Nutrition for Developing Countries Flashcards
Chronic Hunger
- Inability to acquire sufficient food (to meet dietary energy requirements) over a period of at least 1y
- May kill more people globally than the acute crisis of a famine does.
- It results from the continuous failure to generate sufficient livelihoods to sustain the population.
Poverty
- Central to chronic hunger
- Is considered to be an integral part of chronic hunger.
- Even in famine, the richer households within a population rarely go hungry.
Understanding poverty
Con Pov Fail
- The consumption approach: income or production is insufficient to provide basic nutrition or necessities - the cost of life in society.
- The poverty Line: income below a global minimal standard - usually useless when comparing across-cultures.
- The failure of capabilities: Failure to achieve basic human capabilities - accessing healthcare, achieving an adequate standard of living.
Tackling hunger
Public action such as providing jobs, healthcare, education and social security (to an extent) - in general - development.
Millennium Development Goals
FAO 2005 & UN, 2015
linked to reducing hunger
1)Eradicate extreme poverty and hunger
2)Achieve universal primary education
3)Promote gender equality and empower women
4)Reduce child mortality
5)Improve maternal health
6)Combat HIV/AIDS, malaria and other diseases
7)Ensure environmental sustainability
8)Develop a global partnership for development
Barriers to education
1) Expense = food acquisition prioritised over school fees
2)Productivity = children, esp. girls, required to help run the household (collect firewood, carry water…)
3)Health = stunting/illness can prevent/delay enrolment
4)Malnutrition = cognitive ability is impaired by e.g. IDA, IDDs, SAM, MAM & LBW
“…a farmer with 4y of primary education is, on average, almost 9% more productive than a farmer with no education” (FAO 2005)
Barriers to gender equality
1)Cultural tradition/law =
e.g. ♀ can be barred from owning land (thus no collateral for credit to irrigate, install drainage etc.)
2)Education gender gap =
widest where hunger is most prevalent
3)Vicious cycle of maternal malnutrition
-> low weight baby
->stunting
-> lower education
-> low work capacity
->poverty
“A recent study of 63 countries concluded that gains in women’s education made the single largest contribution to declines in malnutrition during 1970-95, accounting for 43% of the total progress” (FAO 2005)
proportion of undernourished people in dev. countries
1990/92 ->23.3
2014-16 ->12.9
Sociological determinants of physical growth
(Adapted from Crow 1992)
1) Land
2)Income
3)Infant feeding practise
4)Health Practises
5)Environmental sanitation
6) Food resources
7) Nutrient intake
8) infection
9)Nutrient availability at a cellular level
-> Growth
Proxy measures of undernourishment
include measuring nutrient intake (diet histories, weighed intake, questionairres),
nutritional status (including wasting and stunting, MUAC, BMI and so on).
Vulnerable to undernourishment
the poor,
the young,
the sick,
the infirm,
the disabled,
women (status),
pregnant of lactating women (energy sharing)
migrants,
refugees,
broken families,
female-headed households, the elderly
(Filteau & Akik 2017)
Undernutrition
Filteau &Akik 2017
Malnutrition due to nutritional deficiency
Current terminology for childhood acute malnutrition make no reference to mechanism
SAM (severe)
MAM (moderate)
Child indicator = Weight-for-length/height
Anthropometric deficit = <-2.0Z = wasting
MAM = -2.0 to -3.0Z
SAM = <-3.0 Z
Child indicator = Height-for-age
Anthropometric deficit =
<-2.0Z = stunting
MAM = -2.0 to -3.0Z
SAM = <-3.0Z
Adult undernutrition
BMI (kg/m2)
Normal = 18.50-24.90
Mild malnutrition = 17.00-18.49
Moderate malnutrition = 16.00-16.99
Severe malnutrition = <16.00
Consequences of undernutrition
- no energy….
Limited/no fuel affects;
BMR
PAL
Energy storage
Repair
Growth
Structural support
Enzymatic process
The Cycle of Malnutrition & Infection
-> INFECTION
->Slow recovery time
->Fewer antioxidants
-> Immune system less effective
->decreased tissue resistance
-> MALNUTRITION
-> Increased need for energy and nutrients
-> decreased absorption of nutrients
-> decreased appeitite
-> INFECTION
Payne & Cutler – 1984:
“…from the [related] ‘cost of production’ perspective, it is [also] vital to improve the growth potential and work capacity of adults and children through supplementary feeding so that they can be made fully productive and disease resistant, thus breaking out of the supposed trap of the vicious cycle of undernutrition-diseae-suboptimal production-further poverty-more undernutrition.”
Uncomplicated underweight
(Filteau & Akik 2017)
cause
what is used for energy instead
treatment
Weight loss and wasting due to negative energy balance
- Low intake of low energy-dense foods
- Malabsorption
- Increased energy loss via urine
- Increase energy expenditure (infection, malignancy, fever etc.)
- Infection-related anorexia
Compensated by use of stored energy
- Adipose
- Lean tissue (muscle mass)
Treatment
- Incr. intake of energy and EAAs
- Treatment of infections to restore appetite, improve gut function & reduce energy costs (e.g. fighting infection)
