Malnutrition
Sources:
The World Food Problem
Leathers & Foster, 2009
The Omnivore’s Dilemma
Michael Pollan, 2006
http://www.amazon.com/World-Food-Problem-Toward-
Undernutrition/dp/1588266389
Malnutrition
• Undernutrition
– Lack of nutrients
• Calories
• Protein
• Micronutrients
– Low income countries
• Overnutrition
– Obesity
• Too many calories
– High and middle income
countries
http://i105.photobucket.com/albums/m203/sspasha/Malnutrition.jpg
Undernutrition
• Undernutrition
– Secondary
Malnutrition
– Micronutrient
Malnutrition
– Protein Energy
Malnutrition
• Most important
Severe Protein
Energy Malnutrition
http://www.bio.davidson.edu/people/kabernd/seminar/2002/tech/ma
lnutrition.jpg
Global Undernutrition
http://paperdreamer.files.wordpress.com/2008/04/world_hunger_map.jpg
Secondary Malnutrition
• Diet normal
• Food not digested or
absorbed
– Diarrhea
– Parasites
Tapeworm
Micronutrient Malnutrition
• Deficiency in:
– Vitamin A
– Iodine
– Iron
– Zinc
– Calcium
– Vitamin D
– B Vitamins
– Vitamin C
Rickets (Vitamin D deficiency)
http://www.talkorigins.org/faqs/homs/rickets.jpg
Vitamin A Deficiency
• Night Blindness
– 500,000 children/year
– xerophthalmia
• Half of these will die
– within a year of becoming
blind
• Rice diet lacking green
vegetables
– Vitamin supplements help:
cost $3/year
xerophthalmia – Golden Rice could help
http://www.vitaminsdiary.com/UserFiles/Image/keratomalacia.jpg
Vitamin A Deficiency
http://upload.wikimedia.org/wikipedia/commons/thumb/7/7d/Vitamin_A_deficiency.PNG/800px-Vitamin_A_deficiency.PNG
Iodine Deficiency
• Iodine deficiency
– affects 740 million people
worldwide
– single greatest cause of
preventable brain damage
in babies
– Goiter
– Stillbirth
– Miscarriages
– Mental Retardation
• Prevented by iodized salt
Goiter (thyroid enlargement) • Best sources of natural iodine
– Sea weed
http://www.voanews.com/english/images/emory_edu_goiter_Iodine_Deficiency_Disorder
_195_eng_11may06_0.jpg
– Sea food
38 million newborns are not
protected from iodine deficiency
http://images.google.com/imgres?imgurl=http://www.unicef.org/progressforchildren/2007n6/images/pfc6_sources_of_data_used_in_unicef_analysis_2000-
2006.gif&imgrefurl=http://www.unicef.org/progressforchildren/2007n6/index_41796.htm&h=361&w=600&sz=20&hl=en&start=75&sig2=xIUDzxMbqzKvhSoLjqx6cw&um=1&tbnid=AHRtpUj1tsOS5M:&tbnh=81&t
bnw=135&ei=AptlSJ6DD6fuigHGy4y7Cw&prev=/images%3Fq%3Dunicef%26start%3D60%26ndsp%3D20%26um%3D1%26hl%3Den%26rlz%3D1B3GGGL_enUS240US242%26sa%3DN
Iron Deficiency Anemia
• Affects 2 billion people,
• 90% live in developing
countries
– 39% of preschool children
– 52% of pregnant women
• Reduced
– physical activity
– mental activity
• Increased
– birth mortality
– Worms
– Malaria
http://www.micronutrient.org/reports/images/Page16Image.jpg – HIV
• High iron rice could help
Other Deficiencies
• Zinc
– Growth retardation
– delayed sexual maturation
– skin and eye lesions
– 48% of world at risk for
zinc deficiency
• Calcium
– Osteoporosis: bone loss
• Vitamin D
Swaddled babies at risk for – Rickets: bone malformation
Rickets: not enough sunlight • Not enough sunlight
exposure:
– Swaddled babies
http://www.ulanbatoronline.org/cammp_section/article_images_lamc_lati
mes/scans/latimes_images/thumbnails/babyswaddle.jpg
Other Deficiencies
• Vitamin C
– Causes Scurvy: problem in
refugee camps
• Niacin
– Causes Pellagra: dermatitis,
diarrhea, dementia
– Due to diet high in maize
(low in tryptophan)
• Thiamin
– Causes Beriberi
Scurvy – Due to diet high in
polished rice
• Folate
http://www.athropolis.com/arctic-facts/misc/scurvy.jpg – Birth defects: Anancephaly
and Spina Bifida
Protein Energy Malnutrition
(PEM)
• Underconsumption of
calories or protein
• Most important form of
malnutrition
• Associated with poverty
– Not enough food
– Poor quality food
• Kwashiorkor
– Extreme protein deficiency
• Marasmus
Kwashiorkor
– Extreme calorie deficiency
Kwashiorkor
• Protein deficiency often
associated with weaning
onto thin cereal gruels.
– Cassava
– Plantains
• Bloating of the stomach
due to edema
– Fluid leaking into body
– Wasted muscles
• Antibodies degraded to
provide protein to body
– Infection
http://www.imageenvision.com/md2/sym_0004-0703-1422-
2622_nurse_standing_with_a_group_of_african_children_showing_symptoms_of_the_protein – Dysentery
-deficiency_disease_kwashiorkor.jpg
– Death
Marasmus
• Calorie deficiency
– Lack of food
– Poorest populations
– Neglected
• Infants
• children
• Protein used for energy
• Results in wasting
– Deterioration of tissues
• Brain development
impaired
Overnutrition
• Consumption of too many
calories
– Obesity
• Medical problems
– Heart disease
– Diabetes
– Cancer
http://www.mercola.com/images/blog/2005/01.01.junkfood.gif
Overnutrition
• Global problem
– Overnutrition has surpassed
undernutrition
• Worst in middle and high income
countries
• Rising in low income countries
– Can co-exist with undernutrition
• Same country
• Same household
– Projected to get worse as
incomes rise
• Industrial food
– High in calories
http://i.dailymail.co.uk/i/pix/2008/05/16/article-0-064EFCA50000044D-848_468x296.jpg
Industrial Food
• Economies of scale
– Industrial agriculture
• Commodity grains
– Factory farm animals
• Confinement
• Processing
– White flour
– Corn and soy ingredients
• Low Prices
– Must sell more
• Supersizing
• Fat and sugar added
• New products
http://www.salembargains.com/Images/Cereal-Aisle2.jpg
Global Overnutrition
http://news.bbc.co.uk/nolpda/ukfs_news/hi/newsid_7151000/7151813.stm
Global Overnutrition
http://www.fao.org/FOCUS/E/obesity/obes3.htm http://www.fao.org/FOCUS/E/obesity/obes1.htm
Overnutrition in the USA
• Overweight population
– 2/3 of adults
– 1/3 of children
• Reasons
– Excess fat, sugar in diet
– Not enough fiber
– Sedentary lifestyle
• Poor are overweight
– Industrial food inexpensive
• Fast food
• Processed
• Energy dense
– Fruits, vegetables more
expensive
http://www.epidemiologic.org/obesity/obesity-epidemic2004-msn-small.JPG
http://www.geographyalltheway.com/ib_geography/ib_resources/imagesetc/obesity_poverty.jpg
Overnutrition rising in developing
countries
• Increase in global food
market
– Industrial food
• Urbanization
– Fast Food
• Diet change
– Decline in traditional diet
– Increased meat
http://www.fao.org/FOCUS/E/obesity/obes2.htm
Calorie consumption
Balanced Protein
• Protein are made of amino
acids
• Essential amino acids
– Body cannot make
– Required in diet
• Animal proteins have
perfect balance of amino
acids
– Meat
– Milk
– Eggs
http://www.ibabuzz.com/allyoucaneat/wp-content/uploads/2007/09/eggs.jpg
Complementing Proteins
• Plant proteins
– are deficient in different
essential amino acids
• Cereals
– Low in lysine
• Beans
– Low in methionine
• Must eat both cereal and
beans together
– To get balanced amino acids
– Complementing proteins
Rice and Beans
http://www.d16acbl.org/U174/black%20beans.jpg
Calorie Deficiency
• Most widespread problem
among poor
• Cannot get enough calories
(energy) in diet
– Most get enough protein
• Calorie requirements vary
– Age
– Sex
– Pregnancy
– Lactation
Nutritional Needs
• RDA
– Recommended Daily
Allowance
– Level of nutrients adequate
for 97-98% of the group
– Good target for individuals
• EAR
– Estimated Average
Requirement
– Level of nutrients adequate
http://www.fda.gov/diabetes/pyramid.gif
for ½ individuals in group
– Always lower than RDA
– Good target for average
intake of a group