Final Review Flashcards
Risk factors responsible for causing the most human deaths globally
- Unsafe sex
- Unsafe water, sanitation, hygiene
- malnutrition
- war and genocide
- tobacco
Definition of malnutrition
”People are malnourished if their diet does not provide adequate calories and protein for growth and maintenance or if they are unable to fully utilize the food they eat due to illness (undernutrition). They are also malnourished if they consume too many calories (overnutrition).” (UNICEF
PEM (Protein Energy Malnutrition)
~most common form of malnutrition
~refers to a form where there is inadequate protein intake.
protein is harder to get in a diet because it is expensive. Protein provides more calories for more energy.
Kwashiorkor (type of protein malnutrition)
protein deficiency predominant; seen with weaning because baby is no longer receiving breast milk high in protein and amino acids and is replaced with diet low in protein but high in carbs. Causes edema (swelling of the stomach which makes it seem like the child is getting enough food)
Marasmus (type of malnutrition)
severe energy deficiency (not enough calorie intake)
~ inadequate energy intake in all forms, including protein
~child will look emaciated rather than swelling of edema
Stunting
Chronic under-nutrition that results from a depletion of stored nutrients
~Height for age – low height compared to a reference population of the same age. (children)
Underweight
Acute Under-nutrition: happens when we do not get enough of essential nutrients that our body cannot store for long periods of time.
~Weight for age- low weight compared to a reference population of the same age. (children)
Wasting
Acute Under-nutrition: happens when we do not get enough of essential nutrients that our body cannot store for long periods of time.
~Weight for height – low weight compared to a reference population of the same height.
(children and adults)
Middle Upper Arm Circumference
Measurement of acute-malnutrition
Children and Adults
Why does malnutrition matter?
~significantly retards development of children and is result of social and environmental factors. In developing countries mothers often feed children filling foods that are lacking in calories or proper vitamins (Ex: Rice and porridge).
~Has long lasting effects on subsequent growth, morbidity, cognitive development, educational attainment and productivity in adulthood.
~One of the most sensitive indicators of food security, vulnerability and overall socio-economic development of a country.
what leads to malnutrition?
poverty, low dietary diversity, low food accessibility (poor diet quality–bulky foods that have low energy-nutrient density) and increasing food prices, low maternal education and autonomy, poor sanitation and water supply
example of very malnourished area
South Asia– almost half of all children under 5 in Bangladesh, Nepal and India are underweight
In India: 21% of all children <5 (24M children) severely malnourished
Why is malnutrition high in India despite low income poverty?
-low birth weights (major factor is maternal undernutrition–micronutrient dificiency, low BMI, low stature), low rate of breastfeeding (introduction to solid foods earlier)
effects of malnutrition
Undernutrition leads to reduced productivity, hampering economic growth and effectiveness of investments in health and education, poor growth, no schooling, mortality (to diarrhea, malaria, pneumonia, etc)
PEM and micronutrient deficiencies lead to
Increased risk of opportunistic infection, reduced response to vaccines, reactivation of viral infections
Vitamin A deficiency (VAD)
Important in immune function; Protects skin and mucosa; Increases leucocyte activity
~Contributing factor in 2.2 million deaths each year from diarrhea and 1 million deaths from measles among preschool children under five (diminishes the ability to fight infections); contributes to maternal mortality;
Severe deficiency can also cause irreversible corneal damage, leading to partial or total blindness (night blindness is one of the first signs of VAD)
Test showed: Period vitamin A delivery in the community can greatly reduce child mortality in developing countries
Key Points of malnutrition
Malnutrition is a huge problem globally;
Underlies much mortality and morbidity;
Interacts synergistically with infection;
Has long-term consequences for growth and development
The good news is that potential interventions are cheap and effective
Micronutrients
critical for:
Regulation of growth, activity, development
Immune and reproductive function
~required by humans and other organisms throughout life in small quantities to orchestrate a range of physiological functions, however come unreceived because of factors including poverty and gender inequality
micronutrient malnutrition
Consequences:
More severe illness; More infant and maternal deaths; Lower cognitive development; Stunted growth; Lower work productivity
~Harder to detect than most other forms of malnutrition; sufferers are not always underweight
~Can jeopardize immunity and increase susceptibility; creating a sickness cycle
chronic disease
~In medicine: long-lasting or recurrent disease
~In human biology and public health: degenerative diseases or the result of man-made context
Examples: high blood pressure, arthritis, respiratory diseases like emphysema, and high cholesterol, Heart Disease, Cancer, Respiratory Disease, Diabetes
Associated with longer term life, and areas that are undergoing modernization, “disease of affluence”
~Ex. China
Allostatic load
Cumulative wear and tear on the body that results from chronic or repeated stress (chronic stress) or inefficient management of stress
~It represents the physiological consequences of chronic exposure to fluctuating or heightened neural or neuroendocrine response that results from repeated or chronic stress.
Effect of allostatic load
Increased poverty corresponds to increased stress and deaths from CVD and elevated BP. Failure to shut off allostatic activity after stress - inability to shut off stress response resulting in over exposure to stress hormones
~can accelerate pathophysiology when they are overproduced or mismanaged; this kind of stress can cause hypertension and lead to heart disease and diabetes and obesity. Constant or even irregular exposure to these hormones can eventually induce illnesses and weaken the body’s immune system
Latino paradox
Hispanic and Latino Americans tend to have health outcomes that paradoxically are comparable to, or in some cases better than, those of their U.S. white counterparts, even though Hispanics have lower average income and education.
despite being a relatively poor, marginalized group that faces discrimination and may have uncertain legal status, characteristics that generally contribute to higher levels of mental health disorders, recent Latino (and particularly Mexican) migrants to the US have better mental health outcomes than populations in their home countries and other groups in the US.
types of allostatic load
~Frequent activation of the allostatic systems - repeated hits from multiple stressors resulting in overexposure to stress hormones
~Lack of adaptation to repeated stressors - lack of adaptation to the same stressor
~Failure to shut off allostatic activity after stress - inability to shut off stress response resulting in over exposure to stress hormones
How inequality affects health
~Stressful/unhealthy environments
~Relative Status: hierarchies and feelings of lack of control generate stress
~Social Cohesion: shared values, goals and resources within a society; can ameliorate stress
~Social Support: low SES is associated with reduced social support due to jobs, transportation time and other burdens
