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Malnutrition

Posted by Adelin Luis Monday, May 10, 2010

Malnutrition is the insufficient, excessive or imbalanced consumption of nutrients. A number of different nutrition disorders may arise, depending on which nutrients are under or overabundant in the diet.

The World Health Organization cites malnutrition as the gravest single threat to the world's public health. Improving nutrition is widely regarded as the most effective form of aid. Emergency measures include providing deficient micronutrients through fortified sachet powders, such as peanut butter, or directly through supplements. The famine relief model increasingly used by aid groups calls for giving cash or cash vouchers to the hungry to pay local farmers instead of buying food from donor countries, often required by law, as it wastes money on transport costs.[7][8]

Long term measures include investing in modern agriculture in places that lack them, such as fertilizers and irrigation, which largely eradicated hunger in the developed world. However, World Bank strictures restrict government subsidies for farmers and the spread of fertilizer use is hampered by some environmental groups.

Causes

Conflicts and disease

Conflicts and war can cause a shortage of farming labor, or by creating internally displaced persons or refugees without access to land for farming.

Malnutrition can also be a consequence of other health issues such as diarrheal disease or chronic illness , especially the HIV/AIDS pandemic

Poverty and food prices

As much as food shortages may be a contributing factor to malnutrition in countries with lack of technology, the FAO (food and agriculture Organization)has estimated that eighty percent of malnourished children living in the developing world produce food surpluses. The economist Amartya Sen observed that, in recent decades, famine has always a problem of food distribution and/or poverty, as there has been sufficient food to feed the whole population of the world. He states that malnutrition and faminewere more related to problems of food distribution and purchasing power.

It is argued that commodity speculators are increasing the cost of food. As the real estate bubble in the United States was collapsing, it is said that trillions of dollars moved to invest in food and primary commodities, causing the 2007-2008 food price crisis.

The use of biofuels as a replacement for traditional fuels may leave less supply of food for nutrition and raises the price of food. The United Nations special rapporteur on the right to food, Jean Ziegler proposes that agricultural waste, such as corn cobs and banana leaves, rather than crops themselves be used as fuel.


Dietary practices

A lack of breastfeeding can lead to malnutrition in infants and children. Possible reasons for the lack in the developing world may be that the average family thinks bottle feeding is better. The WHO says mothers abandon it because they do not know how to get their baby to latch on properly or suffer pain and discomfort.

Deriving too much of one's diet from a single source, such as eating almost exclusively corn or rice, can cause malnutrition. This may either be from a lack of education about proper nutrition, or from only having access to a single food source.

Many tend to think malnutrition only in terms of hunger, however, overeating is also a contributing factor as well. Many parts of the world have access to a surplus of non-nutritious food, in addition to increased sedentary lifestyles. In turn, this has created a universal epidemic of obesity. Yale psychologist Kelly Brownell calls this a "toxic food environment” where fat and sugar laden foods have taken precedent over healthy nutritious foods. Not only does obesity occur in developed countries, problems are also occurring in developing countries in areas where income is on the rise.


Agricultural productivity

Food shortages can be caused by a lack of farming skills such as crop rotation, or by a lack of technology or resources needed for the higher yields found in modern agriculture, such as nitrogen fertilizers, pesticides and irrigation. As a result of widespreadpoverty, farmers cannot afford or governments cannot provide the technology. The World Bank and some wealthy donor countries also press nations that depend on aid to cut or eliminate subsidized agricultural inputs such as fertilizer, in the name of free market policies even as the United States and Europe extensively subsidized their own farmers. Many, if not most, farmers cannot afford fertilizer at market prices, leading to low agricultural production and wages and high, unaffordable food prices.

Reasons for the unavailability of fertilizer include moves to stop supplying fertilizer on environmental grounds, cited as the obstacle to feeding Africa by the Green revolution pioneer Norman Borlaug.


Future threats

There are a number of potential disruptions to global food supply that could cause widespread malnutrition.

Climate change is of great importance to food security. With 95% of all malnourished peoples living in the relatively stable climate region of the sub-tropics and tropics. According to the latest IPCC reports, temperature increases in these regions are "very likely." Even small changes in temperatures can lead to increased frequency of extreme weather conditions. Many of these have great impact on agricultural production and hence nutrition. For example, the 1998-2001 central Asian drought brought about an 80% livestock loss and 50% reduction in wheat and barley crops in Iran. Similar figures were present in other nations. An increase in extreme weather such as drought in regions such as Sub-Saharan would have even greater consequences in terms of malnutrition. Even without an increase of extreme weather events, a simple increase in temperature reduces the productiveness of many crop species, also decreasing food security in these regions.

Colony collapse disorder is a phenomenon where bees are dying in large numbers. Since many agricultural crops worldwide are pollinated by bees, this represents a serious threat to the supply of food.

An epidemic of stem rust on wheat caused by race Ug99 is currently spreading across Africa and into Asia and, it is feared, could wipe out more than 80% of the world’s wheat crops.


Effects

Mortality

According to Jean Ziegler (the United Nations Special Rapporteur on the Right to Food for 2000 to March 2008), mortality due to malnutrition accounted for 58% of the total mortality in 2006: "In the world, approximately 62 million people, all causes of death combined, die each year. One in twelve people worldwide is malnourished. In 2006, more than 36 millions died of hunger or diseases due to deficiencies in micronutrients".

According to the World Health Organization, malnutrition is by far the biggest contributor to child mortality, present in half of all cases. Underweight births and inter-uterine growth restrictions cause 2.2 million child deaths a year. Poor or non-existent breastfeeding causes another 1.4 million. Other deficiencies, such as lack of vitamin A or zinc, for example, account for 1 million. According to The Lancet, malnutrition in the first two years is irreversible. Malnourished children grow up with worse health and lower educational achievements. Their own children also tend to be smaller. Malnutrition was previously seen as something that exacerbates the problems of diseases such as measles, pneumonia and diarrhea. But malnutrition actually causes diseases as well, and can be fatal in its own right.


Illness

Malnutrition increases the risk of infection and infectious disease; for example, it is a major risk factor in the onset of active tuberculosis. In communities or areas that lack access to safe drinking water, these additional health risks present a critical problem. Lower energy and impaired function of the brain also represent the downward spiral of malnutrition as victims are less able to perform the tasks they need to in order to acquire food, earn an income, or gain an education.


Psychological

According to the Lancet, Malnutrition, in the form of iodine deficiency, is "the most common preventable cause of mental impairment worldwide." Even moderate iodine deficiency, especially in pregnant women and infants, lowers intelligence by 10 to 15 I.Q. points, shaving incalculable potential off a nation’s development. The most visible and severe effects — disabling goiters, cretinism and dwarfism — affect a tiny minority, usually in mountain villages. But 16 percent of the world’s people have at least mild goiter, a swollen thyroid gland in the neck.

Research indicates that improving the awareness of nutritious meal choices and establishing long-term habits of healthy eating has a positive effect on a cognitive and spatial memory capacity, potentially increasing a student's potential to process and retain academic information.

Some organizations have begun working with teachers, policymakers, and managed foodservice contractors to mandate improved nutritional content and increased nutritional resources in school cafeterias from primary to university level institutions. Health and nutrition have been proven to have close links with overall educational success. Currently less than 10% of American college students report that they eat the recommended five servings of fruit and vegetables daily. Better nutrition has been shown to have an impact on both cognitive and spatial memory performance; a study showed those with higher blood sugar levels performed better on certain memory tests. In another study, those who consumed yogurt performed better on thinking tasks when compared to those who consumed caffeine free diet soda or confections. Nutritional deficiencies have been shown to have a negative effect on learning behavior in mice as far back as 1951.

"Better learning performance is associated with diet induced effects on learning and memory ability".

The "nutrition-learning nexus" demonstrates the correlation between diet and learning and has application in a higher education setting.

"We find that better nourished children perform significantly better in school, partly because they enter school earlier and thus have more time to learn but mostly because of greater learning productivity per year of schooling."
91% of college students feel that they are in good health while only 7% eat their recommended daily allowance of fruits and vegetables.
Nutritional education is an effective and workable model in a higher education setting.
More "engaged" learning models that encompass nutrition is an idea that is picking up steam at all levels of the learning cycle.

There is limited research available that directly links a student's Grade Point Average (G.P.A.) to their overall nutritional health. Additional substantive data is needed to prove that overall intellectual health is closely linked to a person's diet, rather than just another correlation fallacy.

Nutritional supplement treatment may be appropriate for major depression, bipolar disorder, schizophrenia, and obsessive compulsive disorder, the four most common mental disorders in developed countries. Supplements that have been studied most for mood elevation and stabilization include eicosapentaenoic acid and docosahexaenoic acid (each of which are an omega-3 fatty acid contained in fish oil, but not in flaxseed oil), vitamin B12, folic acid, and inositol.


Cancer

Cancer is now common in developing countries. According a study by the International Agency for Research on Cancer, "In the developing world, cancers of the liver, stomach and esophagus were more common, often linked to consumption of carcinogenic preserved foods, such as smoked or salted food, and parasitic infections that attack organs." Lung cancer rates are rising rapidly in poorer nations because of increased use of tobacco. Developed countries "tended to have cancers linked to affluence or a 'Western lifestyle' — cancers of the colon, rectum, breast and prostate — that can be caused by obesity, lack of exercise, diet and age."

[edit]Metabolic syndrome

Several lines of evidence indicate lifestyle-induced hyperinsulinemia and reduced insulin function (i.e. insulin resistance) as a decisive factor in many disease states. For example, hyperinsulinemia and insulin resistance are strongly linked to chronic inflammation, which in turn is strongly linked to a variety of adverse developments such as arterial microinjuries and clot formation (i.e. heart disease) and exaggerated cell division (i.e. cancer). Hyperinsulinemia and insulin resistance (the so-called metabolic syndrome) are characterized by a combination of abdominal obesity, elevated blood sugar, elevated blood pressure, elevated blood triglycerides, and reduced HDL cholesterol. The negative impact of hyperinsulinemia on prostaglandin PGE1/PGE2 balance may be significant.

The state of obesity clearly contributes to insulin resistance, which in turn can cause type 2 diabetes. Virtually all obese and most type 2 diabetic individuals have marked insulin resistance. Although the association between overweight and insulin resistance is clear, the exact (likely multifarious) causes of insulin resistance remain less clear. Importantly, it has been demonstrated that appropriate exercise, more regular food intake and reducing glycemic load (see below) all can reverse insulin resistance in overweight individuals (and thereby lower blood sugar levels in those who have type 2 diabetes).

Obesity can unfavourably alter hormonal and metabolic status via resistance to the hormone leptin, and a vicious cycle may occur in which insulin/leptin resistance and obesity aggravate one another. The vicious cycle is putatively fuelled by continuously high insulin/leptin stimulation and fat storage, as a result of high intake of strongly insulin/leptin stimulating foods and energy. Both insulin and leptin normally function as satiety signals to the hypothalamus in the brain; however, insulin/leptin resistance may reduce this signal and therefore allow continued overfeeding despite large body fat stores. In addition, reduced leptin signalling to the brain may reduce leptin's normal effect to maintain an appropriately high metabolic rate.

There is a debate about how and to what extent different dietary factors— such as intake of processed carbohydrates, total protein, fat, and carbohydrate intake, intake of saturated and trans fatty acids, and low intake of vitamins/minerals—contribute to the development of insulin and leptin resistance. In any case, analogous to the way modern man-made pollution may potentially overwhelm the environment's ability to maintain homeostasis, the recent explosive introduction of high glycemic index and processed foods into the human diet may potentially overwhelm the body's ability to maintain homeostasis and health (as evidenced by the metabolic syndrome epidemic).


Hyponatremia

Excess water intake, without replenishment of sodium and potassium salts, leads to hyponatremia, which can further lead to water intoxication at more dangerous levels. A well-publicized case occurred in 2007, when Jennifer Strange died while participating in a water-drinking contest. More usually, the condition occurs in long-distance endurance events (such as marathon or triathlon competition and training) and causes gradual mental dulling, headache, drowsiness, weakness, and confusion; extreme cases may result in coma, convulsions, and death. The primary damage comes from swelling of the brain, caused by increased osmosis as blood salinity decreases. Effective fluid replacement techniques include Water aid stations during running/cycling races, trainers providing water during team games such as Soccer and devices such as Camel Baks which can provide water for a person without making it too hard to drink the water.



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