1. HW220 Unit 3 Jennifer Koslo, MS, RD, CSSD Schlenker & Long (2007) pg 11-12, 245

2. Welcome to seminar! Please read my welcome announcement There are readings from all 3 texts this week There are lesson summaries available for you to print Seminar is focused on the ecology of malnutrition and information contained in William’s chapter 10

3. What is meant by the term “ecology of malnutrition”? What is the link between the food environment and malnutrition? Why is malnutrition a public health concern worldwide?

4. Poor nutrition because of an insufficient or poorly balanced diet or faulty digestion or utilization of foods. Can refer to both over nutrition and under nutrition The American Heritage Dictionary (2003)

5. Individuals and Families with incomes below poverty level. Single mother plus child: $14,000; family of 4: $21,200 (USDHHS, 2008) Estimated at 10% of all US households Schlenker (2007) pg 11-12, 245

6. Single parent families Families without health insurance Household head without high school diploma Other populations?

7. Infants Children Pregnant women Homeless Older adults

8. Skin -rough/irritated bruises, swollen No energy, fatigued Falls asleep in school Gums- redness/receding Teeth - missing/cavities Abdomen - swollen

9. Hair- dry/dull/stringy Lips- dry/lesions Tongue -red/swollen Muscles- poor tone Irritable, attention problems Over/underweight

10. The relationship of people and their social and physical environment will influence their nutrition and health. People who live in inferior housing, limited education, low-pay work, and low self esteem more often affected by health issues and malnutrition. Costs of malnutrition create a burden on society. Schlenker (2007) pg 245

11. Schlenker (2007) pg 246 A limited ability to secure foods in adequate amounts that meets the nutritional and health needs of an individual.

12. Most affected are children in low-income households % Below Poverty Level 10% White 24% African American 22% Hispanic Schlenker (2007) pg 246

13. Ask the following 4 questions: Did you ever run out of food and have no money? Ever skip a meal because you ran out of food or had no money? Ever hungry but didn’t eat due to not enough food or money? Ever cut your kid’s meal size due to not enough food or money? Schlenker (2007) pg 247

14. Children experience feelings of anxiety, sadness, and worry about their family’s situation. They tend to have lower reading scores and trouble with social skills. When food is available: These children tend to eat more food and eat fast when food is available. What are some typical low-cost foods that may comprise a food insecure families diet? Schlenker (2007) pg 246

15. In the USA, we have overabundant supplies of low cost food. The real issue lies in how the distribution of food based on a person’s available income. Schlenker (2007) pg 246

16. Federal food assistance programs are available to support adequate nutritional needs of low income, children, elderly, and pregnant single moms at risk. What are some of these programs, and how do they work? Schlenker (2007) pg 248

17. The fast food industry provides low-cost foods that tend to be high fat & calorie laden. Most often these foods are lacking in key micronutrients as well as sources of quality protein needed for maintaining cell growth and function.

18. If one tends to incorporate high calorie/fat laden foods over the course of a child’s developmental years from (age 3-15), the impact on health can be harmful. In the USA we have seen a rise in obesity & Type II Diabetes in children under Age 15.

19. Food companies market “junk foods” at schools, with advertisements reaching in the billions of dollars. Targeting children directly without educating them on selecting nutrient rich healthy foods reinforces children’s poor dietary habits. Nestle (2007) pg 260-261

20. Should schools allow high calorie/ high fat “junk foods” to be sold in school lunches? Should school lunch programs be consistent with Dietary Guidelines? Should teachers be taught nutrition? Nestle (2007) pg 267

21. Children and adults who experience extensive malnutrition can have significant impact on cognitive performance. This effect can lead to low scores in school, lower earnings and chronic health problems. Schlenker (2007) pg 247

22. Feeling of hopelessness and isolation can overcome low income families. Trying to secure food sources when aid runs out leads to feelings of insecurity and loss of power to provide for one’s family. Schlenker (2007) pg 247

23. Unlike the USA, many countries have an unequal distribution of food. Estimates of 1/5 of world’s population is chronically undernourished. As of 2008 (2004 statistics) the World Bank has estimated that there were an estimated 982 million poor people in developing countries who live on $1 a day or less Schlenker (2007) pg 246

24. Most child deaths outside USA are associated with malnutrition. About 1/3 of children under age 5 who survive has stunted growth. Schlenker (2007) pg 246

25. Most common deficiencies are Iodine and Vitamin A. Ironically approx. 80% of malnourished kids live in countries that report food surpluses! Schlenker (2007) pg 246

26. Malnutrition affects billions of people worldwide In the US about 12.5% of the population lives at or below poverty level Poor diet affects cognitive and physical development Food assistance programs provide some relief Almost 1/5 of the world’s popl’n or 1.1 billion people live on less than $1/day World hunger complex issue: war, natural disasters, lack of education, unsafe water, lack of jobs Vitamin A deficiency leading cause of blindness There is enough land to feed the world’s hungry but solving world hunger is not an easy task