1. © T. M. Whitmore TODAY Irish famine example The Nutrition Transition

2. © T. M. Whitmore Questions? Synergy between nutrition and disease continued Especially vulnerable populations Four faces of hunger Global Hunger

3. © 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)

4. © 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

5. © 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

6. © 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.

7. © T. M. Whitmore Irish “hunger” Responses II Corn laws repealed 1846  Little heal since the Irish had no cash regardless of grain prices Late in 1846 a Whig administration dedicated to a laissez-faire policy  Extension of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

8. © 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 pork

9. © T. M. Whitmore 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

10. © T. M. Whitmore Related historic processes of change Interconnected “Transitions” Interconnected  Demographic Transition (DT) Demographic Transition  Stages of change in mortality and fertility => population growth over time  Regional differences-geography  Epidemiologic Transition (ET) Epidemiologic Transition  Shift in the patterns of causes of death over time  Regional differences-geography  Nutrition Transition Nutrition Transition  Shifts in dietary and physical activity- inactivity patterns  Regional differences-geography

11. © T. M. Whitmore 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 DTDT  First phase in ETET

12. © T. M. Whitmore The Nutrition Transition’s “Stage 2: “Famine” Early agriculture and contemporary least developed areas generallyleast developed areas  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 DTDT  First-Second phases in ETET

13. © T. M. Whitmore The Nutrition Transition’s “Stage 3: “Receding Famine”Stage 3 Scientific agriculture, early industrialization, and contemporary developing areasearly industrializationcontemporary 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 DTDT  Second/Third Phases of ETET

14. © T. M. Whitmore The Nutrition Transition’s “Stage 4: “Nutrition-related Non-communicable Disease (NR-NCD)”Stage 4 Associated with “modern” industrial lifestylesmodern” industrial lifestyles  A diet high in total fat, cholesterol, sugar, and other refined carbohydrates and low in polyunsaturated fatty acids and fiber diet high in total fat, cholesterol, sugar  Often accompanied by an increasingly sedentary life  Stage 4 in DTDT  Third Phase of ETET

15. © T. M. Whitmore The Nutrition Transition’s “Stage 5: “Behavioral Change”Stage 5 “Post-modern” industrial lifestyles  A new dietary pattern => changes in diet associated with the desire to prevent or delay degenerative diseases and prolong healthnew dietary pattern  May be associated with increased “recreational” or health related exercise  Stage 4 in DTDT  Third Phase of ETET

16. Demographic Transition Model Nutrition Patterns 1 & 2Nutrition Patterns 3, 4, & 5

17. Nutrition Patterns 1 & 2 Nutrition Patterns 3, 4, & 5

18. New York Times

20. Stages of Health, Nutritional, and Demographic Change Focus on famine alleviation/prevention Focus on family planning, infectious disease control Chronic diseases predominate Reduced fertility, aging Focus on medical intervention, policy initiatives, behavioral change Focus on healthy aging spatial redistribution Demographic TransitionEpidemiologic TransitionNutrition Transition Receding pestilence, poor environmental conditions Reduced mortality, changing age structure High prevalence infectious disease Diet-related noncommmucable diseases predominate Receding famine High prevalence undernutrition High fertility/mortality Source: Popkin, Barry M. ( 2002) Public Health Nutrition 5:93-103.

21. Stages of the Nutrition Transition Urbanization, economic growth, technological changes for work, leisure, & food processing, mass media growth Pattern 3 Receding Famine Slow mortality decline increased fat, sugar, processed foods shift in technology of work and leisure Pattern 4 Degenerative Disease accelerated life expectancy, shift to increased DR-NCD, increased disability period reduced fat, increased fruit, veg,CHO,fiber replace sedentarianism with purposeful changes in recreation, other activity Pattern 5 Behavioral Change extended health aging, reduced DR-NCD MCH deficiencies, weaning disease, stunting starchy, low variety, low fat,high fiber labor-intensive work/leisure obesity emerges, bone density problems reduced body fatness, improved bone health Source: Popkin, Barry M. ( 2002) Public Health Nutrition 5:93-103.

32. Source: USDA/Center for Nutrition Policy and Promotion, March 3, 2006

34. Source: Source: USDA/Economic Research Service

35. New York Times

37. Source: Source: USDA/Economic Research Service