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Global health > Chapter 6: Malnutrition > Flashcards

Chapter 6: Malnutrition Flashcards

1
Q

Malnutrition is a result of numerous interlocking ___ and ____ factors

A

social and economic factors

Malnutrition is not simply due to the lack of food.
Just like poverty isn’t bc of lack of money

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2
Q

What could malnutrition be an end result of? 4 things

A

Poverty
Lack of education
Social inequity
And chronic recurrent infections

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3
Q

What are one of the main consequences of malnutrition? (Increased…)

A

Increased mortality from common childhood illnesses

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4
Q

Case mortality in what 5 diseases are higher among malnourished children?

A

Measles
Bronchiolitis
Whooping cough
Pneumonia
Gastroenteritis

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5
Q

Widespread starvation is ultimately a failure of what?

A

Failure of Food distribution from the rest of the country

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6
Q

What was Malthus’s early 19th century theory?

A

That malnutrition was an unavoidable feature of life in developing countries
Because there would always be far more ppl than food available

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7
Q

Sick children survived better if they were not, what?

A

Not separated from their mothers

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8
Q

What did Cicely Williams’s studies in west Africa led her to identify?
When in Malaysia, she was the first to criticize what?

A

Kwashiorkor

Criticize infant food companies for advertising practices

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9
Q

Cicely Williams was influential in what, and she is also considered the founder of what ?

A

Influential in reestablishing breastfeeding

Founder of the study of maternal and child health

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10
Q

What is Amartya Sen study, and what did his research show?

A

Studied famine,
Research showed that malnutrition is complex,
A result of numerous interrelated contributory factors

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11
Q

Micronutrient deficiencies have clinical effects even in children who might appear ….

A

Well nourished, ex survey

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12
Q

What 3 things have combined to halt/reverse the gains in MalNu improvements before 2005

A

Recession
Rising food costs
Wars

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13
Q

What 4 interventions are available that have nutritional benefits?

A

Feeding programs
Micronutrient fortification
Maternal education
Agricultural extension projects

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14
Q

Adverse effects of malnutrition are particularly important during what periods ?

A

Rapid growth periods such as childhood and pregnancy

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15
Q

Early malnutrition during what can have Lifelong adverse effects?

A

the period of major organ development

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16
Q

A diet deficient in macronutrients is called what?

A

Protein-energy malnutrition

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17
Q

Some types of what cannot be produced by the body ?

So they can only be obtained from what?

A

Fats and amino acids
Obtained from our food

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18
Q

Can most micronutrients be made in the body

A

No

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19
Q

What are micronutrients?

A

Vitamins: thiamin, vitamin C, folic acid

Minerals: iron, calcium, iodine

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20
Q

What are the diseases that arise as a result of; vitamin C, iron, and iodine?

A

Survey
Anemia
Hypothyroidism

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21
Q

Malnutrition means what?
What does the term refer to?

A

Means “bad” nutrition
Refers to wife range of diseases resulting from abnormalities in dietary intake

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22
Q

What is the fastest growing nutritional problem in the world

A

Obesity

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23
Q

Levels of nutrition still differ widely between what?

A

Countries of similar income

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24
Q

Why do countries with similar income differ widely in levels of malnutrition?

A

Agricultural performance
Pro-poor government policies
Civil unrest
Attitudes towards women

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25
Q

What are the 3 broad groups of requirements that must be met before a pops children can have reliable nutrition?

A

1) access to reliable source of nutritious food (household food security)
2) adequate care for women and children
3) safe and healthy society w access to preventive care & basic health services

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26
Q

Common infections/ factors of malnutrition in children?

A

Gastroenteritis
HIV infection
TB

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27
Q

Combo of what 2 things lead to inadequate child-rearing practices ?

A

Maternal poverty
Lack of education

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28
Q

Lack of knowledge about what 3 things contribute to maternal impact on malnutrition?

A

Breastfeeding
Contraception
Nutritional requirements of children

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29
Q

High phytate levels in vegetarian ___ diets inhibits absorption of what which leads to development of what disease?

A

Cereal diets inhibits absorption of calcium
Leads to rickets

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30
Q

Apart from long term adverse effects on growth, malnutrition greatly increases ___ by reducing ___.

A

Increases mortality of common disease
By reducing the child’s immune response

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31
Q

How many kids under 5 are undernourished and underweight?

A

90 million +

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32
Q

What is the monitoring agency for the nutrition goal

A

Food and Agriculture Organization

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33
Q

FAO tracks malnutrition by measuring ____ through ____.

A

Daily caloric intake
Through household income/expenditure survey

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34
Q

What are the bad sides of the FAO surveys

A

Don’t measure food eaten outside of the house
Measure money spent on food vs type of food

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35
Q

How many ppl are undernourished globally?

A

795 million (1 in 9)

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36
Q

What is the MDG target for malnutrition?

A

11.6%

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37
Q

Which two regions account for the larger share of global undernourishment? How much has it increased since 1990?

A

South Asia
Sub Saharan Africa

Increases by 44 million

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38
Q

Most underweight children live where?

A

South Asia

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39
Q

Setbacks in a small area can go unnoticed if there are what?

A

Large improvements in another region

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40
Q

Countries with highest percentage of undernutrition are where ?

A

In Africa
(Especially Sun Saharan Africa)

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41
Q

What are the 4 most affected African counties in undernutrition?

A

Burundi
Chad
DRC
Eritrea

42
Q

What are the 4 most affected counties by undernutrition in Asia ?

A

Bangladesh
Nepal
North Korea
Cambodia

43
Q

What are 3 of the principal contributory factors of malnutrition in Asia ?

A

Poor education
Gender inequality
Poverty

44
Q

What are 3 of the principal contributory factors of malnutrition in Africa ?

A

Conflict
Government ineffectiveness
High rates of HIV/AIDS

45
Q

Countries with the highest level of malnutrition is prolonged what 2 things? What are examples of 4 counties?

A

Humanitarian or natural disasters

North Korea
Afghanistan
Sudan
Haiti

46
Q

On what two people does the burden fall most heavily on?

A

Women and small children

47
Q

First two targets of SDG on hunger is by 2030 end what?

A

End Hunger and Malnutrition

48
Q

How many ppl suffer from malnutrition globally and what percentage are preschool kids

A

795 million, 20-25% preschool

49
Q

What is the case mortality of severe malnutrition

A

1 in 4 die

50
Q

What is the most obvious and easily measurable result of malnutrition

A

Poor growth

51
Q

Why is BMI not used

A

Harder to calculate

52
Q

Marasmus vs Kwashiorkor

A

Marasmus: very wasted, symmetrically small, no edema
Kwashiorkor: less growth failure, poor skin, edema

53
Q

Why does one get kwashiorkor or marasmus ?

A

Abnormal hormone/immune response to starvation
Alfatoxins in grain
Micronutrient deficiencies

54
Q

When does the child’s brain grow most rapidly?

A

Conception to the 2nd or 3rd bday

55
Q

Malnutrition in early school years causes what 3 things that will reduce the child’s ability to learn

A

Apathy
Reduced activity
Lack of curiosity

56
Q

Severe malnutrition has profound adverse effects on what?

A

A child’s immune system

57
Q

Of the 10 mill kids that die a year from major killers (respiratory infections, diarrhea etc), what % of deaths were from malnutrition

A

25-50%

58
Q

It is possible to have micronutrient deficiencies despite what?

A

A normal diet

59
Q

What is micronutrient deficiency often referred to as

A

Hidden hunger

60
Q

Regular Provision of micronutrient ROI = what 3 things

A

improved growth, development, and survival

61
Q

How much of the worlds population live in areas where there’s little iodine in soil

A

1/3

62
Q

Iodine is an essential factor in what hormone, which is an essential factor needed for early what?

A

Thyroid hormone, early brain development

63
Q

How does the subtle problem of iodine deficiencies manifest itself?

A

As poor school performance and lack of energy

64
Q

Iodine deficiencies is the single most common cause of preventable what?

A

Mental retardation and brain damage

65
Q

The average IQ is how many points higher in an iodine supplemented pop?

A

13 points

66
Q

Before vitamin A supplementation and measles vaccine how many kids were blinded per year

A

250k

67
Q

What happened to the Morality rate from measles with the addition of vitamin A?

A

Rate was halved

68
Q

What are examples of Food fortification with iodine and vitamin A

A

Iodine: salts and cooking oil
Vit A: maize, wheat, sugar

69
Q

What is the most common micronutrient deficiency in the world?

A

Iron

70
Q

What happens to children who are born to iron deficient mothers

A

Breast milk is low in iron
Baby has Marginal storage of iron at north to deal with a period of rapid physical and neurological growth

71
Q

How many children in the developing world between 6mo-2yr are iron deficient

A

At least half

72
Q

Worst affected children in iron deficiency are found in countries where children are weaned onto what?

A

A rice porridge low in iron

73
Q

What are the effects of iron deficiency in adults?

A

Reduced ability to work
Increases risks during childbirth

74
Q

Zinc is necessary for what 2 things?
Zinc deficient women have a higher rate of what?

A

Brain development
Normal labour

Higher rate of obstructed labour

75
Q

Acute and longer term use of zinc does what with gastroenteritis?

A

Acute use shortens duration of illness
Long term use reduces risk of pneumonia, malaria, and recurrent gastroenteritis

76
Q

Folate is essential for what 2 things?

A

Fetal growth & development
Production of red blood cells

77
Q

Folate deficiency during pregnancy is associate with what for the mother, and what for the baby?

A

Anemia for mom
Fetal defects for baby esp Spina Bifida

78
Q

Folate during pregnancies reduces what?

A

Developmental abnormalities particularly congenital heart defects

79
Q

Combined what supplementation is essential for prenatal care

A

Folate - iron supplements

80
Q

What is the longest lasting uncontrolled experiment lacking informed consent

A

Formula feeding

81
Q

In 19th century dry nursing with other animal milk, what milk was the best option?

A

Donkey milk

82
Q

Children in 19th century who weren’t breastfed suffered what?

A

Much higher mortality

83
Q

Nestle and Von Leibig breast milk substitutes were based on what 4 ingredients?

A

Cows milk
Wheat
Malt
Sugar

84
Q

Baby formulas started during American Civil war by adding ___ to ___ which extended its storage life

A

Sugar to evaporated cows milk

85
Q

Cookbooks included recipes for milk formula which additives included what

A

Cows milk
Cod liver oil
Orange juice
Sugar

86
Q

By WWII ____ recipes became the most common form of infant nutrition

A

Evaporated milk recipes

87
Q

By the 1970s what % of 2-3 month old babies in the US were breastfed

A

25%

88
Q

What was a major factor behind the popularity of commercial formulas

A

Aggressive marketing by baby food industries

89
Q

Breastfeeding delivery isn’t complicated by malnutrition and infection resulting from incorrect ____ by a mother who has not had any access to ___

A

Incorrect mixing of powder with dirty water by a mom who hasn’t had access to education

90
Q

Commerciogenic malnutrition pamphlet “Child nutrition in developing countries” and “The Baby Killer” campaign led to what?

A

International boycott of Nestle products in 1977

91
Q

Code of conduct by WHO in 1981 and Innocenti Declaration in 1990 places restrictions on what?

A

Advertising of baby formulas
and requires sales ppl to not provide milk or promotional gifts in hospitals

92
Q

Exclusive breastfeeding in the first 6 months of life protects the child from what?

A

Wide range of diseases
Particularly gastroenteritis and malnutrition

93
Q

How many deaths of children / year can be prevented from exclusive breast feeding

A

Over a million

94
Q

First large attempt to repopularize breast feeding was in 1989 by WHO and UNICEF creating a pamphlet called

A

Protecting, promoting, and supporting breastfeeding: the special role of maternity service

95
Q

The baby friendly hospital initiative in 1991 includes what strategies?

A

Extra training for health care staff
Promotion of breastfeeding before and after pregnancy
Support for breastfeeding by trained lactation consultants

96
Q

Food security exists when all people at all times have ___ access to what?

A

Physical, social, and economic access to sufficient, safe, and nutritious food to meet their dietary needs and food preferences for an active and healthy life

97
Q

What are the 4 pillars of food security

A

Availability
Access
utilization
stability

98
Q

1974 world food conference declared “every man woman and child has the inalienable right to be ….”

A

Free from hunger and malnutrition

99
Q

Food aid was first provided to developing countries in 1950s was a way for developed countries to do what?

A

Dispose of grain surpluses

100
Q

What are some of the controversies/criticism food aid has attracted?

A

Creating disincentives
Depressing food prices
Distorting markets
Delaying need for policy reform

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