Chapter 8: Nutrition and Global Health

Adults

Nutritional Status -Underweight: BMI is less than 18.5 -Normal weight: BMI is 18.5 to 25 -Overweight: BMI is greater than 25 -Obese: BMI is greater than 30

Infancy and Young Childhood (Nutritional Needs Throughout the Life Cycle)

-"Window of opportunity" is conception to 2 years of age -Nutritional gaps during this time can cause problems with stature and mental development, and frequent infection -Children need sufficient protein, energy, and fats as well as iodine, iron, vitamin A, and zinc -Grow best and stay healthiest if exclusively breastfed

Overweight and Obesity (Key Nutritional Needs)

-A balanced, healthy diet is crucial for the prevention of obesity and non-communicable diseases -Basic components to a healthy diet: vegetables, fruits, whole grains, legumes, and nuts, with limited amounts of red and processed meat -Various dietary components are playing a large role in the growth of global obesity and overweight

Overweight and Obesity (Nutrition, Health, and Economic Development)

-Associated with comorbidities have high medical costs that can trap poor households in cycles of debt and illness -Affect worker productivity -Affect mental health, especially harmful to the academic achievement of children and adolescents

Birthweight

A child has a low birth rate

Height for age

A child is stunted if it's height age is two z-score below the international reference height for age

Weight for Age

A child is underweight if its weight is two z-scores below the international reference weight for age

Low Birthweight

Babies born under 2,500 grams

Overwight

Excess weight relative to height; commonly measured by BMI among adults. The international reference for adults is as follows: -25-29.99 for grade I (overweight) -30-39,99 for grade II (obese) ->40 for grade III -For children, overweight is measured as weight-for-height two z-scores above the international reference

3 million

How many deaths each year can be attributed to nutrition-related causes for children under 5

Underweight

Low weight for age

1980

Obesity has nearly doubled worldwide since what year?

Malnutrition

Refers to those who do not get proper nutrition (whether too little, too much, or the wrong kind)

Undernutrition

The three most commonly used indexes for child undernutrition are: height-for-age, weight for age, and weight for height

United States

What country has the highest proportion of the world's obese people? (13%)

Childhood Obesity

What has emerged as one of the most serious public health challenges of the 21st century?

The Determinants of Nutritional Status: Overweight and Obesity

-Most immediate cause is an increase in total energy intake coupled with a decrease in energy expenditure -Genetic and cultural factors are inportant -Rising global rate of obesity is being driven by global financial and trade liberalization, increased income and socioeconomic status, and urbanization

Gauging Nutritional Status

-Nutritional status of infants and children is gauged by measuring and weighing them, then plotting weight and height on a growth chart -Child's position on growth curve indicates whether growth is normal -Large share of nutritional deficits are mild, but still have negative consequences on development

Added Sugars (Key Nutritional Needs)

-Overconsumption provides large amounts of energy without supplying specific nutrients -The consumption of sugar-sweetened beverages (SSBs) in particular has been scientifically shown to promote weight gain, type 2 diabetes, and coronary heart disease -Adults who drink one SSB or more per day are 27% more likely to be overweight or obese

Undernutrition (Nutritional State of the World)

-The rate of underweight in children younger than 5 years of age in low- and middle- income countries fell from about 28% in 1990 to about 17% in 2011 -However, still about 100 million children globally suffer from moderate or severe underweight, about 165 million are stunted, and more than 50 million are wasted

The Needs of Young Children and Pregnant Women

-Undernourishment raises the risk of illness, associated with decreased intellectual capacity -Malnourished children who rapidly gain weight are at high risk of nutrition-related chronic diseases as adults -Undernourished women have greatly increased risks of dying of pregnancy-related causes

Addressing Future Nutrition Challenges

-Policy makers need to understand the exceptional importance of nutrition to health and human productivity and act accordingly -Governments need to work with the food industry to improve the way in which foods are fortified and to be sure that processed foods are healthy -Further research on what works -Create partnerships of civil society, government, and the private sector -Nutrition-specific interventions-those interventions that can have a direct impact on nutrition -Examples: promotion of exclusive breastfeeding, micronutrient supplementation, and food fortification -The enabling environment for nutrition-this concerns laws, policies, resources, and institutional issues that relate to the approach countries take to nutrition and how effective they are at formulating, implementing, and monitoring nutrition interventions

Pregnancy and Birthweight (Nutritional Needs Throughout the life cycle)

-Pregnant women need a sufficient amount of protein and energy and should consume 300 more calories a day -iron, iodine, folate, zinc, and calcium are also important to the health of the women and child -The birthweight of a baby is an extremely important determinant of the extent to which a child will thrive and become a healthy adult

Fats (Key Nutritional Needs)

-Saturated and trans fats have been shown to be harmful to cardiovascular health by raising cholesterol levels -Saturated and trans fats are found largely in red meat and dairy products; trans fats are also prominent in processed foods made with partially hydrogenated oils, used to extend shelf life

Sodium (Key Nutritional Needs)

-Sodium is found in high quantities in restaurant and processed foods -High sodium intake can lead to hypertension, which is a major risk factor for stroke and fatal coronary heart disease -Evidence suggests that sodium intake should be limited to 1.7 grams per day (less than 5 grams of salt a day)

Dietary Fiber and Refined Carbohydrates (Key Nutritional Needs)

-Sources of dietary fiber include whole grains, legumes, fruits, and vegetables -Dietary fiber helps prevent obesity, diabetes, cardiovascular diseases, and various cancer -Whole grains are often processed to produce refined carbohydrates, which removes the majority of the fibers and other nutrients

Adolescence (Nutritional Needs throughout the life cycle)

-Adolescents need protein and energy to grow, as well as iron, iodine, folic acid, and calcium -Adolescent girls who are poorly nourished are much more likely to give birth to an underweight child and experience complications during pregnancy than well-nourished girls -Children who are stunted are generally unable to make up later for their retarded growth

Adulthood and Old Age (Nutritional Needs Throughout the Life Cycle)

-Adults need a well-balanced diet with protein, energy, and iron in order to stay productive -Foods that contain too much fat, cholesterol, sugar, or salt can be harmful -The ability of older people to live on their own can depend on their nutritional status -Older adults need calcium to reduce of osteoporosis

Zinc

-Best sources in red and white meat, and shellfish -Severe deficiency is associated with growth retardation, impaired immune function, skin disorders, hypogonadism, and cognitive dysfunction -Deficiency is a major risk factor for morbidity from diarrhea, pneumonia, and malaria

Folic Acid and Calcium

-Folic acid is primarily found in leafy green vegetables and in enriched products, such as flour -Calcium is generally found in dairy products -Deficiencies of folic acid in pregnant women are associated with neural tube defects in their children, such as spina bifida

Iodine

-Found in some types of seafood and in plants that are grown in soil that naturally contains iodine -Deficiency associated with a growth on the thyroid called a goiter and the failure to develop full intellectual potential -Often occurs in people who live in mountainous regions where less seafood is consumed and the soil is deficient in iodine

Iron

-Found most easily in fish, meat, poultry; also in fruits, grains, vegetables, nuts, and dried beans -Lack of iron associated with iron deficiency anemia, associated with fatigue and weakness -Iron-deficient pregnant women have an increased risk of giving birth to a premature or low birth-weight baby, or hemorrhaging and dying in childbirth

Vitamin A

-Found mostly in green leafy vegetables, yellow and orange fruits that are not citrus, and carrots -Deficiency associated with xerophthalmia, eventually can lead to permanent blindness -Important to growth and proper functioning of immune system; can impact severity of illness and chance of survival of pneumonia, diarrhea, and measles

Poor Nutrition (Nutrition, Health, and Economic Development)

-Impacts maternal health, which affects household income and survival and health status of children -Affects children's ability to grow or achieve full intellectual capacity, impacting future prospects -Leads to lower productivity in adult workers -Impacts life expectancy

Immediate Causes to Undernutrition

-Inadequate dietary intake: weakens the body and opens it up to infection -Illness: make it harder for people to eat, absorb the nutrients they take in, and raises the need for some nutrients -Relationship creates a cycle of illness and infection -The lack of safe water and sanitation are important causes of diarrheal disease, and therefore contribute to the cycle of infection and malnutrition -Made worse when food is handled in unhygienic ways -Children susceptible to worm infection, making it harder to absorb nutrients

Stunting

Failure to reach linear growth potential because of inadequate nutrition or poor health

Wasting

Weight, measured in kilograms, divided by height in meters squared, that is two z-scores below the internation reference

diarrhea, pneumonia, measles, communicable diseases

What are illnesses that contribute to the risk factor for death from other causes?

Noncommunicable disease

What is overweight and obesity closely linked with?

Eradicate Poverty and Hunger

What is the Millennium Development Goal #1?

Underweight

What is the leading risk factor for death of children under 5 globally?

45%

What percent of all deaths in children under 5 are attributable to nutritional related causes?

30%

What percent of the world's population is overweight or obese? (Most of these people are in low and middle income countries)