Study Guide 12 Malnutrition

overnutrition - Energy intake in excess of energy use leads to an overweight and obese population toxicity

- Obesity is a form of this malnutrition -an obese population is caused by: - Overconsumption of micronutrients may lead to __ - Worldwide obesity is increasing alarmingly

• Nutrition Paradox-Public health problem characterized by the coexistence of undernutrition (stunting) and obesity in the same region, same household, even the same person activity transportation energy micronutrients fiber

- What is the nutrition paradox? - Common in countries transitioning from the very poorest to the middle range of gross national income (Mexico, South America, India, and China) - Key factors: • Trend toward decreased physical __, changing modes of __and urbanization • Global dietary shift toward increased intake of __-dense foods high in fat and sugars but low in __and __

undernutrition wasting height severe acute growth

1. Lack of adequate energy to support optimal growth in children or to maintain a healthy, active body in adults. Results in __, which is a Very low body-weight-for-__or extreme thinness - A hallmark of __ __ malnutrition (SAM) - Examples: Marasmus, Kwashiorkor, poor appetite (cancer or AIDS patients), anorexia nervosa, those with too little to eat, etc Also results in Stunted __ - Shorter than expected for an individual's chronological age; chronically undernourished

overgrazing cash subsistence local

Causes of Undernutrition • Agricultural Practies - Deforestation - __of livestock - Crop rotation - Use of agricultural land for __crops (cofon, coffee, tobacco) replaces __crops (sorghum and corn) • Less food available for __consumption • Large landholders pay insufficient wages

healthcare poverty food poor biases men boys religion

Causes of Undernutrition • Impact of Disease - Disease and lack of __to fight disease reduce the work capacity - Reduced ability to ward off __and malnutrition - Example: AIDS epidemic • Unequal distribtion of __ - Rural __ - Cultural __ • Limited food distributed first to __and __ • Nutrition services primarily directed toward pregnant and lactating women, infants, and young children • Access can differ by ethnicity and __

transportation refrigeration drinking sanitation education

Causes of Undernutrition • Lack of infrastructure - Roads and __ - Electricity and __ - Water management: irrigation, safe __water, sewage systems - __services - Communication systems - Healthcare delivery system - Public __

insufficient climates high imported slow education production

Causes of Undernutrition • Overpopulation - Resources are __to support the number of people living there - Common in arid __, areas with __birth rates, poor access to __foods, seasonal and chronic food shortages - Improve food/population ratio: • __population growth to reduce birth rates - Improve __of women and girls - Increase food __, food importation

protein energy weight muscle subcutaneous edema blood growth sores proetin energy immune

Kwashiorkor Results from inadequate __ and lower __ intake. Symptoms: -some __ loss and __ wasting -maintenance of some __ fat tissue -__ results in abdominal distention from lack of __ proteins -retarded __ and developemt -development of __ and skin problems -may be reversed if adequate __ and __ in a given time -many die due to weekened __ system

protein calories skin and bones muscle subcutaneous physical brain anemia dehydration heart infection

Marasmus -results from inadequate __ and __ Symptoms -Appearance-"__" -wasting of __ tissue -little __ fat -stunted __ and __ growth/development -__ Death can occur from __, __ failure, or __

famine droughts

Potential Solutions to Malnutrition • Global solutions to malnutrition - United Nations Millennium Development Goals (MDGs) • Eradication of extreme poverty and hunger - Short-‐‐term initiatives to prevent __after natural disasters and in war-torn regions • Monitor __, floods, other problems - Long-term initiatives such as a "global partnership for development"

mortality physical intellectual developing lactating 3

Protein-Energy Malnutrition (PEM) • Consequences - Increased __(infectious diseases) - Impaired __growth - Impaired __maturation - Reduced work capacity • Exists today - Developing countries • Pregnant and lactating women, infants, children < __ years old - Developed countries • Children/adults with Cerebral Palsy, institutionalized patients, elderly, alcoholics, those with AIDS, eating disorders, and other terminal illnesses, trained athletes, hospitalized patients (long-‐‐term IV tube feeds), etc

: inability to obtain enough energy and nutrients to meet daily needs patterns money food production and imports are insufficient to meet the needs of the population in that area

What is Food insecurity? • Very low food insecurity: normal eating __are disrupted and food intake reduced due to insufficient __or other food resources - What are Food shortages?

- Obesity more prevalent in low-income populations reduction energy cost satiety environment stress resources hormones metabolism

What is the Poverty-Obesity Paradox - Studies that followed children of lower income over time saw that a __ in income during early childhood increased child's risk of becoming overweight or obese - 4 hypotheses being studied: • Low income populations purchased __-dense food w/longer shelf lives due to __of foods • Low income populations select energy-dense foods for high __ • Diets may reflect their __: food deserts and less walkability in their neighborhoods • Link between obesity and poverty may be explained by __; caused by insufficient __; chronic stress results in release of stress __> that slow __, increase appetite, etc

Protein Energy Malnutrition Marasmus Kwashiorkor

What is the disorder caused by inadequate intake of protein and energy (kcal) What are the two common forms?

malnutrition undernutrition, nutrient deficiency, overnutrition

a state of poor nutritional health that can be improved by adjustments in nutrient intake - Contributor to high infant mortality rates, poor childhood growth, and diminished work capacity in adults worldwide -three types

famines climate food harvesting

• Causes (less access to nourishing foods) - __: severe foodshortages - Natural disasters: floods, droughts, weather events - Major __events - Wars may induce acute __shortages or access to planting, __, options, etc

prenatal brain salt thyroid oxygen metabolic protein

• Iodine - Deficiency • __iodine is critical for fetal __development • Mild deficits in school-age children impair __performance, retard __development • Occurrences have been greatly reduced in areas where iodine added to __or oil, or to irrigation water - Functions • Essential constituent of __hormones that regulate __use, basic __rate, __synthesis, and thermogenesis - Prevention • Universal salt iodization, such as in the U.S. • Planning, educating, implementing

breastfeeding infectious distribution

• Local solutions - Programs to encourage __ - Programs to combat __ disease • GOBI: UNICEF campaign to eliminate common childhood infections via simple but effective strategies - Programs to promote equitable food __

20 iron iodine vitamin A

• Major Micronutrient Deficiencies - Up to __% of the world population is deficient in at least one micronutrient - It is the "hidden hunger" - Most prevalent global micronutrient deficiencies: __, __ and __

cardiovascular 2 cancers healthcare

• Overnutrition and health implications - Obesity increases chronic disease risks: __disease, type __diabetes, certain __ - Worldwide obesity is increasing alarmingly - Global burden of diabetes is huge: lives lost, __costs, work absenteeism, reduced productivity, and lost productive capacity due to early death

production organic local energy energy warming activity

• Promote food equity and preserve the environment - Influence local and global markets - Personal food choices (vegetables, fruits, nuts, whole grains, and beans) influence greater __ of these healthful foods - Buying __reduces use of chemical pesticides and herbicides - Buying __reduces costs and resources for distribution, transportation, and storage - Avoid __-dense, nutrient-poor choices - Avoid overconsumption - Plant foods: main source of diet to preserve __, reduce global __ - Physical __ is important in maintaining health and combating overnutrition

developed high sustainable

• Technological strategies - Green Revolution: increase productivity of __land while keeping environmental quality • Support the creation of __-yield grain varieties - __agriculture techniques - Transgenic crops (GMOs); still controversial

Iron 50 women, infants, children cofactor

• The most common micronutrient deficiency in the world; considered an epidemic • this deficiency is cause of ~__% of world's anemia Who is at the highest risk? - Functions • Oxygen transport • __for 200+ enzymes involved in cellular transportation, division, neurotransmission, immunity, and growth - Prevention • Increase __-rich food sources or use cast iron pan • Iron supplementation with "Sprinkles" - Lipid encapsulated iron in powder form

work weakness manual micronutrient oxygen cognitive

• Undernutrition and health implications - Decreased __productivity • Debilitating __from undernutrition affects productivity • Detrimental in __labor: subsistence farming is the main source of food/income • __deficiency contributes to poor work capacity and productivity: - Iron deficiency anemia reduces __transport - Deficiencies impair __and growth development • Protein/calorie malnutrition • Nutrients for growth and development: iron, iodine, and vitamin A

infection infection energy immune appetite diarrhea malnutrition

• Undernutrition and health implications - Underweight population • Suffers more acute __and long term health problems • Cycle of malnutrition and __ - Decreased resistance to infection • Reduced __reserves and weakened __response • Infection exacerbates malnutrition: reduces __; causes vomitng, __, and weight loss • Vicious cycle of __and infection: childhood diseases, HIV/AIDS

• Malnutrition during fetal development contributes to obesity and chronic disease in adulthood when food is plentiful mortality

• Undernutrition and health implications - What is the "Fetal Origins Theory" • The early imbalance results in metabolic disease later in life - Increased __rates • Neonatal • Infant • Pregnancy

40 blindness infection visual grains

• Vitamin A - Deficiency • Affects over __% of children under age 5 in the West and Central Africa • Leading cause of __in children - Due to greater vulnerability to severe __, such children are at high risk for death - Functions • Role in __cycle, cell proliferation, and cell differentiation - Prevention • Vitamin A capsules monthly for 6 month period • Food fortification by adding to food staples such as __• Increase consumption of foods high in vitamin A (if available)

nutrient deficiency undernutrition vitamins excess single foods fortification

• When one or more essential nutrient is inadequate in the diet • Prolonged __prompts one or more deficiencies • Poor-quality diet can supply ample energy (calories) but inadequate __and minerals - Scurvy, pellagra, goiter, rickets, and night blindness in developed countries often stem from inadequate selection from available foods and supplements - Nutrient Toxicity • Associated with __ consumption of one or more nutrients • May occur with mega doses of a __-micronutrient supplements - Nutrient deficiency may be treated • Eating a variety of __available to most people • __to prevent deficiency disease