Post Midterm Material Flashcards
1
Q
List the four main groups of factors affecting food choice.
A
Culture
Nutrition Knowledge & beliefs
Food
Practical considerations
2
Q
Describe the cultural factors affecting food choice. [4]
A
- Acceptable foods
- Customs
- Food symbolism
- Religious beliefs
3
Q
Describe the nutrition knowledge and beliefs influence on food selection. [3]
A
- Health concerns
- Attitudes and values
- Education
4
Q
Describe practical considerations affecting food choice. [4]
A
- Food availability and cost
- Hunger
- Convenience
- Health status
5
Q
Describe how food preferences influence food choice. [3]
A
- Taste, smell, colour, texture, temperature
- Hereditary
- Familiarity
Primarily learned; change over time; informed by culture
6
Q
What is culture? [3]
A
- The system of shared beliefs, values, customs, behaviours, and artifacts that the members of society use to cope with their world and with one another, and that are transmitted from generation to generation through learning
- All cultures are equally developed – none is better, more advanced, or more primitive than any other
- Food is a major part of culture (it both informs and demonstrates culture)
- Something we learn throughout life
- Culture is dynamic, it’s always changing.
“Customary ways of thinking and acting”
7
Q
A
Answer: C
At the end of the day, what foods you’re able to eat depends on convenience, availability and cost, as well as health status (i.e., ability to acquire and prepare food). Your preferences, beliefs knowledge, and culture all come secondary to practical considerations.
8
Q
Describe the importance of cultural factors in dietary habits. [5]
A
- How food is acquired and stored
- Which foods are selected for consumption (food availability)
- How foods are prepared
- Meal patterns
- Attitudes towards food
9
Q
What is acculturation? [2]
A
- The adoption of the behavior patterns of the surrounding culture
- Results in changes in culture and customs, food, clothing, language
10
Q
What is ethnocentrism? [3]
A
- The belief that one’s own value system and lifestyle is most appropriate
- Judging another culture by the values and standards of one’s own culture
- How ethnocentrism can be expressed: When we encounter lifestyle/values that are different from ours and respond with: dissaproval, anger, disgust, disbelief, pity, or amusement.
11
Q
What is cultural relativism? [3]
A
- Beliefs, values, customs, behaviours, ethics (i.e., culture) is relative to social context
- Belief that there are no right or wrong cultures, cultures are just different
- We should not judge another society’s culture
12
Q
Describe the influence of religion on food for Jewish people.
A
- Jewish dietary rules based on scholarly interpretations of the Torah
- Kosher: what acceptable is to eat
- “The pig ….. he is unclean to you. Of their flesh you shall not eat, and their carcasses you shall not touch; they are unclean to you.” (Leviticus 11:8)
13
Q
Describe the influence of religion on food for Islamic people.
A
- Halal: that which is permitted
- Examples of non-halal (i.e., ‘haram’ = prohibited) foods: pork (pig); animals not slaughtered in accordance with halal practices; alcohol
14
Q
The body functions best with what kind of diet?
A
A diet emphasizing lean protein, high fibre, complex carbohydrates, vegetables & fruits, and minimizing sugar and sodium.
15
Q
What is the basis for modern dietary habits? [2]
A
* Agricultural revolution: human culture moved away from hunter-gatherer to agriculture and settlement approximately 12,000 years ago.
* Industrial revolution: consolidation and intensification in agriculture and industry; began in the UK ~1750-1850
16
Q
Describe some processes in the food industry that were introduced during the Industrial Revolution. [6]
A
- Refining whole grains: removal of most of the fibre and vitamins
- Refining sugar: processed sugar cane or sugar beets
- Pasteurization
- Refrigeration
- Canned food
- Hydrogenation
Industrialization increases food processing and consumption of processed foods.
17
Q
What are some of the social determinants of health? [10]
A
- Income & social status
- Physical environments
- Employment & working conditions
- Education & literacy
- Childhood experiences
- Gender
- Culture
- Social support
- Race
- Indigeneity
18
Q
Define urban ‘slums’ and provide examples of nutrition-related challenges associated with living in an urban slum.
A
A “slum” is defined by the following 5 characteristics:
1. Overcrowding
2. Inadequate access to safe water
3. Inadequate access to sanitation and infrastructure
4. Housing is of poor structural quality
5. Insecure residential status
Globally, it is estimated that approximately 1/3 of people living in an urban setting are living in an urban slum and lack access to improved water, improved sanitation, sufficient housing area, and/or housing of adequate quality.
19
Q
Describe production via sack gardens and how they improve food security in the context of urban slums. Also list: Benefits [4]. Challenges [3].
Sack gardens: urban farming initiative, can contribute to food security in urban slums
A
**Empty sugar sack filled with soil, manure, stones
* In holes, plant kale, spinach, Swiss chard, etc.
* Applies agricultural knowledge of many urban poor who have migrated from rural villages
Benefits?
* Improved food security
* Average harvest: vegetables for 4 meals/wk
* Dietary diversification
* May be able to sell some of harvest
Challenges?
* Limited availability of clean soil, water, manure, seedlings, space
* Damage from pests and animals
* Goats and “midnight harvesters”
20
Q
Wash interventions reduce [3].
A
WASH interventions reduce:
* diarrhea: kills 1,370 children per day; 60% of these deaths due to inadequate WASH
* intestinal parasites
* environmental enteropathy
21
Q
Comment on the extent to which diarrhea is responsible for children’s deaths throughout the world
A
Diarrhea burden from birth–24 months predicts stunting
Example: In a pooled analysis of 9 studies, 28% of stunting at 24 months attributed to having 5+ episodes of diarrhea from birth–24 months
Diarrhea kills 1370 children per day. This is more than malaria, aids and measles combined. 60% due to inadequate WASH.
22
Q
Who pays via lost opportunities when water is not available on premises?
A
“When water is not on premises and needs to be collected, it’s our women and girls who are mostly paying with their time and lost opportunities” -Sanjay Wijesekera, UNICEF Water, Sanitation, and Hygiene Division
Worldwide, women and girls spend an estimated 200 million hours—every day—collecting water. -UNICEF, 2016
= 8.3 million (24-hour) days
More than 2 billion people do not have access to safe drinking water.
23
Q
Consider the role of social norms and personal beliefs in
strategies to reduce open defecation and give examples of initiatives that have aimed to change social norms
A
- Social pressure used to help end open defecation and increase sanitation facilities via large media campaign (key message: women should be able to use a latrine in privacy and security)
- Encouraged girls’ families to
demand a latrine of boys’ families before marriage - Appears to have increased latrine ownership among families with boys of marriage age by ~20% in 2004
- Resulted in ~700,000 more toilets in the state in 2008 versus 2004
“No toilet, no bride” – “No loo, no I do”
24
Q
A
Answer: C
Vitamin A is integral to a strong immune response.
25
Answer: Zinc
10-14 days of supplementation in addition to oral rehydration.
26
List some improved water sources. [7]
## Footnote
Even improved sources can be contaminated.
Improved sources of drinking water include:
* Piped water into dwelling
* Piped water to yard/plot
* Public tap
* Tubewell or borehole
* Protected dug well
* Protected spring
* Rainwater collected and stored until used
27
List some improved sanitation.
* Flush toilet
* Piped sewer system
* Septic tank
* Flush/pour flush to pit latrine
* Pit latrine with slab
* Composting toilet
## Footnote
~2.4 billion people worldwide do not have access to an “improved” sanitation facility. 13% of global population engages in “open defecation”
28
How many people wash their hands after potential contact with waste?
Though hard to measure, it is estimated that **only 19% of people** throughout the world wash hands after potential contact with excreta.
29
What is 'pourism'?
“Poorism” (i.e., taking tourists into slums to observe people living in significant economic poverty) is a growing niche in the tourism industry throughout Africa and elsewhere (e.g., Brazil, India).
30
What is 'voluntourism'?
Doing volunteer work on another country with an
aim to make a positive contribution
Pros: learn about others; deepen empathy; tourism provides economic opportunities; if volunteer is trained to do the work they are doing - may be helpful
Cons: drains local resources; disrupts local economy; volunteers inexperienced; inadequate supervision; short involvement; may have (very) negative impacts on people
31
From a public health perspective, why would we want to reduce the number of people who engage in open defecation?
* Reduce chance of excreta entering water crops and food crops
* Infection can spread through feces
* Limit risk of transmission of transmission
* Vectors (i.e., pests like flies) can spread disease
* Support mental health
32
Most of the people worldwide who defecate in the open live in India (most in rural areas).
True or False?
True.
33
Open defecation is associated with increased infant mortality, stunting, and reduced cognitive development.
True or false?
True
34
Most people without a latrine do without because they cannot afford to build one; if they could build one, they would use it
True or False?
False.
## Footnote
Millions of people choose to defecate in the open even if they have access to improved sanitation.
35
If governments built latrines for everyone who did not have one (and nothing else changed), most people who currently defecate in the open would continue to do so
True or False?
True
36
What are the consequences of open defecation in India?
* High rate of stunting (~40%) among children
* Diarrhea is cause of death for ~10% of the children <5 years of age who die each year.
37
How did these children contribute to changing sanitation practices in their community?
## Footnote
Children in Rajnandgaon, Chhattisgarh, India, promote toilet use
* Associated shame with open defecation.
* Connected open defecation to health implications.
* Social pressure on those resisting
* Expressed distaste in the filth of their environment (i.e., surrounding mountains, roads)
* Actually going out and preventing people from accessing areas they use to defecate
* Demonstrates the importance of youth empowerment and community engagement
38
Describe the current use of toilet facilities in India.
* In 2015/16, 39% of households in India practiced open defecation
* In 2019/21, the proportion was 19%
* Open defecation continues to be much more common in rural vs. urban areas.
39
Describe how food is central to climate change. [2]
* Food and agriculture are a key contributor of the greenhouse has emissions that drive climate change
* Food and agriculture are very sensitive to the impacts of a changing climate (higher temperatures, reduced precipitation, more extreme weather events)
40
Describe how global temperature increases are not consistent worldwide. [3]
Increases in temperature are greater in regions at (1) higher latitudes (compared to those located closer to the equator), (2) over land (compared to over oceans), (3) in continental interiors (compared to coastal regions).
41
Livestock production accounts for [...] of agricultural land, and [...] of land surface of the planet
Livestock production accounts for **77%** of agricultural land, and **~30%** of land surface of the planet
42
Livestock production accounts for [...] of current greenhouse gas (GHG) emissions – roughly equal to emissions from all forms of
transportation combined)
Livestock production accounts for **14.5%** of current greenhouse gas (GHG) emissions – roughly equal to emissions from all forms of
transportation combined)
43
How do high temperatures reduce yields of crops? [3]
1. Impacts plant biology
2. Higher temperatures cause glaciers to melt
3. Higher temperatures change weather patterns
44
How do high temperatures reduce yields of crops? [3]
1. Impacts plant biology
2. Higher temperatures cause glaciers to melt
3. Higher temperatures change weather patterns
45
Describe how 'small' changes in temperature have BIG impacts.
1°C rise in temperature during growing season leads to **10%** reduction in wheat, rice, maize yields
## Footnote
Wheat, rice, maize provide 60% of world's dietary energy intake (kcal)
46
Why do melting glaciers reduce crop yields?
* Mountain glaciers melt; rivers that rely on them disappear; irrigation systems that rely on rivers will be challenged
* Mountain glaciers in the Himalayas feed major rivers in India and China; these rivers provide water for 1.4 billion people!
* Melting glaciers (non-mountainous) in Greenland and Antarctic ice sheets raise sea level; poses particular risk for river deltas of Asia where rice is produced; threatens agricultural viability in these regions
47
How do changing weather patterns reduce crop yields?
* More drought
* More heat waves
48
How does impacts on plant biology reduce crop yield? [3]
* Reductions in pollination
* Reductions in photosynthesis
* Increases in dehydration
49
What is the difference between mitigation strategies and adaptation strategies?
50
Describe sustainable diets as a strategy to mitigate climate change.
* Low environmental impacts
* Nutritionally adequate
* Safe and healthy
* Culturally acceptable
* Accessible
* Affordable
* Consuming a 'sustainble diet' reduces GHG emissions and can result in substantial personal health benefits
51
Give 3 reasons we should reduce meat consumption.
1. Meat production is an inefficient use of land and water and drives deforestation
2. Livestock production is responsible for a significant proportion of greenhouse gas emissions
3. Overconsumption of meat has negative health consequences (e.g., diet high in red and processed meats is associated with higher rates of cancer, obesity, diabetes…)
| BUT, meat is a good source of heme iron, zinc, B12, and protein.
## Footnote
Also, livestock provide livelihood and food security for almost 1 billion people worldwide
52
Describe how malnutrition can confer greater risk of disease. (e.g., from COVID-19).
* **Undernutrition**: weakened immune system may increase risk and severity of infection
* **Overnutrition**: poor metabolic health (e.g., obesity, type 2 diabetes) associated with worse health outcomes (e.g., hospitliziation and death)
53
Aside from malnutrition, what other factors affect how COVID-19 does not treat people equally?
* People who already experience inequality are more affected by both the virus and the strategies implemented to contain its spread.
* Factors:
* Poverty
* Conflict (displacement)
* Fragile states (not as resilient)
* Minorities
* Marginalization
* Women and children
54
Describe how COVID-19 exposes the vulnerability and weaknesses of our already fragile food system.
* Our food system is already challenged by climate change
* In some areas, strategies to contain the virus has caused food shortages and lack of of access to nutrition support services that many marginalized groups rely upon
55
Describe how COVID-19 exposes disparities in healthcare.
* Healthcare capacity varies dramatically throughout the world
* Preventive services (including nutrition) should be better integrated into healthcare
* Healthcare services should address challenges faced by sub-groups at particular risk
56
Describe the way forward in regards to global nutrition in the context of COVID-19.
* Strengthened coordination, alignment, financing, and accountability
* Requires coordination of efforts from national governments and civil society organizations
* Requires political commitment and investment
57
Discuss food waste. [3]
* Approximately 1/3 of all food produced for human consumption is wasted.
* Approximately 30% of the world's agricultural land is used to produce food that is never eaten
* Amount of GHG emissions resulting from food that is produced but not consumed is significant: if food waste was a country, it would be the 3rd highest emitter of GHGs
58
Describe food waste in Canada.
* Canadians waste almost $50 billion of food every year (3% of Canada's 2016 GDP; more than the combined BDP of the world's 32 poorest countries; would feed everyone in Canada for 5 months)
* 21-47% of food waste in Canada occurs in the household
59
What are some strategies to reduce food waste? [6]
* Source reduction
* Feed Hungry People
* Feed Animals
* Industrial Uses
* Composting
* Incineration or Landfill
60
What is the green revolution?
* Increase agricultural production (primarily in the 1960s) via:
* (1) High-yield varieties of cereals (e.g., wheat, rice)
* (2) Irrigation
* (3) Fertilizers (synthetic nitrogen sources)
* (4) Pesticides, Herbicides
61
How has food production changed since the 1950s?
* 1950: world produced 700 million tons of grain from 600 million hectares
* Forty years later: 1.9 billion tons from roughly the same amount of land
* ... an increase of 170%
62
Name 3 benefits of the Green Revolution.
1. Dramatic increases in yields of staple cereal grains
2. Reduced/eliminated need for food imports in some countries
3. Reduction in poverty/hunger in countries affected by Green Revolution - but effects are uneven
63
Describe 6 disadvantages of the Green Revolution.
1. Dependent on fertilizers, irrigation, chemical pesticides, mechanical plowing
2. Environmental effects (e.g., eutrophication)
3. Expensive: poor farmers cannot afford fertilizers, pesticides, machines, and equipment (*e.g., in Bangladesh, necessary nputs cost 60% more than traditional varieties and methods and there is high rates of interest on loans*)
4. Loss of crop diversity; depletion of soil fertility
5. Increasing disparity between rich landowners and tenant farmers
6. Increased yields are not experienced everywhere
64
What is sustainable intensification?
* Sustainable agriculture intensification = more output from same land area while reducing environmental impacts (and considering social, political, and economic factors)
* Produce more, in environmentally sustainable way
* Use resources at a rate that does not exceed Earth's capacity to replace them.
65
What is sustainable production characterized by? [6]
1. Using crop varieties or livestock breeds that produce a lot relative to inputs
2. Avoiding unnecessary external inputs (e.g., human labour, machinery, diesel, gasoline, nitrogen, seeds, irrigation, herbicides, electricity)
3. Using agroecology: nutrient cycling, nitrogen fixation, predation and parasitism
4. Minimizing strategies with negative effects on the environment and/or human health
5. Using human and social capital
6. Minimizing greenhouse gas emissions, water pollution, negative impaccts on biodiversity, etc.
66
What are the three views of aid's role and timeline?
1. Aid as **temporary** : 'Big push' out of poverty traps, cope with short-term crisis and disasters (e.g., humanitarian responses/relief)
2. Aid as **permanent**: Global social safety net, redistribution of some wealth and resources
3. Aid as **distortion**: Distorts markets and causes dependency
67
Compare the timeliness of local/regional procurement (LRP) with transoceanic delivery of food.
LRP: Quicker delivery
Transoceanic: Longer delivery
68
Compare the cost of local/regional procurement (LRP) with transoceanic delivery of food.
LRP: Often cheaper; especially grains and pulses
Transoceanic: Particular items may be cheaper (e.g., fortified oil, corn soy blend)
69
Compare the recipient satisfaction of local/regional procurement (LRP) with transoceanic delivery of food.
LRP: Generally preferred overall (re: quality, storability, texture)
Transoceanic: Preferred on some criteria (re: cleanliness, perceived nutritional quality); measured quality ~same or better
70
Compare the price impacts on local markets of local/regional procurement (LRP) with transoceanic delivery of food.
LRP: Does not appear to have significant impact
Transoceanic: May have negative impacts on local markets
71
Does food aid promote 'dependency' (at household, community, or national level)?
* Dependency occurs if an intervention intended to meet a recipient's current need results in reduced capacity for recipient to meet needs in the future
* Does providing aid discourage self-reliance?
72
Is aid effective?
(Yes, no, maybe)
* Yes: Humanitarian aid saves lives; aid is needed to make progress towards development goals
* Maybe: benefits of aid may be exaggerated; aid may not reach those who need it most
* No: aid increases risk of conflict/war, it promotes corruption, it weakens dependency, it may promote dependence, it undermines social capital
73
Describe why the dependency narrative is not true.
* In one scenario in Karnali
* Farmers grow diverse local crops (diversity has increased in recent years)
* Local grains = 65% of dietary consumption
* Food aid covers: ~20% of total need (an important resource for households with high levels of food insecurity
74
Why is it hard to evaluate the effects of food aid?
* Significant methodological issues exist with most data collected
* Often report on (which may not be generalizable)
* Many confounding variables (unlikely all measured and considered in analysis)
* There is a lag between the intervention (aid) and the outcome to be evaluated (and disagreement on what potential outcomes should be assessed)
75
What are the 5 key principles of the Paris Declaration (2005)?
1. **Ownership**: Developing countries set their own strategies for poverty reduction, improve their institutions and tackle corruption
2. **Alignment**: Donor countries align behind these objectives and use local systems
3. **Harmonization**: Donor countries coordinate, simplify procedures and share information to avoid duplication
4. **Results**: Developing countries and donors shift focus to development results and results get measured
5. **Mutual accountability**: Donors and partners are accountable for development results
76
What is Golden Rice?
* A variety of rice produced through **genetic engineering**
* Added pathway to produce **beta-carotene** (provitamin A)
* Research report first published in Science in 2000
* 2005: Golden Rice 2 variety announced (produces 23 times more beta-carotene than original Golden Rice)
* Not currently available due to 'extreme interpretation of the precautionary principle'.
77
What is the precautionary principle?
"Take no action unless you are certain it will do no harm".
78
Golden Rice could be one way to reduce vitamin A deficiency. Why would we want to reduce vitamin A deficiency?
* Vitamin A deficiency is a pervasive killer of malnourished children and pregnant mothers.
* Each year, at least a half million children and a hundred thousand women go blind or die from VAD because resistance to infection is reduced.
79
Why do some people (and organizations such as Greenpeace) oppose genetically modified organisms (GMOs)?
* Primarily fear of contamination of other crops.
* Once this spread occurs, there's no way to reverse the change.
* Concerned of the long-term impacts on the environment and long-term health of humans because there's no proof they are safe.
80
How much Golden Rice would a person need to eat to reduce the risk for vitamin A deficiency?
A cup of rice a day.
81
If Golden Rice were to be available, what factors would be most important to farmers deciding whether or not to grow it?
* Amount of yield
* Profitability
## Footnote
Golden rice does not measure up; consumer demand may not be there.
82
What are the pros of Golden rice? [4]
* Humanitarian intention
* Would be distributed free
* Easy substitution for regular white rice
* Increases beta-carotene in a **staple food**
83
What are the cons of Golden rice?
* Concerns re: GMO
* Emphasizes reliance on cereal grains; **dietary diversification** would be better
* Yellow colour may not be acceptable
84
What are ethical concerns with the use of GMO crops? [5]
1. Potential harm to human health
2. Potential negative impact on the environment
3. Negative impact on traditional farming
4. Corporate dominance
5. They are 'unnatural'
85
What is a crime against humanity?
* Any of the following acts committed as a part of a widespread of systematic attack directed against any civilian population, with knowledge of the attack:
* Murder
* Extermination
* Enslavement
* Torture
* Other inhuman acts of a similar character intentionally causing great suffering or serious bodily or mental injury
86
What is period poverty?
Refers to lack of access to menstrual products and/or safe hygiene facilities It is estimated to affect ~500 million women and girls worldwide.
87
Describe the Ethiopian Famine of 1983-85.
* A defining event in celebrity engagements with humanitarian causes; "Tonight thank God it's them intsead of you"
* "Band Aid representation of famin [contributed to] a view of humanitarianism in which moral responsibility towards impoverished parts of imagined 'Africa' is based on **pity rather than demand for justice.**
88
Describe the International Declaration of Human Rights (1948).
Everyone has the right to a standard of living adequate for the health and well-being of himself and his family, including food, clothing, housing, and medical care and necessary social services.
89
Describe how children with severe acute malnutrition were treated before RUTFs.
* Hospitalized and fed milk-based diet
* Challenges:
* Required a lot of resources (e.g., in 2002, MSF needed 2000 staff to treat 10,000 children in Angola)
* In-patient treatment difficult for family (hard to leave home for weeks at a time)
* Severely malnourished children prone to infections; spread among children in close quarters.
90
Describe the development of RUTF.
* 1996: Andre Briend (a French pediatric nutritionist working in Malawi) had the idea
* The product that spurred the idea: Nutella
* Developed as a home-based alternative
* Used on a large scale in 2005 to respond to famine in Niger
91
Describe Plumpy'nut.
* 500 kcal
* 25%
* 25% oil
* 25% sugar
* 25% milk powder
* Micronutrients
| Dose: 200kcal/kg/day for 6-8 weeks (~2-3 sachets daily)
92
What are advantages of RUTF?
* Does not require water, cooking, or refrigeration (lasts 2 years without refrigeration)
* Low water content (<2%; discourages microbial growth)
* Can be administered by anyone, anywhere
* Children can be treated at home
* Easy to eat
* Highly palatable
* Very effective
93
Is the formulation of RUTF optimal?
* Successful in promoting weight gain but:
* Effects on mortality and relapse unknown
* We need greater measurement of functional outcomes
94
What is microcredit?
What is the underlying assumption?
* Small loans given to people (or groups for social collateral) living in **poverty** (often remote areas)
* Underlying assumption: poor lack capital to invest in their small businesses; being able to do so would improve success of business and thus their family living standards.
95
How do microloans lead to poverty reduction?
* Access to microfinance
* Invest in future
* Increase income
* Increase education, health, etc.
* Get out of poverty
96
What are 4 impacts of microfinance that have been on food security and nutrition?
* Does not appear to impact meal quantity but does improve meal quality
* Increase in meat consumption in Tanzania, Zimbabwe and Rwanda, increase fish consumption in Zanzibar
* Generally, improvements in diet quality of household observed if microcredit client was female but not if client was male
* Farms receiving microcredit loans have average income 9.5% higher and are 1% more efficient
97
Describe why microcredit loans are not always a good thing.
* Mixed impacts on income
* Some people are made poorer
* Appears to negatively impact clients' children's education (does not seem to increase child labour)
* Loans should target entrepreneurs rather than the 'poorest of the poor'
## Footnote
Impacts are context-specific. Do not assume benefits.
