Jump to content

Malnutrition

From Wikipedia, the free encyclopedia

This is an old revision of this page, as edited by 70.112.4.25 (talk) at 18:40, 20 March 2009 (rvv User:Nangparbat ). The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.

Malnutrition
SpecialtyEndocrinology, intensive care medicine, nutrition Edit this on Wikidata

Malnutrition is a general term for a medical condition caused by an improper or inadequate diet and nutrition.[1][2]

According to the World Health Organization, hunger and malnutrition are the single gravest threats to the world's public health and malnutrition is by far the biggest contributor to child mortality, present in half of all cases.[3]

In addition to infant mortality risks, lifelong malnutrition can begin in utero and is typically associated with the mother's stature (associated with her childhood nutritional status), her nutritional status prior to conception, and diarrheal disease, intestinal parasites, and/or respiratory infection status. Multiple studies have shown that nutritional status of adults is substantially influenced by their nutritional experience from conception through early childhood. Even if individuals have had adequate nutrition from childhood on, their health outcomes are still impacted. [4]

Causes of Malnutrition

Sociopolitical

In the late eighteenth and early nineteenth century, the English economist Thomas Malthus noted how increases in food production were likely to occur along a slow arithmetic progression due to the law of diminishing returns while population growth follows much faster, geometric progressions. His theory argued that this lag in productivity caused food shortages, that it would lead to famines worldwide as humans surpassed the carrying capacity of the land, and that it would create checks on socio-cultural systems in the forms of poverty and misery as humans would earn and live off of just enough to subsist and survive. This Malthusian argument has long since been refuted on several grounds but has none the less served as a backdrop for understanding of the causes of malnutrition.

The actual causes of malnutrition can be varied and complex and are difficult to encapsulate in a single theory. Certainly, as Malthus suggests, lack of agricultural productivity combined with increases in population can cause and are often correlated to malnutrition.[citation needed] Over-cultivation, overgrazing, and deforestation lead to desertification or otherwise impoverished soils that can not support crops or cattle for subsistence agriculture[5] but this scenario only accounts for malnutrition in certain, specific instances and does not consider larger social issues such as the influence of political inequality. Further, malnutrition can stem from impacts of natural disasters, from the results of conflict and war, as an impact of the HIV/AIDS pandemic[6] as a consequence of other health issues such as diarrheal disease or chronic illness [1] from lack of education regarding proper nutrition, or from countless other potential factors.

Various scales of analysis also have to be considered in order to determine the sociopolitical causes of malnutrition. For example, the population of a community may be at risk if it lacks health-related services, but on a smaller scale certain households or individuals may be at even higher risk due to differences in income levels, access to land, or levels of education [7]. Also within the household, there may be differences in levels of malnutrition between men and women, and these differences have been shown to vary significantly from one region to another with problem areas showing relative deprivation of women [8]. Children and the elderly tend to be especially susceptible. Approximately 27 percent of children under 5 in developing world are malnourished, and in these developing countries, malnutrition claims about half of the 10 million deaths each year of children under 5.

Often the consequences of malnutrition exacerbate its causes and form a vicious downward spiral. For example, in cases of malnourishment, lack of sufficient nutrients can weaken the immune system and invite infectious disease [9] , and by compromising digestive function, many of these diseases can intensify malnutrition. 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.

Since the time of Malthus, various new theories and approaches have developed for understanding the truly complex mechanisms and underlying causes of malnutrition. Most famous among recent theorists is the Indian economist and philosopher Amartya Sen[citation needed] whose breakthrough 1981 book Poverty and Famines: An Essay on Entitlement and Deprivation went beyond the Malthusian argument that lack of food production led to hunger and demonstrated that malnutrition and famine were more related to problems of food distribution [10] A person’s entitlements, according to Sen, are “commodity bundles that a person in society can command using the totality of rights and opportunities that he or she faces,” (p.8) and famine can then be described as a collapse of entitlements for a certain segment of society and the failure of the state to protect those entitlements.[citation needed]

Effects

Mortality due to malnutrition

See also: child mortality
  • 1 person dies every second as a result of hunger - 4000 every hour - 100 000 each day - 36 million each year - 58 % of all deaths (2001-2004 estimates).[11][12][13]
  • 1 child dies every 5 seconds as a result of hunger - 700 every hour - 16 000 each day - 6 million each year - 60% of all child deaths (2002-2008 estimates).[14][15][16][17][18]

According to the World Health Organization, hunger is the gravest single threat to the world's public health.[3] 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 millions people, all causes of death combined, die each year. One in twelve people worldwide are malnourished.[19] In 2006, more than 36 millions died of hunger or diseases due to deficiencies in micronutrients"[20]. The World Health Organization estimates that one-third of the world is well-fed, one-third is under-fed and one-third is starving. [19]

Hunger and malnutrition have an even bigger impact on children’s health than was previously thought. 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. Hunger 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. This is the impact The Lancet seeks to identify.[3]

Children are not only affected by the consequences of malnourishment, but the societies they live in suffer as well. Both severe and moderate cases of malnutrition have a significant impact on the outcomes children face for the remainder of their lives and are also a cause of severe illnesses leading to growth retardation both physical and mental, and possibly death. The risk of death is not limited to only those who suffer from severe forms of malnutrition, though the risk of death is higher among severely malnourished children. Considering the elevated risks of mortality among children that are associated with moderate forms of malnutrition, combined with a high prevalence worldwide, it would seem more appropriate to distinguish that the deaths of children as a result of malnourishment is attributable to moderate, rather than severe conditions of malnutrition. Another factor that largely keeps malnutrition from being properly treated is a lack of education in many developing countries. This lack of education allows cultures of superstitions to persist. For example, in some cases in China, breast-feeding started at a very late stage. As such, there is an increasing wide effort to implement an access for education about proper feeding methods.

Biological effects

An extended period of malnutrition can result in starvation or deficiency diseases such as scurvy. Malnutrition increases the risk of infection and infectious disease; for example, it is a major risk factor in the onset of active tuberculosis.[21]

Malnutrition appears to increase activity and movement in many animals - for example an experiment on spiders showed increased activity and predation in starved spiders, resulting in larger weight gain.[22] This pattern is seen in many animals, including humans while sleeping.[23] It even occurs in rats with their cerebral cortex or stomachs completely removed.[24] Increased activity on hamster wheels occurred when rats were deprived not only of food, but also water or B vitamins such as thiamine[25] This response may increase the animal's chance of finding food, though it has also been speculated the emigration response relieves pressure on the home population.[23]

Responses to malnutrition

Societal responses to malnutrition vary depending upon which factor one subscribes to as the primary cause of hunger and malnutrition. While most responses are targeted to address undernutrition, there are several that also respond to overnutrition.

If the principal cause of malnutrition is that humans have populated the earth (or a specific geographic region) beyond its carrying capacity, then a restricted population size is the solution. This is an argument that is espoused by people of both liberal and conservative persuasions. In the late 1700’s, Thomas Malthus originally argued that nothing could be done as only natural disasters could check population growth, but he later included the possibility of voluntary limits through “moral restraint.”[26]1 More recently, Robert Chapman suggests that an intervention through government policies is a necessary ingredient of curtailing global population growth.[27] Garret Hardin takes an anti-immigration, isolationist approach arguing that “…all sovereign states must accept the responsibility of solving their population problems in their own territories.”[28] Hardin also asserts that immigration acts as a sort of pressure release valve which allows countries to continue to ignore solving their population problems.

Others, Amartya Sen among them, argue that other social and economic factors, such as declining wages, unemployment, rising food prices, and poor food-distribution systems, rather than population numbers per se, lead to malnutrition and in severe cases famine. For Sen, “no matter how a famine is caused, methods of breaking it call for a large supply of food in the public distribution system. This applies not only to organizing rationing and control, but also to undertaking work programmes and other methods of increasing purchasing power for those hit by shifts in exchange entitlements in a general inflationary situation.”[29]

One suggested policy framework to resolve access issues is termed food sovereignty, the right of peoples to define their own food, agriculture, livestock, and fisheries systems in contrast to having food largely subjected to international market forces. Food First is one of the primary think tanks working to build support for food sovereignty.

One policy adopted in recent decades to alleviate world malnutrition is direct humanitarian aid in the form of food. For the rich donor countries, this is a way to reduce domestic excess supply created by domestic agricultural subsidies, stabilizing farm prices in rich countries, even if the cost of supplying the food to its final beneficiaries is high. Food aid may be provided for short-term emergencies (natural disasters or human-made like war) or in the form of a long-term program for an extended period. For recipient countries, emergency food aid is welcome, though aid in cash may also be welcome because the food may often be purchased locally in zones not affected by the emergency, thus benefitting local farmers. Long-term foreign food aid has been criticized as discouraging local production and distorting markets.

Neoliberals advocate for an increasing role of the free market. The World Bank itself claims to be part of the solution to malnutrition, asserting that the best way for countries to succeed in breaking the cycle of poverty and malnutrition is to build export-led economies that will give them the financial means to buy foodstuffs on the world market.

There are several different technical approaches in combating under-nutrition including nutritional education and medical nutrition which consists of micro-nutrient supplementation, immunizations and food fortifications. Nutritional education is a preventative measure that focuses on raising awareness on what foods are necessary for the body to gain the nutrients needed to function. In recent years many foods, such as Spirulina and peanut butter, have been developed or refined for mass-production in hopes of combating malnutrition and its effects. Foodstuffs are usually selected that allow the supplementing of the required daily 2000kcal, as well as the requirements in proteïn and other micro-nutrients. These allow the curing of protein-energy malnutrition. See IIMSAM and Plumpy'nut for more on these efforts.

Statistics

See also: Global Hunger Index

There were 923 million hungry people in the world in 2007, an increase of 80 million since 1990,[30] despite the fact that the world already produces enough food to feed everyone - 6 billion people - and could feed the double - 12 billion people.[31]

Year 1990 1995 2005 2007
Hungry people in the world (millions)[32] 842 832 848 923
Year 1970 1980 1990 2005 2007
Share of hungry people in the developing world[33][34] 37 % 28 % 20 % 16 % 17 %
Percentage of population affected by undernutrition by country, according to United Nations statistics.

Number of undernourished people (million) in 2001-2003, according to the FAO, the following countries had 5 million or more undernourished people [2]:

Country Number of Undernourished (million)
India 217.05
China 154.0
Bangladesh 43.45
Democratic Republic of Congo 37.0
Pakistan 35.2
Ethiopia 31.5
Tanzania 16.1
Philippines 15.2
Brazil 14.4
Indonesia 13.8
Vietnam 13.8
Thailand 13.4
Nigeria 11.5
Kenya 9.7
Sudan 8.8
Mozambique 8.3
North Korea 7.9
Yemen 7.1
Madagascar 7.1
Colombia 5.9
Zimbabwe 5.7
Mexico 5.1
Zambia 5.1
Angola 5.0

Note: This table measures "undernourishment", as defined by FAO, and represents the number of people consuming (on average for years 2001 to 2003) less than the minimum amount of food energy (measured in kilocalories per capita per day) necessary for the average person to stay in good health while performing light physical activity. It is a conservative indicator that does not take into account the extra needs of people performing extraneous physical activity, nor seasonal variations in food consumption or other sources of variability such as inter-individual differences in energy requirements.

Malnutrition and undernourishment are cumulative or average situations, and not the work of a single day's food intake (or lack thereof). This table does not represent the number of people who "went to bed hungry today."

The U.S. Department of Agriculture reported that in 2003, only 1 out of 200 U.S. households with children became so severely food insecure that any of the children went hungry even once during the year. A substantially larger proportion of these same households (3.8 percent) had adult members who were hungry at least one day during the year because of their households' inability to afford enough food.[3]

Climate Change and Malnutrition

With 95% of all malnourished peoples living in the relatively stable climate region of the sub-tropics and tropics, climate change is of great importance to food security in these regions. According to the latest IPCC reports, temperature increases in these regions are "very likely."[35] Even small changes in temperatures can lead to increased frequency of extreme weather conditions.[36] 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.[37] 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.[38]

See also

Organizations

References

  1. ^ "malnutrition" at Dorland's Medical Dictionary
  2. ^ Sullivan, arthur (2003). Economics: Principles in action. Upper Saddle River, New Jersey 07458: Pearson Prentice Hall. p. 481. ISBN 0-13-063085-3. {{cite book}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)CS1 maint: location (link)
  3. ^ a b c Malnutrition The Starvelings
  4. ^ Behrman, J.R., Harold Alderman, and John Hoddinott. 2004. Hunger and Malnutrition. Copenhagen consensus-Challenges and Opportunities. http://www.copenhagenconsensus.com
  5. ^ Darkow, M.B.K. "Desertification: Its Human Costs" Forum for Applied Research and Policy. (1996) 11:12-17.
  6. ^ Baro, Mamadou and Tara F. Duebel "Persistent Hunger: Perspectives on Vulnerability, Famine, and Food Security in Sub-Saharan Africa" Annual Anthropological Review. (2006) 35:521-38.
  7. ^ Fotso, Jean-Christophe and Barthelemy Kuate-Defo. "Measuring Socio-economic Status in Health Research in Developing Countries: Should We Be Focusing on Households, Communities, or Both?" Social Indicators Research. (2005) 72:189-237.
  8. ^ Nube, M. and G.J.M. van dem Boom. "Gender and Adult Undernutrition in Developing Countries." Annals of Human Biology (2003) 30:5:520-537.
  9. ^ Seipel, Micheal M.O. "Social Consequences of Malnutrition." Social Work. (1999) 44:5.
  10. ^ Sen, A.K. Poverty and Famines: An Essay on Entitlement and Deprivation. Oxford: Oxford University Press. (1981)
  11. ^ Jean Ziegler. “The Right to Food: Report by the Special Rapporteur on the Right to Food, Mr. Jean Ziegler, Submitted in Accordance with Commission on Human Rights Resolution 2000/10”. United Nations, February 7, 2001, p. 5. “On average, 62 million people die each year, of whom probably 36 million (58 per cent) directly or indirectly as a result of nutritional deficiencies, infections, epidemics or diseases which attack the body when its resistance and immunity have been weakened by undernourishment and hunger.”.
  12. ^ Commission on Human Rights. “The right to food : Commission on Human Rights resolution 2002/25”. Office Of The High Commissioner For Human Rights, United Nations, April 22, 2002, p. 2. “every year 36 million people die, directly or indirectly, as a result of hunger and nutritional deficiencies, most of them women and children, particularly in developing countries, in a world that already produces enough food to feed the whole global population”.
  13. ^ United Nations Information Service. “Independent Expert On Effects Of Structural Adjustment, Special Rapporteur On Right To Food Present Reports: Commission Continues General Debate On Economic, Social And Cultural Rights”. United Nations, March 29, 2004, p. 6. “Around 36 million people died from hunger directly or indirectly every year.”.
  14. ^ Food and Agriculture Organization Staff. “The State of Food Insecurity in the World, 2002: Food Insecurity : when People Live with Hunger and Fear Starvation”. Food and Agriculture Organization of the United Nations, 2002, p. 6. “6 million children under the age of five, die each year as a result of hunger.”
  15. ^ Food and Agriculture Organization of the United Nations Economic and Social Dept. “The State of Food Insecurity in the World 2004: Monitoring Progress Towards the World Food Summit and Millennium Development Goals”. Food and Agriculture Organization of the United Nations, 2004, p. 8. “Undernourishment and deficiencies in essential vitamins and minerals cost more than 5 million children their lives every year”.
  16. ^ Jacques Diouf. “The State of Food Insecurity in the World 2004: Monitoring Progress Towards the World Food Summit and Millennium Development Goals”. Food and Agriculture Organization of the United Nations, 2004, p. 4. “one child dies every five seconds as a result of hunger and malnutrition”.
  17. ^ Food and Agriculture Organization, Economic and Social Dept. “The State of Food Insecurity in the World 2005: Eradicating World Hunger - Key to Achieving the Millennium Development Goals”. Food and Agriculture Organization of the United Nations, 2005, p. 18. “Hunger and malnutrition are the underlying cause of more than half of all child deaths, killing nearly 6 million children each year – a figure that is roughly equivalent to the entire preschool population of Japan. Relatively few of these children die of starvation. The vast majority are killed by neonatal disorders and a handful of treatable infectious diseases, including diarrhoea, pneumonia, malaria and measles. Most would not die if their bodies and immune systems had not been weakened by hunger and malnutrition moderately to severely underweight, the risk of death is five to eight times higher.”.
  18. ^ Human Rights Council. “Resolution 7/14. The right to food”. United Nations, March 27, 2008, p. 3. “6 million children still die every year from hunger-related illness before their fifth birthday”.
  19. ^ a b http://library.thinkquest.org/C002291/high/present/stats.htm
  20. ^ Jean Ziegler, L'Empire de la honte, Fayard, 2007 Template:ISBN-13 p.130.
  21. ^ Schaible UE, Kaufmann SH (2007). "Malnutrition and infection: complex mechanisms and global impacts". PLoS Med. 4 (5): e115. doi:10.1371/journal.pmed.0040115. PMID 17472433.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  22. ^ Provencher, L.; Riechert, S.E. (1991) Short-Term Effects of Hunger Conditioning on Spider Behavior, Predation, and Gain of Weight Oikos 62:160-166
  23. ^ a b Wald, G.; Jackson, B. (1944) Activity and Nutritional Deprivation Proceedings of the National Academy of Sciences of the United States of America 30:255-263
  24. ^ "George Wald: The Origin of Death". Retrieved 2007-05-14.
  25. ^ Guerrant, N.B., Dutcher, R.A. (1940) Journal of Nutrition 20:589.
  26. ^ Malthus, Robert Thomas. 1976 (1798). An Essay on the Principle of Population. Philip Appleman, ed. New York: Norton.
  27. ^ Chapman, Robert. 1999. “No Room at the Inn, or Why Population Problems are Not All Economic.” Population and Environment, 21(1): 81-97.
  28. ^ Hardin, Garrett. 1992. “The Ethics of Population Growth and Immigration Control.” In Crowding Out the Future: World Population Growth, US Immigration, and Pressures on Natural Resources, Robert W. Fox and Ira H. Melham, eds. Washington, DC: Federation for American Immigration Reform.
  29. ^ Sen, Amartya. 1982. Poverty and Famines: An Essay on Entitlements and Deprivation, Oxford: Clarendon Press.
  30. ^ Food and Agriculture Organization Economic and Social Development Department. “The State of Food Insecurity in the World, 2008 : High food prices and food security - threats and opportunities”. Food and Agriculture Organization of the United Nations, 2008, p. 2. “FAO’s most recent estimates put the number of hungry people at 923 million in 2007, an increase of more than 80 million since the 1990–92 base period.”.
  31. ^ Jean Ziegler. “Promotion And Protection Of All Human Rights, Civil, Political, Economic, Social And Cultural Rights, Including The Right To Development: Report of the Special Rapporteur on the right to food, Jean Ziegler”]. [[United Nations Human Rights Council|Human Rights Council] of the United Nations, January10, 2008.“According to the Food and Agriculture Organization of the United Nations (FAO), the world already produces enough food to feed every child, woman and man and could feed 12 billion people, or double the current world population.”
  32. ^ Food and Agriculture Organization Economic and Social Development Department. “The State of Food Insecurity in the World, 2008 : High food prices and food security - threats and opportunities”. Food and Agriculture Organization of the United Nations, 2008, p. 48.
  33. ^ Food and Agriculture Organization Agricultural and Development Economics Division. “The State of Food Insecurity in the World, 2006 : Eradicating world hunger – taking stock ten years after the World Food Summit”. Food and Agriculture Organization of the United Nations, 2006, p. 8. “Because of population growth, the very small decrease in the number of hungry people has nevertheless resulted in a reduction in the proportion of undernourished people in the developing countries by 3 percentage points – from 20 percent in 1990–92 to 17 percent in 2001–03. (…) the prevalence of undernourishment declined by 9 percent (from 37 percent to 28 percent) between 1969–71 and 1979–81 and by a further 8 percentage points (to 20 percent) between 1979–81 and 1990–92.”.
  34. ^ Food and Agriculture Organization Economic and Social Development Department. “The State of Food Insecurity in the World, 2008 : High food prices and food security - threats and opportunities”. Food and Agriculture Organization of the United Nations, 2008, p. 6. “Good progress in reducing the share of hungry people in the developing world had been achieved – down from almost 20 percent in 1990–92 to less than 18 percent in 1995–97 and just above 16 percent in 2003–05. The estimates show that rising food prices have thrown that progress into reverse, with the proportion of undernourished people worldwide moving back towards 17 percent.”.
  35. ^ "Climate Change 2007: Synthesis Report." 12-17 Nov 2007. Intergovernmental Panel on Climate Change. 5 Nov 2008 <http://www.ipcc.ch/pdf/assessment-report/ar4/syr/ar4_syr.pdf>.
  36. ^ "Climate Change 2007: Synthesis Report." 12-17 Nov 2007. Intergovernmental Panel on Climate Change. 5 Nov 2008 <http://www.ipcc.ch/pdf/assessment-report/ar4/syr/ar4_syr.pdf>.
  37. ^ Battista, David. "Climate Change in Developing Countries." University of Washington. Seattle. 27 Oct 2008.
  38. ^ "Climate Change 2007: Synthesis Report." 12-17 Nov 2007. Intergovernmental Panel on Climate Change. 5 Nov 2008 <http://www.ipcc.ch/pdf/assessment-report/ar4/syr/ar4_syr.pdf>.
Look up malnutrition or undernutrition in Wiktionary, the free dictionary.
Retrieved from "https://en.wikipedia.org/w/index.php?title=Malnutrition&oldid=278579709"