International/ Global Nutrition

Question 1

Conceptual Framework Malnutrition

Answer 1

Basic –>
Underlying –>
intermediate causes –> maternal and child malnutrition + short-term and long-term consequences

Question 2

examples of basic causes

Answer 2

• lack of capital

- social, economic, political context

Question 3

examples of underlying causes

Answer 3

• poverty
• food insecurity
• unhealthy household
• environment
• inadequate care

Question 4

examples of immediate causes

Answer 4

• inadequate intake

- disease

Question 5

examples of short term consequences

Answer 5

mortality, morbidity, disability

Question 6

examples of long term consequences

Answer 6

adult size, intellectual ability, economic productivity, reproductive performance, metabolic and cardiovascular disease

Question 7

Maternal and child undernutrition and cause of death

Answer 7

underlying cause of 3.1 milling deaths

45% child deaths annually

Question 8

global deaths

Answer 8

stunting, severe wasting, & intrauterine growth restriction

Question 9

Latin america

Answer 9

Stunting: z score

Question 10

HAZ vs WHZ

Answer 10

HAZ accesses stunting

WHZ accesses wasting

Question 11

overweight in children

Answer 11

WHZ>2
overall 7%: 43 million children
54% increase since 1990

Question 12

maternal undernutrition

Answer 12

BMI 10% in asia and africa

-deficits in child development, health, and productivity

Question 13

maternal overweight and obesity

Answer 13

> 70% in americas and caribbean
40% in Africa
-maternal morbidity, preterm birth, increased infant mortality

Question 14

undernutrition in pregnancy

Answer 14

• affects fetal growth and post natal growth

- major determinant of stunting and subsequent obesity & noncommunicable diseases into adulthood

Question 15

vitamin A and Zn deficiencies

Answer 15

• death

- have the largest remaining disease burden among micronutrients considered

Question 16

iron and iodine

Answer 16

-contribute to children’s failure to reach developmental potential

Question 17

4 part framework for scaling up nutrition

Answer 17

• country level
• scale up evidence based cost effective interventions: window of opportunity: 1000 days: -9–> 24 months
• multi-sectoral approach: food security, social protection, health
• assistance for country owned nutrition programs and capacity

Question 18

what evidence based interventions will be increased to 90% coverage –> 15% reduction in deaths

Answer 18

1. periconceptual folic acid
2. maternal balanced energy protein supplementation
3. maternal calcium supplementation
4. multiple micronutrient in pregnancy
5. promote breastfeeding
6. appropriate complementary feeding
7. vitamin A supplementation
8. preventative Zn supplementation: 6-59mths
9. management of severe acute malnutrition: SAM
10. management of moderate acute malnutrition: MAM

Question 19

what type of intervention addresses underlying determinants of nutrition?

Answer 19

nutrition-sensitive interventions:

-agriculture, health, social problems, early child development, education, water and sanitation

Question 20

4 maternal and birth outcome interventions

Answer 20

1. iron and folate supplementation
2. maternal iodine supplementation through salt iodization
3. maternal calcium supplementation
4. reduce tobacco consumption and indoor air pollution

Question 21

newborn babies interventions

Answer 21

promotion of breastfeeding

Question 22

8 infants and children interventions

Answer 22

1. promote breastfeeding
2. behavior change for improved complementary feeding
3. zinc supplementation
4. zinc management in diarrhea
5. vitamin a fortification/ supplementation
6. universal salt iodization
7. handwashing/ hygiene interventions
8. treat severe acute malnutrition

Question 23

3 broad categories of nutrition related interventions

Answer 23

1. general nutrition interventions
2. micronutrient interventions
3. disease control interventions

Question 24

8 examples of interventions

Answer 24

1. food aid
2. daily supplements
3. sprinkles of micronutrients
4. staple food fortification
5. selective plant breeding/ modification: phytate reduced maize
6. biofortification
7. diet diversification
8. education: complementary +/- food supplements, positive deviance