chap3: defining malnutrition

variety is essential in proteins

- 20 amino acids that make up the building blocks for all proteins used by humans - 9 essential amino acids cannot be made by the body (must be found in diet)

PCM or PEM or undernutrition

- Protein-Calorie Malnutrition/Protein-Energy Malnutrition - fatal nutritional disorders: kwashiorkor and marasmus

complete protein

- a food that contains all 9 essential amino acids in sufficient concentrations to meet human needs - animal products (meat, milk, eggs) are complete proteins - plant products (cereals, legumes) are missing 1 or more of the essential amino acids or contain the acid in too low a concentration - BUT you can obtain complete proteins by eating different types of grain and vegetable products

zinc deficiency

- affects child growth, causes diarrhea and difficulty absorbing other micronutrients - causes impaired immune system, making the person more susceptible to disease

B vitamins deficiency

- beri-beri: symptoms include lethargy and fatigue, a thiamin (B vitamin) deficiency from eating only polished rice - pellagra: symptoms include dermatitis, skin lesions, weakness and mental confusion, a niacin (B vitamin) deficiency from eating corn that has been prepared in ways that either remove niacin or make it nutritionally unavailable

iodine deficiency

- causes goiter and leads to a reduction in mental abilities - babies born to iodine deficient mothers can suffer from "cretinism" which can result in learning disabilities in children - even mild iodine deficiency can reduce IQ by 10-15 pts. - iodine deficiency is the greatest single cause of preventable brain damage and mental retardation - 1/3 of the world's population lives in iodine deficient environments

marasmus

- condition of both protein and calorie deficiency - Greek word for "wasting away" / low body weight - as daily food intake is inadequate to meet requirements for protein and calories, the body beings to use reserves stored in the fat cells, as those reserves are used up the person enters the end stages of starvation

Estimated Average Requirement (EAR)

- daily intake amount that will be adequate for half the individuals in the group - always lower than RDA

fallacy of adding up grams of protein in the diet

- deficiency in 1 or more of the 9 essential amino acids leads to a deficient diet - sufficient protein does not ensure sufficient calories (60 grams of pure protein yields 224.6 calories)

vitamin C

- ex: foods such as fruits and veggies - scurvy: results from a deficiency of vitamin C (which is required for the synthesis of collagen in humans)

polishing

- grains = husk, bran, endosperm, and germ - husk is removed bc it is inedible - removing the bran and germ (polishing) reduces the variety of vitamins and proteins in the grains - polished grains taste better, but have a lower variety of nutrients - if you have a narrow diet lacking in veggies and other proteins, then polishing can cause micronutrient malnutrition

The "overview" to the World Development Report for 2004 states that Clients can play two roles in strengthening service delivery. These two roles are:

- help tailor the service to their needs - be effective monitors of providers

secondary malnutrition

- illness that prevents proper digestion or absorption of food - it is called "secondary" bc it does not result directly from the nature of the diet (as do other types of malnutrition) - loss of appetite: anorexia - diversion of nutrients to parasitic agent: tapeworms robs the body of nutrients it would have otherwise obtained - diarrhea: importance of safe drinking water

calorie deficiency appears to be a bigger problem than protein deficiency

- in its food balance sheet FAO showed that in Africa, food available per capita would provide 2,618 calories and 69 grams of protein per person per day in 2011. - the available proteins are substantially higher than the requirements for all groups, but available calories are lower than the requirements for most adult men

A country can become eligible to receive assistance from the Millenium Challenge Corporation (MCC) only if:

- it is committed to investing in its own citizens - it is committed to good governance - it is committed to economic freedom

vitamin A deficiency

- night-blindness, death from respiratory and gastro-intestinal disease - 1 study suggests that vitamin A supplements could reduce deaths of children age 6 mo. to 5 yrs. by 23% - also plays a role in maintaining the immune system and in fighting cancer

proteins and calories

- nutrients that we get almost exclusively from food (can't come from any supplements or fortification) - therefore: under-consumption of proteins and calories is a problem related to food shortage

calories

- nutritional role: body gains energy contained in food (carbohydrates and fats) and uses it to provide energy for various needs: - involuntary functions, physical activity, mental activity, fighting disease, and growth - source: transform solar energy into human energy, photosynthesis in plants

protein

- nutritional role: building cells that make up muscles, membranes, cartilage, hair, carry oxygen around the body, carry nutrients into and out of cells and help assimilate food, contribute development of antibodies that fight disease, work as enzymes to speed up digestive process - source: getting nitrogen into the chemical equation through nitrogen fixing bacteria, lightning storms, and sea algae

scurvy

- often presents itself initially as symptoms of malaise and lethargy, then formation of spot on skin, spongy gums, and bleeding from the mucous membranes - spots are most abundant on the thighs and legs - person looks pale, feels depressed, and is partially immobilized - as it advances, there can be open, suppurating wounds, loss of teeth, jaundice, fever, and death - once common among sailors

rickets

- origin: to twist - symptoms: muscle weakness, increased tendency for fractures (easily broken bones) - predominant cause is a vitamin D deficiency, but lack of adequate calcium in the diet may also lead to rickets (severe diarrhea and vomiting may be the cause of the deficiency)

This course will focus primarily on protein-calorie malnutrition rather than on micronutrient malnutrition. Why is this the case?

- protein-calorie malnutrition affects more people than micronutrient malnutrition, by itself. - protein-calorie malnutrition can only be addressed by increasing the quantity of food eaten, which requires more food to be produced - micronutrients can be added to people's diets without requiring significant additional production of food - Nutrients can be added to the diet with small changes in the way people eat food, they can be added in fortified foods and they are added automatically when people get wealthier. - Protein-calorie malnutrition, on the other hand can only be address by significant increases in the quantity of food eaten.

vitamin D deficiency

- rickets: softening of bones in children due to deficiency or impaired metabolism of vitamin D - potentially leading to fractures and skeletal deformity - among the most frequent childhood diseases in many developing countries - majority of cases occur in children suffering from severe malnutrition (usually resulting from famine or starvation during the early stages of childhood) - vitamin D is important in fighting cancer, diabetes, and heart disease

Which of the following famines was not caused or made worse by failed government policies

- was not: the recent famine in Zambia - was: the recent famine in Zimbabwe, the Irish Potato Famine, the North Korean Famine, and the Chinese 'Great Leap Forward Famine'

iron deficiency

-anemia - causes tiredness, reduced capacity to work, increased susceptibility to infection, diminished ability to learn - severely anaemic women are 4x more likely to die during pregnancy

the body needs to have a balance among the 9 essential amino acids...

...and in correct proportions in order to produce proteins necessary for life

6 categories of nutrients

1. carbohydrates 2. fat 3. proteins 4. vitamins 5. minerals 6. water

the major 3 micronutrient dietary deficiencies

1. iodine deficiency 2. vitamin A deficiency 3. iron deficiency

recent findings about how to reduce micronutrient undernutrition:

1. iron deficiency is rare in Ethiopia bc the dietary staple (Teff) is threshed by beating it on the ground and the soil is iron rich 2. Canadian scientists have developed a way to fortify salt with both iron and iodine 3. in Tanzania, scientists are experimenting with a fortified kool-aid for children 4. crops that are specifically bred to contain micronutrients (ex: golden rice)

4 classifications of malnutrition

1. over-nutrition 2. dietary deficiency / micronutrient malnutrition 3. secondary malnutrition 4. protein-calorie malnutrition (undernutrition)

solutions to micronutrient malnutrition

1. vitamin supplements 2. food fortification - adding micronutrients to foods 3. dietary diversity 4. general improvements in health 5. reduction in poverty 6. knowlege

what is the recommended daily intake of calories for the average American?

2,618 for men 1,877 for women - these numbers combine the numbers for both active and inactive people of all ages - these numbers are not very useful for an individual decision

"We have the capacity, let us get it done"

Jeff Sachs

"We should concentrate our efforts only in those countries that are already serous about eliminating poverty"

Presidents Bush and Obama / the Millennium Challenge Corporation

"We should concentrate on the types of programs that we know work"

William Easterly / The World Bank

nutrient

any substance obtained from food that contributes to mental or physical health or growth

If you consume more amino acids than you need, your body will

burn the extra amino acids for energy

protein deficiency is a more widespread problem than calorie deficiency (T/F)

false

PCM can only be solved by

increasing amount of food eaten by an individual

malnutrition

over or under consumption of any essential nutrient

describe how diarrhea and secondary malnutrition are linked

prevention of nutrient absorption: diarrheal infections irritate the lining of the gastrointestinal tract, creating difficulty in absorbing nutrients at the same time causing it to shed contents before digesting has had time to occur

protein or calories - what's the difference?

proteins contain calories, and both calories and proteins are macronutrients

kwashiorkor

results from protein deficiency, usually as a child is weaned from breast milk (which provides adequate protein to newborns) - swollen bellies, or edema, and depigmentation of hair (black hair turns reddish)

Recommended Daily Allowance (RDA)

shows the nutrient level at which 97-98% of the group will be adequately nourished - useful as targets for an individual: an individual who gets his or her RDA of a nutrient can be quite confident of obtaining an adequate level of that nutrient - but they aren not appropriate as a targets for the average intake of a group

The Law of Conservation of Energy states that energy can neither be created nor destroyed, it only changes form. If I attach a generator to a stationary bicycle, I can (by pedaling) light up a light bulb; I am not creating energy, but I am transforming energy of one form (muscular energy) into energy of another form (electrical energy). The muscular energy I used is derived from the calories in the food I eat. What is the original energy source in the food we eat?

the sun that the plants used for its photosynthesis process

protein-calorie malnutrition is a major source of nutrition-related disease (T/F)

true

Proteins from the following source tend to be deficient in at least one of the essential amino acids

vegetables