1. World View of Nutrition Chapter 18

2. The Tragic Facts ~12mill children under 5 YOA die each year – 55% are from undernutrition 1/10 US households have issues with hunger 1/6 worldwide are chronically undernourished 2/3 undernourished live in Asia Problem growing at the fastest rate are in Africa - Ethiopia, Sudan, Rwanda, Burundi, Kenya, Somalia, Tanzania Problem is getting WORSE, not better

9. Common Maladies from Undernutrition Vit A: Xerophthalmia (eye dries out) Vit D: Rickets B’s: Rickets, Beriberi, Pellagra Vit C: Scurvy Iron: Anemia Iodide: Goiter Zinc: All areas of growth

10. A few definitions… Hunger Uneasy or painful sensation caused by a lack of food (acute) May in time, lead to malnutrition Malnutrition Failure to achieve nutrient requirements (chronic) Results: discomfort, weakness -> mental retardation, chronic diseases, death Food insecurity Limited or uncertain availability of nutrients/food Food security Assess to enough food

11. Malnutrition in the U.S. Prevalence and distribution Linked with economic and social factors Reflects 10.4% of US households

12. Malnutrition in the U.S.: Groups at Risk Working poor May or may not qualify for food assistance Can’t get to proper facilities Isolated Lack access to food resources Elders Economic difficulties Physical ailments Nursing home settings

14. Malnutrition in the U.S.: Groups at Risk Homeless Lack consistent cooking facilities Limited income, if any ~30% are substance abusers Children Dependent on family circumstances Hunger affects school performance Eating Disorders

15. Malnutrition in the U.S. Attacking hunger in America The Food Stamp program Extends food buying power Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Food, nutrition services for pregnant and lactating women, and children to age 5 National School Lunch Program Free and reduced price meals Child and Adult Care Food Program

16. Malnutrition in the U.S. Attacking hunger in America (Government programs) School Breakfast Program Summer Food Service Program Special milk program Commodity Supplemental Food Program Food Distribution Program on Indian Reservations Older Americans Act Nutrition Program Disaster Feeding Program The Emergency Food Assistance Program (TEFAP) Others Non-government (food pantries, rescue missions, etc.)

17. Malnutrition in the Developing World

18. Concern: Supply vs Demand Demand: In 1800 world population was 1 bill By 2000 world population was 6 bill By 2050 some estimates are as high as 8 – 12 bill, but AIDS might take it down to 7-9 bill. Increases mostly coastal and river basin areas Supply: Green Revolution of 1960’s introduced high-yielding, disease resistant rice, wheat, corn, greater use of fertilizers, water, cultivation practices. Green revolution might be at capacity because remaining lands largely unsuitable for farming. Currently, problem is food distribution, not food production Soon, it will be BOTH!

19. Concern: Supply vs Demand Solution: Control demand side to 2:1 (birth control) Birth control shown effective in developed countries, but not in undeveloped countries. Why? In undeveloped countries, surviving children care for parents in their later years! Only when people have enough to eat and are financially secure will they have fewer children. Education is the long term solution: Proven effective in Brazil, Egypt, India and Mexico

20. Why Hunger??

21. Poverty is #1 reason Limits access to food Limits purchase of farm equipment/supplies, boats, etc Discourages education Population growth Parent’s source of security No access to birth control Infection and Disease Limited immunizations, limited hygiene and sanitation, poor drinking water, limited access to medical care HIV – June 2000 = 34.3 mill (90+% in developing countries, 2/3 in Africa) Currently 42 mill, -> 3.7 mill orphans Poor diet accelerates AIDS infection

22. Why Hunger?? Politics and Natural Disasters War diverts resources away from needed food (military spending has doubled in last 20 years), working class goes into the Army. Currently 1% of world’s goods = economic development, whereas 6% = military expenditures. Refugees Sanctions Floods, droughts, mudslides, hurricanes Inequitable Food Distribution Enough food is now being produced, problems with distribution to areas of greatest need. Social structure prioritizes father having the greatest need, then older boys, then women, then children

23. Why Hunger?? Agriculture and Environment Need irrigation, pesticides, fertilizers – most can’t afford Environment - competition bet. Farmland and urbanization Clear-cutting and over irrigation produces deserts Over-fishing depletes another renewable resource In 1975 38% lived in cities, now 50%; 70% by 2050 Inadequate or deteriorating shelters Lack proper food storage – leads to 40% loss of perishable foods

24. Why Hunger??

25. General Effects of Semistarvation

26. Critical Phases of Undernutrition? Pregnancy Risk to both mother and fetus Africa has 1/20 chance of mother dye from pregnancy related problems (US = 1/8,000) Fetal and Infant Stages Often born prematurely -> weakened immune sys., 5-10X chance of dying before 1 YOA Many nutrients needed for proper brain development Childhood Rapid growth phase. Most vulnerable = brain, inc. illness, stunted growth, anemia, many learning problems Later years Greater medical costs = less spent on proper nutrition Unable to take care of themselves

27. Malnutrition in the Developing World (micronutrients) Iodine deficiency disorders Most common cause of preventable brain damage

28. Malnutrition in the Developing World (micronutrients, cont) Vitamin A deficiency Leading cause of preventable blindness Iron-deficiency anemia Limits productivity of population World Bank suggests: Increase diversity of the food supply Fortify specific foods Provide supplementation when necessary

29. Reducing Undernutrition Short Run Aid must be given – people are starving Long Run Improving the infrastructure for poor people Currently rely on outside sources for basic needs Focus on local conditions (Peace Corps) Help people meet their own needs Requires training, storage facilities, marketing and credit Need greater focus on impoverished women (end cycle of female neglect)

30. Reducing Undernutrition Long Run Appropriate technologies for processing, preserving, marketing, distributing food Education on proper diets, sanitation, cooking, birth control, AIDS prevention, infant/child rearing Employment training “The world has both the food and the technical expertise to end hunger. What is lacking is the political will to do so.”

31. Resources World Health Organization (WHO) – coordinates international health work. www.who.int/nut Food and Agriculture Organization (FAO) – A UN agency – promotes agricultural development, improved nutrition and food security. www.fao.org World Bank. A development Bank which provides loans, policy advice, technical assistance and knowledge sharing services to low and middle income countries to reduce poverty. www.worldbank.org

32. Resources Peace Corps: education, youth outreach, and community development; health and HIV/AIDS; agriculture and environment; business development; and information technology. www.peacecorps.gov Samaritan’s Purse: nondenominational evangelical Christian organization providing spiritual and physical aid to hurting people around the world. Focus = victims of war, poverty, natural disasters, disease, and famine with the purpose of sharing God's love through His Son, Jesus Christ. www.samaritanspurse.org

33. Resources Food for the Hungry International: long-term development among the extremely poor, recognizing their dignity, creativity, and ability to solve their own problems. We focus on: Sustainable Food Production, including agricultural training and assistance, agro-forestry, reforestation, and land conservation Water Resource Development for both drinking and irrigation Primary Health Care Income Enhancement, including micro-enterprise development and skills training. www.fhi.net