zinc, and calcium
Fetuses that do not get sufficient nutrition from the mother may suffer from stillbirth, mental impairment or birth defects

15. Nutritional Needs Throughout the Life Cycle
Infancy and Young Childhood
Children need sufficient protein and energy as well as iodine, iron, vitamin A, and zinc
Nutritional gaps during this time can cause problems with stature and mental development, and frequent infection
Grow best and stay healthiest if exclusively breastfed for first 6 months
“Window of opportunity” is in utero to two years of age

16. Nutritional Needs Throughout the Life Cycle
Adolescents need protein and energy to grow as well as iron, iodine, folic acid, and calcium
Adolescent girls who are poorly nourished are much more likely to give birth to an underweight child and experience complications during pregnancy than well-nourished girls

17. Nutritional Needs Throughout the Life Cycle
Adulthood and Old Age
Adults need a well-balanced diet with protein, energy, and iron
Foods that contain too much fat, cholesterol, sugar, or salt can be harmful
Older adults need calcium to reduce risk of osteoporosis

18. Nutritional State of the World
Undernutrition
26% of under-5 children are underweight according to most recent estimates
Rates of underweight vary considerably by region
Only about 0.5% of total deaths in low- and middle-income countries are directly due to undernutrition
Deaths are usually “nutrition related”

19. Nutritional State of the World
Low Birthweight
11% of babies in low- and middle-income countries are born low birthweight according to recent estimates
About 3% of DALYs lost in low- and middle-income countries are attributable to low birthweight

20. Nutritional State of the World
Vitamin A
About 250 million children suffer from vitamin A deficiency worldwide
6.5% of all deaths of children under-5 in low- and middle-income countries are due to vitamin A deficiency

21. Nutritional State of the World
Iodine
About 70 million people worldwide are affected by iodine deficiency
Associated with substantial DALYs lost in low- and middle-income countries

22. Nutritional State of the World
Iron
About 1.6 billion people were affected by anemia between 1993 and 2005
Substantial public health problem for children under 5 and pregnant women, especially in low- and middle-income countries
0.7% of DALYs lost in low- and middle-income countries is related to iron deficiency anemia

23. Nutritional State of the World
Zinc
Second most important micronutrient responsible for death and DALYs in children under 5
About 4% of DALYs lost in children under 5 years of age are due to zinc deficiency

24. Nutrition, Health, and Economic Development
Nutrition impacts health and human development
Link to what people learn and their productivity
Poor nutrition:
Impacts maternal health, which affects household income and health of children
Affects children’s ability to learn in school, which impacts their future prospects
Leads to lower productivity in adult workers