international nutrition Flashcards
- Name the first 4 of the 8 Millennium Development Goals (MDG) and current “prognosis” for achieving them.
- Eradicate extreme poverty & hunger
(“Halve the proportion of people who suffer from hunger”: on track- 15% by 2015) 2. achieve universal primary education (enrollment = 90% in all but 2 regions) 3. promote gender equality and empower women (gender parity in primary school = 95% in 6/10 regions) 4. Reduce under 5 child mortality by 2/3. (overall decreased by 28%, from 12.5M to 8.8M due to malaria, HIV control and measles immunization)1. Eradicate extreme poverty & hunger
(“Halve the proportion of people who suffer from hunger”: on track- 15% by 2015) 2. achieve universal primary education (enrollment = 90% in all but 2 regions) 3. promote gender equality and empower women (gender parity in primary school = 95% in 6/10 regions) 4. Reduce under 5 child mortality by 2/3. (overall decreased by 28%, from 12.5M to 8.8M due to malaria, HIV control and measles immunization)
What is the largest group of under 5 child mortality
neonates- 41% of under 5 deaths. Progress is slow
What percentage of world population is “hungry”
13.10%
- Name the last 4 of the 8 Millennium Development Goals (MDG) and current “prognosis” for achieving them.
- improve maternal health (50% of births attended by skilled birth attendants, esp rural & low SES). 6. Combat HIV/AIDs, malaria, other dz (10-fold increase in antiretroviral Rx; 42% of those in need of treatment). 7. ensure environmental sustainability (deforestation slowed). 8. Global partnership for development
What are the causes of hunger
poverty is principal cause. Underlying cause of poverty is economic and political systems. Also conflict is cause of hunger for refugees
Who is at risk for malnutrition
women of childbeearing age, infants, children under 5
- Describe the framework for the contextual factors that contribute to malnutrition.
social, economic and political context > lack of capital (financial, human, etc) > income poverty > household food insecurity, inadequate care and/or unhealthy household environment/ lack of health services > inadequate dietary intake and/or disease > maternal and child undernutrition > short and long term consequences
List basic causes of malnutrition
basic: Poor roads and lack of electricity lead to isolation. Limits markets and access to resources. This is in social, political, economic context and due to lack of capital.
list underlying causes of malnutrition
Underlying causes: income poverty (no electricity or running water, indoor air pollution, food insecurity), inadequate health care,
list immediate causes of malnutrtion
inadequate intake, monotonous diet, food insecurity, disease and illness
Short term consequences of under nutrition
morbidity, mortality, disability
Long term consequences of under nutrition
Stunted growth, limited intellectual capacity, economic productivity, reproductive performance, chronic diseases (metabolic and cardio)
Describe nutrition problems related to mothers
10-19% of women have BMI <18.5%. Being underweight and short stature are independent risk factors for poor reproductive outcomes. Undernutrition increases risk of death during childbirth by 20%
Stunting and undernutrition
stunting in infants correlates with stunting in mothers
What is the critical window for height and weight
The first 1000 days
What causes stunting
chronic malnutrition (NOT energy deficity). Micronutrient deficiencies such as zinc, iodine, iron, etc. Inflammation and recurrent infection. More common in rural vs urban, and in males vs females
Describe the triple burden
diarrhea, stunting and chronic disease
- State and describe three major nutrition problems in developing countries, including growth, dietary, and reproductive outcomes.
- protein energy malnutrition (stunting»_space; wasting). 2. mineral deficiencies (hidden hunger). 3. Enteropathy
- Describe the implications of the “3 myths” about global malnutrition.
myth 1: Malnutrition is primarily a matter of inadequate food intake- Can also be due to inappropriate feed and care, poor sanitation and disease. Myth 2: Improved nutrition can only come as by-product of poverty reduction - education, using resources avaible, positive deviance and water/sanitation can all improve nutrition. Myth 3: Broad based action to improve nutrition not feasible- fortification programs (ie. iodized salt), promoting breastfeeding, Vit A supplements, Zn supplements for diarrhea and good management of common illnesses can improve nutrition
Single most important factor in prevention of deaths in <5 yr old kids
exclusive breastfeeding- an infant not BF is 23X more likely to die of diarrhea. This is the least expensive and most cost effective method.
Second most potent strategy to prevent child deaths
Improved complementary feeding with breast feeding. Traditional complementary feeding is low in Zn, Vit A and iron, so supplements and fortifications can aid in this.
Describe maternal interventions to improve nutritional status
- Peri-conceptional folate supplementation, Iodine fortification. 2. Balanced energy-protein supplement. 3. Calcium supplement. 4. Multiple micronutrient supplementation in PG
Describe infant interventions to improve nutritional status
- Promotion of breastfeeding . 2. Appropriate complementary feeding. 3. Vitamin A supplementation. 4. Preventive Zn supplementation. 5. Management severe & moderate acute malnutrition (SAM & MAM)
Discuss plant breeding as intervention
Increase bioavailability of phytate reduced maize.
Discuss biofortification as intervention
Plant breeding to increase micronutrients. NOT GMO.
Discuss education strategies for interventions
- behavior chang communication- negotiate priorities through health centers or directly with families. 2. positive deviance- who in community is successful and why?
