International Nutrition Double Burden of Disease Many nations around the world are dealing with under nutrition and obesity Many societies have made transition from agrarian to more developed societies at an extremely rapid pace Have also made the nutrition transition to excessive food that is high in fat and sugar From an evolutionary perspective humans have a preference for foods rich in sugar and fat useful for survival during cycles of feast and famine Evolutionarily those who have the thrifty gene are less able to adapt metabolically to the excess sugar and fat theory of early origins of chronic disease and reduced physical activity Impact of Malnutrition on Society Reduced hunger and malnutrition leads to increased productivity incomes reduced child mortality improved maternal and infant health greater resistance to malaria and other diseases reduced pressure on the environment greater participation in trade and development improved school attendance learning and literacy and improved gender equality and empowerment of women More than 1 02 billion hungry people Why don t all have access to healthy food Changing food production and distribution Deteriorating natural resources Educational level Health status Maldistribution of wealth poverty Political instability lack of infrastructure Unclean water supplies Malnutrition Inadequate quantity of food Undernutrition Overnutrition Inadequate quality of food Deficiency diseases Nutrient toxicities Obesity Causes of Malnutrition Primary Lack of access to food Secondary Faulty absorption Increased metabolic demands Diseases and infections Lack of knowledge Poor food choices Synergism Between Malnutrition and Infection Ongoing cycle Improving nutritional intake in the presence of exposure to infection does not reverse the cycle leaky bucket Treating infection without improving Nutritional status does not reverse the cycle Leads to ongoing illness impaired growth and often death How Does Infection Impair Nutritional Status Loss of appetite Diarrhea vomiting Cultural practices associated with illness may lead to decreased intake Medicine may decrease appetite or decrease absorption of nutrients Increased nutrient needs Loss of body nitrogen Parasites consuming nutrients Fever increased BMR Impaired ability to work to obtain food How Does Malnutrition Impair Community Malnutrition is the most common cause of immunodeficiency worldwide Immune system is extremely complex All forms of immunity impacted by all nutrient deficiencies Increased likelihood of acquiring an infection Increased likelihood of dying from that infection Who is Most Affected by Undernutrition Women Pregnancy lactation increases nutritional needs Malnourished mothers give birth to low weight babies 5 5 pounds Infants Children Infants die from malnutrition infection parasites malaria Infant mortality rate in poor vs rich communities Japan 2 4 infant deaths per 1000 live births Ethiopia 67 8 infant deaths per 1000 live births Afghanistan 103 infant deaths per 1000 live births of those who die each year due to malnutrition and related illness are children Breastfeeding is protective for the fist 2 years Female children are undervalued in many societies less access to food Who is Most Affected by Over Nutrition Adults who are from middle and upper socio economic classes Who are educated and have sedentary jobs Children of well to do adults Obesity Compromises present and future health Mainly urban residents more sedentary Poverty Main cause of malnutrition The wealthiest fifth of the world s people consume an astonishing 86 of all goods and services while the poorest fifth consumes 1 Forms of Protein Energy Malnutrition Not enough protein and or poor quality protein kwashiorkor Big Four Nutrition Problems in the World 1970 Protein energy malnutrition Iron deficiency anemia Vitamin A deficiency Iodine deficiency disorders increase in food Increase in agriculture Production i e increase in availability Quantity of food Adequate Quality of food Safe nutritious Moon face Edema Flaky paint dermatitis apathy Not enough calories marasmus Nutritional Anemias Anemia reduction in Hemoglobin Hematocrit Number of RBC Most widespread nutritional deficiency disease 2 1 billion people affected Including developed countries Primarily in women and children Adverse effects on Ability to learn work Outcome of pregnancy Causes Inadequate intake of Iron Folate Protein Decreased bioavailability of iron Heme iron meat poultry fish Nonheme iron major source worldwide Possibly solutions Supplementation Fortification Iodine Deficiency Diseases Goiter swelling in front of neck Hypothryroidism low metabolic rate Hyperthyroidism high metabolic rate Cretinism severe mental and physical retardation 200 million people affected worldwide 3 million cretins Major cause low intake of iodine Solutions fortification of foods ex Salt with iodine Vitamin A Deficiency Caused by inadequate intake of vitamin A and low lipid intake Affects mainly preschoolers Major cause of preventable blindness worldwide 350 000 become blind annually Deficiency increases risk of other diseases Infectious diseases Diarrhea Upper respiratory diseases High risk of poor growth Associated with Night blindness Corneal drying Bitot s spots Keratomalacia Xerophthalmia Zinc Deficiency Compromises linear growth Delays sexual maturation Increases infection and delays wound healing skin rashes Supplements of zinc reduce morbidity from diarrhea Nutritional Intervention Strategies to Combat Undernutrition Need to find sustainable solutions Increase local food production Increase distribute income so people can afford food Improved food distribution Clean water sources Solve local political conflicts Empower women Ready to Eat Theraputic Foods RUTF Plumpy Nut Oral rehydration therapy To avoid refeeding syndrome Mixture of water electrolytes and sugar Saves one million lives per year Nutritional Intervention Strategies to Combat Micronutrient Deficiencies Supplementation Fortification of widely eaten foods condiments ex Salt sugar MSG Public health education Dietary diversification Animal Cloning vs GE animals Animal Cloning Born as a result of asexual reproduction No new genes in them GE Introducing new genes into animal A method of altering animal not copying it New DNA new traits Bovine Growth Hormone A protein hormone Destroyed in pasteurization process No activity of taken by mouth Given to cows to increase milk production by 10 25 increase
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