A global perspective on nutrition and food security

Question 1

What is a non-nutrient? Give examples.

Answer 1

Compounds not consider as nutrient but is said to be important e.g. phytochemicals, phenolic compounds, glucosinaletes (cabbage))

Question 2

What is the meaning of optimal nutrition?

Answer 2

The mix of different macro nutrient together with the micro nutrient. Can be used to promote health and well-being.

Question 3

Describe physical and mental health.

Answer 3

for humans, physical health means a good body health which is healthy because of regular physical activity (exercise), good nutrition and adequate rest

Mental health: mental health referes to people’s cognitive and emotional well-being.
This two is interrelated and effects eachother.

Question 4

How does WHO describe and decide a good health?

Answer 4

Our economy and society (“the social and economic environment” you live in)
Where we live, what is physically around us(“the physical environment”)
What we are and what we do (“the person’s individual characteristics and behaviors”) -> what do we work with etc.

Question 5

What is some of the leading causes to death in the world?

Answer 5

ischaemic heart disease (def: reduced blood flow, the heart don’t get enough blood), stroke, lower respiratory inf, Chronic Ibstructive Pulmonary disease.

Question 6

Why is the concept of health complex?

Answer 6

Complex interactions between internal factors and external environmental factors determine nutritional status and health/diseases. Understanding of nutrition and all interaction requires the study of several levels of human functions and environmental factors

Question 7

How does one study nutrition?

Answer 7

Due to the complex structure of how nutrient effect the body, nutrition can be studied in multiple ways.

Constitutional:
including the cell nucleous that can be studied through molecular biology and foods.
! Nutrient can directly influence genetic expression and transcription.

Cell metabolism, circulation, all organ systems and central nervous can be studied through biochemistry of the food, physiology, pathology, pharmacology etc.

External environment:
Food security/insecurity, household characteristics; care, social circumstances, housing, sanitation, politics, agriculture, health services (resources; ideologies) can be studied with foods, agriculture, food systems, sociology, anthropology, economics, politics, policy.

! Nutrients- substrates and cofactors in metabolic reactions in cells -> growth in maintenance. E.g. fat tissue releases several hormone-like chemicals or adipokines which perhaps provide a link to cancer development.

Question 8

Which is the basic factors that influence human function and health?

Answer 8

Food sources and chemical and physical structure. Digestion and utilization in the body. Physiological needs. Under/over consumption leads to consequences. Nutrient interactions. Security and safety.

Question 9

What is an essential nutrient?

Answer 9

A nutrient that needs to be supplied in exact amounts.

Question 10

What is optimum nutrition and what is the health consequences and outcomes of this?

Answer 10

Optimum nutrition is food-secure individuals with adequate, balanced and prudent diets.

This leads to health, well being, normal development and high quality of life.

Question 11

What is undernutrition: hunger and what is the health consequences and outcomes of this?

Answer 11

Food-insecure individuals living in poverty, ignorance, politically unstable environments, disrupted societies, war.

This leads to decrease physical and mental development. Compromised immune systems. Increased immune systems, vicious circle of undernutrition, underdevelopment, poverty.

Question 12

What is overnutrition and what is the health consequences and outcomes of this?

Answer 12

Over-consumption of food, especially macro-nutrient, plus: low physical activity as well smoking, stress, alcohol abuse.

This leads to obesity, metabolic syndrome, cardiovascular disease, type 2 diabetes melitus, certain cancers: chronic NCDs, often characterized by over nutrition of macro nutrients and undernutrition of micro nutrients.

Question 13

What is malnutrition and what is the health consequences and outcomes of this?

Answer 13

Nutrition transition: individuals and communities previously food insecure -> confronted with abundance of palatable foods -> some undernourished, others too many macro nutrients and too few micro nutrients.

This leads to double burden of infectious diseases plus NCDs, often characterized by over nutrition of macro nutrients and undernutrition of micro nutrients.

Question 14

What is a noncommunicable diseases (NCDs)?

Answer 14

a medical condition or disease that is non-infectious or non-transmissible – no transfer of an infectious agent from one organism to another (e.g. between different people.

Question 15

Give some examples of NCDs.

Answer 15

Atherosclerosis (related to cholesterol), lung cancer(tobacco use), heart attack (diet, heritage) and stroke (hypertension).

Question 16

What factors are related to NCDs?

Answer 16

Develops over time in genetically susceptible individuals, exposed to several risk factors (not only what we eat)  Societal (economics status, cultural habits, environment..), Behavioral (smoking, diet, physical inactivity, air pollution, heredity..), Biological risk factors (obesity, high blood pressure, high lipid levels, insulin resistance..)

Question 17

What are the four main types of NCDs?

Answer 17

The four main types of NCDs are: Cardiovascular diseases (like heart attacks and stroke), Cancer, Chronic respiratory diseases (such as chronic obstructed pulmonary disease (COPD) and asthma), diabetes – accounts for about 80% of deaths caused by NCDs. NCDs are leading cause of death and disability globally, killing more than three in five people and responsible for nearly half of the global burden of disease.

Question 18

Describe the NCD causation pathway.

Answer 18

Underlying determinants like globalization, urbanization, ageing population together with the common risk factors lik tobacco use, air pollution and unhealthy diets as well as intermediate risk factors like overweight/obesity and raised blood sugar and blood lipids leads to disease like CVD and T2D(type 2 diabetes)

Question 19

Name some health problem related to obesity.

Answer 19

T2D, dyslipidemia, cancer risk, mood disorders, heart disease, reproductive disorder, liver disease and hypertension.

Question 20

Why is obesity and NCDs increasing in developing countries?

Answer 20

Nutritional transition – effect of urbanization, global trade and information exchange. Changes from traditional low-energy dense high-fiber diet to high energy-dense food low in micro nutrients.

Question 21

Name a few strategies for change in public health.

Answer 21

A range of simple, cheap and/or cost-effective interventations exist for addressing NCDs
Prevention interventations that target modifiable risk factors abd promote healthy living, such as: education about NCDs and their risk factors. Effeorts to prevent and reduce the use of tobacco and the harmful use of alcohol. Environments that support increased consumption of fruit and vegetables, reduced salt intake, and increased physical activity.

Question 22

How is the public working to prevent childhood obesity?

Answer 22

Changing behaviours and the environment – eating and physical activity habits are likely to be developed at a young age. An ‘obesongenic’ enviroment (Harmfull with
obesogenic enviroment

Question 23

What are som problem regarding health in developing countries?

Answer 23

Multifactorial causes of problem in developing countries
Conflict and natural disasters (droughts, floods, cyclones)
HIV and AIDS
Lifestyle changes – combination of under- and overnutrition
Food insecurity.

Question 24

What does food security mean?

Answer 24

Food security* occurs when all people, all of the time, have physical, social and economic access to sufficient, safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life.
“Food security is an expression of the human right to adequate food wich occurs when “every man, women and child, alone or in community with others, has the physical and economic access at all times to adequate food or means for its procurement.”

Question 25

How many people is suffering from hunger and malnutrition and where is the problem worst?

Answer 25

2016 – 815 million people in the world estimated to be chronically undernourished.
The food insecurity has worsened in parts of sub-saharan Africa, south-eastern asia and western asia.

The SDG(sustainable development goals) ambition of a world without hunger and malnutrition by 2030 will be challenging

Question 26

What are some challenges with the SDG vision?

Answer 26

With an estimated 815 million who are chronically hungry in the developing world now, and 165 million children who are stunted( stunting reflects chronic undernutrition during the most critical periods of growth and development in early life) and will carry the burden of this through their lives. A further 2 billion individuals suffer from iron deficiency or other micro nutrient deficiencies (vitamins, minerals, trace elements) highlighting the importance of the need for nutrients beyond calories. For billions of people, the problems of gaining adequate nutrition and calories are primarily due to lack of access to food. For most, this is due to poverty.

Question 27

Define undernutrition

Answer 27

Undernutrition, defined as the outcome of insufficient food intake (hunger) and repeated infectious diseases. Undernutrition includes being underweight and deficient in vitamins and minerals (micro nutrient malnutrition).

Question 28

Define malnutrition

Answer 28

Malnutrition – not only about under consumption. The term malnutrition refers to both undernutrition and over nutrition. More than a third of all adults are overweight or obese – leading to personal, public health and environmental costs and adding more pressure to the global food system.

Question 29

How is undernutrition measured?

Answer 29

Adults: BMI <18,5 (BMI. Body mass index – a ratio of weight to height, BMI = weight (kg) /height (m2))
Children:
Underweight (too thin for one’s age), Wasting (being to thin for one’s height), Stunting (being too short for one’s age.

Question 30

What is stunting?

Answer 30

Stunting is caused by long-term inadequate dietary intake and continuing bouts of infection and disease, often beginning with maternal malnutrition, leading to poor foetal growth, low birth weight and poor growth.

• > Permanent impairment to cognitive and physical development
• > lower education attainment and reduced adult income.

Is a vicious cycle as the child often get irreversible development problems resulting in a limited potential. This leads to fewer professional opportunities which leads to lower income. The low income and lack of healthcare and reduced access to proper nutrition will continue to impact the health of their children.

Question 31

What does hidden malnutrition imply?

Answer 31

Stunting, nutrition-related anemias, and iron, zinc and vitamin A deficiencies are just a few examples of the types of hidden malnutrition that can occur in individuals who are consuming enough total energy but not enough macro and micro nutrient-rich foods such as meat, fish, eggs, dairy, legumes, fruits and vegetables.

Question 32

Define micro nutrient malnutrition and which are the most common ones?

Answer 32

Defined as being deficient in one or more vitamins and minerals of importance for human health.

Iron, iodine, Vitamin A

Question 33

Describe the problem with iron deficiency.

Answer 33

Iron -> anemia; poor brain development in infants
Iron deficiency is the most comman and widespread nutritional disorder in the world. Malaria, HIV/AIDS, hookworm infestation, and other infections such as tuberculosis are particulary important factors contributing to the high prevalence in some areas.

Question 34

Describe the problem with iodine deficiency.

Answer 34

Iodine -> Goiter, cretinism (infants) with severe brain damage and mental retardation.
Iodine deficiency is one of the main cause of impaired cognitive development in children. The number of countries where iodine deficiency is a public health problem has halved over the past decade – salt iodization has been introduced in many contries.

Question 35

Describe the problem with vitamin A deficiency.

Answer 35

Vitamin A -> Blindness; increased mortality from infectious diseases
~250 million pre-school age (> 5 years) children are vitamin A-deficient.
An estimate 250 000 to 500 000 vitamin A-deficient children become blind every year, half of them dying within 12 months of loosing their sight (imppired immune system)

Question 36

What is protein-energy malnutrition (PEM) and some results from that.

Answer 36

If the person get marginal energy, but insufficient protein intake -> Kwashiorkor (the disease that the first child gets when the new child comes” Trunkal and limb fat, edematous swollen hands, ankels, abdomen.
But if the person get insufficient protein and energy intake -> Marasmus (to waste away or dying away) Retarded growth, aged look, wasted muscles, no subsutaneous fat.

PEM from mild to severe
Kwashiorkor (protein deficiency, manily young children) -> severe edema, hair discoloration, burn-like skin lesions. Rapid reversal of signs two weeks with high protein diet-
Marasmus (energy depletion) Both young children and adults. High energy and protein diet required over many months for recovery.
The current view is that most PEM is the result of inadequate intake or poor utilization of food and energy.

Question 37

Describe the factors that contributes to malnutrition(micro nutrient deficiency) in developing countries.

Answer 37

Vitamin A-deficiency: low intakes of vegtables, meat, oil. Comes from animal food = meat and dairy, bu precursors:carotenoids – plant food (eggplant, carrots), can be coverted to vitamin A. The biggest problem is in availability most is exported.

Iron deficiency: staple food containing high levels of compounds inhibiting iron uptake, low intake of animal products (meat, fish, stable foods- cereals. Antinutrient?

Iodine deficiency: inadequate supply of milk, meat, shellfish.

Question 38

Describe approached to prevent and control micro nutrient deficiencies

Answer 38

Food-based -> micro nutrient fortification (where feasible and affordable), supplementation. Ex. Golden rice, not used so much in the areas where it was needed, costly.
Dietary diversification
Home gardening, nutution education, development of varieties with high micronutrient content, raising of small animals (including fish) for milk, egg, meat for household consumption.

Question 39

What are some challenges in meeting food insecurity involve

Answer 39

Societal choices about pathways to achieve goals (e.g. changing diets for public health and enviromnetal benefits), which require social innovation and attitudinal changes across society
Greater public understanding of the issues around food production, enviroment, nutrition and health needed.

Question 40

Give examples of nutrition-enhancing actions within the food supply chain

Answer 40

Enhance the availability and accessibility of a wide diversity of foods.
Reduce post-harvest nutrition losses.
Enhance the nutritional quality by improving procession procedures, fortification and reformulation.
Keep the nutrient filled foods for themselves.
Increase smallholder/family farmers productivity

Economic growth is a key success factor for reducing undernourishment, -but it has to be inclusive and provide opportunities for improving the livelihoods of the poor. >90% of the 570 million farms worldwide are managed by an individual or a family: producing >80% of the world’s food, in terms of value – their role in fighting hunger is important.