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Today. Vitamins, minerals, & deficiency diseases Synergies between nutrition & disease Especially vulnerable populations 4 faces of hunger. Contemporary acute deficiency diseases: Iron. Iron deficiency : Most common single nutrient deficiency in the world

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Today l.jpg

  • Vitamins, minerals, & deficiency diseases

  • Synergies between nutrition & disease

  • Especially vulnerable populations

  • 4 faces of hunger

Contemporary acute deficiency diseases iron l.jpg
Contemporary acute deficiency diseases: Iron

  • Iron deficiency:

    • Most common single nutrient deficiency in the world

      • > 1/3 of pop in many developing countries

    • Reduces cognitive performance, energy and work ability, and resistance to infection (especially to diarrheal and respiratory diseases) even in mild cases

    • Severe forms = anemia

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Contemporary acute deficiency diseases: Iodine

  • Iodine deficiency:

    • Iodine is lacking in soils from some mountain areas and in domr highly leached soils

      • e,.g., Andes, Himalayas, C Africa, SE Asia...

    • Major consequences:

      • Swelling of thyroid (goiter)

      • Important mental deficiencies (cretinism) in kids if deficient in pregnant women

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Contemporary acute deficiency diseases: Vitamin A

  • Vitamin A deficiency:

    • Major consequences

      • To vision can lead to blindness

      • Also decreased immune function

      • Kids with severe protein-calorie malnutrition often have impaired sight as a result of this

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Synergy: nutrition and disease

  • Poor nutrition (protein-calorie or other nutrient shortages) => reduced ability to fend off new infections or makes existing ones more severe

  • Diseases interfere with nutrient absorption and/or actively deplete nutrients from our bodies

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How poor nutrition => disease

  • Reduction in the body's innate immunities (that react to general patterns of proteins in pathogens)

    • Less effective phagocytosis (process by which microorganisms are engulfed and encapsulated)

    • Weakened epithelial barriers (protective coverings on body surfaces inside and out)

    • Lowered lysozyme production (a bodily protein that functions as an antibacterial)

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How poor nutrition => disease II

  • Reduction in ability to generate acquired immunities - the specific immunities one acquires to a particular disease pathogen

    • Reduced production of humoral antibodies

    • Impaired cell-mediated immunity

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How disease => poor nutrition

  • Most infections interfere with the body's ability to absorb nutrition and/or actively deplete nutrients

    • Reduced appetite

    • Poorer quality of diet ingested

    • Diseases deplete bodily tissue

    • Fevers => increased metabolic rate thus, the body needs more kcal but they may not be there

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Special case of GI tract diseases

  • 1.8 billion cases/yr of infant/weanling GI diseases

  • Predominantly diarrheas, but also intestinal parasites, cholera, & various types of dysentery

    • Impede absorption of nutrients (diarrheas just don't let food sit in gut long enough)

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Special case of GI tract diseases II

  • Many if not most deaths (perhaps 1 million/ yr in the world) can be averted with adequate treatment (called Oral Rehydration Therapy)

    • According to The Lancet (1978), ORT is "potentially the most important medical discovery of the 20th century"

    • Clean water with 60 cent packets of salts/sugars to recover health

    • Full recovery => increased nutrition above basic levels – often hard to get

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Oral Rehydration Therapy

(packet for addition to water)

Oral Rehydration Therapy

(home made)

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Especially vulnerable populations I

  • Increased likelihood of malnutrition and more serious consequences

  • Women in general due to cultural traditions that privilege food to males

  • Pregnant women

    • Poor nutrition => low birth weight babies

    • Developmental problems for baby physically and mentally

    • Reduced resistance to diseases

    • Less able to breast feed (=> less resistance for the baby as well)

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Especially vulnerable populations II

  • Lactating women

    • Poor nutrition seldom greatly interferes with ability to produce milk

    • But, poor nutrition does deplete the mother's body of necessary nutrients

    • If nutrition is not better between end of lactation and next pregnancy => spiral down to chronic anemia etc.

  • Elderly

    • Ability to fend off infections is reduced with great age and malnutrition hurts that as well

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Especially vulnerable populations III

  • Children

    • Malnutrition in infants and children very problematic if timing coincides with critical growth processes

      • Up to age 5 risk is greatest

    • Especially at weaning age (approx 2 yrs)

    • Due to impure water used to make weaning foods (not sufficiently boiled due to lack of fuel) and general low hygiene =>

      • Kids die from diarrheal diseases and dehydration and malnutrition

    • Weaning foods are typically not nutrient-rich enough (e.g., maize gruels)

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Four Faces of Hunger I

  • I. Starvation/Famine

    • Widespread to complete lack of protein/calorie nutrition

    • A small percentage of global hunger – perhaps 1% at risk annually

    • Leads to increased mortality (usually to infectious diseases not starvation per se)

    • Great social disruption => increased problems with diseases and access to food

    • In any famine not all starve – the well off can buy food -- thus NOT usually only a simple shortage

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Four Faces of Hunger II

  • II. Malnutrition/Undernutrition

    • Seasonal or periodic P/C under-nutrition

    • Most serious effects on kids and special needs adults (pregnant and lactating women, the elderly)

    • measures of malnutrition in children

      • Stunting - stature too short for age/sex (adjusted for local norms) => chronic

      • Wasting – weight too light for age/sex (adjusted for local norms) => acute

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Four Faces of Hunger III

  • III. Micro-nutrient deficiencies

    • Vitamin and mineral shortages

    • Sometimes called “hidden hunger”

  • IV. Nutrition-depleting illnesses

    • Secondary malnutrition

    • Most common nutrient depleting diseases are infant/weanling diarrheas – 5 million deaths annually world wide

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Global Hunger

  • Global situation late 1990s

  • Data drawn from FAO’s SOFA report 2007


  • The International Food Policy Research Institute:


  • The concept of “food security”

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Global Trajectories of Hunger I

  • Proportions undernourished (or food insecure)

    • Late 1970s ~ 28%

    • Late 1990s ~17%

    • Thus, some real progress

    • Less progress in absolute numbers

  • Micro-nutrient deficiencies

    • Iron: 40% of global south

    • Iodine: 12% of global south

    • Vitamin A: 14% of kids in global south

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Global Trajectories of Hunger II

  • Absolute numbers undernourished (or food insecure)

    • 1970s ~ 900m; 2000 ~ > 800 m

    • => decrease of ~ 100m in absolute numbers (but smaller %)

  • Children 1993 ~ 200 m; now ~ 175 m

  • World food summit target (MDG) in 2015 => 400m

    • Current trajectory => 475-500m by 2015

    • Progress in some places, regression in others

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Regional differences malnourished or food insecure

  • Global South

    • Sub-Saharan Africa

    • E. Asia, SE Asia, & Pacific

    • South Asia

    • Latin America & Caribbean

    • Near East & N. Africa

  • Developed Economies (mostly N America)