Chapter 6: Malnutrition Flashcards by Monica Barglinski

Malnutrition is a result of numerous interlocking ___ and ____ factors

social and economic factors

Malnutrition is not simply due to the lack of food.
Just like poverty isn’t bc of lack of money

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What could malnutrition be an end result of? 4 things

Poverty
Lack of education
Social inequity
And chronic recurrent infections

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What are one of the main consequences of malnutrition? (Increased…)

Increased mortality from common childhood illnesses

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Case mortality in what 5 diseases are higher among malnourished children?

Measles
Bronchiolitis
Whooping cough
Pneumonia
Gastroenteritis

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Widespread starvation is ultimately a failure of what?

Failure of Food distribution from the rest of the country

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What was Malthus’s early 19th century theory?

That malnutrition was an unavoidable feature of life in developing countries
Because there would always be far more ppl than food available

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Sick children survived better if they were not, what?

Not separated from their mothers

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What did Cicely Williams’s studies in west Africa led her to identify?
When in Malaysia, she was the first to criticize what?

Kwashiorkor

Criticize infant food companies for advertising practices

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Cicely Williams was influential in what, and she is also considered the founder of what ?

Influential in reestablishing breastfeeding

Founder of the study of maternal and child health

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What is Amartya Sen study, and what did his research show?

Studied famine,
Research showed that malnutrition is complex,
A result of numerous interrelated contributory factors

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Micronutrient deficiencies have clinical effects even in children who might appear ….

Well nourished, ex survey

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What 3 things have combined to halt/reverse the gains in MalNu improvements before 2005

Recession
Rising food costs
Wars

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What 4 interventions are available that have nutritional benefits?

Feeding programs
Micronutrient fortification
Maternal education
Agricultural extension projects

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Adverse effects of malnutrition are particularly important during what periods ?

Rapid growth periods such as childhood and pregnancy

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Early malnutrition during what can have Lifelong adverse effects?

the period of major organ development

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A diet deficient in macronutrients is called what?

Protein-energy malnutrition

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Some types of what cannot be produced by the body ?

So they can only be obtained from what?

Fats and amino acids
Obtained from our food

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Can most micronutrients be made in the body

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What are micronutrients?

Vitamins: thiamin, vitamin C, folic acid

Minerals: iron, calcium, iodine

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What are the diseases that arise as a result of; vitamin C, iron, and iodine?

Survey
Anemia
Hypothyroidism

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Malnutrition means what?
What does the term refer to?

Means “bad” nutrition
Refers to wife range of diseases resulting from abnormalities in dietary intake

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What is the fastest growing nutritional problem in the world

Obesity

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Levels of nutrition still differ widely between what?

Countries of similar income

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Why do countries with similar income differ widely in levels of malnutrition?

Agricultural performance
Pro-poor government policies
Civil unrest
Attitudes towards women

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What are the 3 broad groups of requirements that must be met before a pops children can have reliable nutrition?

1) access to reliable source of nutritious food (*household food security*) 2) adequate care for women and children 3) safe and healthy society w access to preventive care & basic health services

Common infections/ factors of malnutrition in children?

Gastroenteritis HIV infection TB

Combo of what 2 things lead to inadequate child-rearing practices ?

Maternal poverty Lack of education

Lack of knowledge about what 3 things contribute to maternal impact on malnutrition?

Breastfeeding Contraception Nutritional requirements of children

High phytate levels in vegetarian ___ diets inhibits absorption of what which leads to development of what disease?

Cereal diets inhibits absorption of calcium Leads to rickets

Apart from long term adverse effects on growth, malnutrition greatly increases ___ by reducing ___.

Increases **mortality of common disease** By reducing the child’s **immune response**

How many kids under 5 are undernourished and underweight?

90 million +

What is the monitoring agency for the nutrition goal

Food and Agriculture Organization

FAO tracks malnutrition by measuring ____ through ____.

Daily caloric intake Through household income/expenditure survey

What are the bad sides of the FAO surveys

Don’t measure food eaten outside of the house Measure money spent on food vs type of food

How many ppl are undernourished globally?

795 million (1 in 9)

What is the MDG target for malnutrition?

11.6%

Which two regions account for the larger share of global undernourishment? How much has it increased since 1990?

South Asia Sub Saharan Africa Increases by 44 million

Most underweight children live where?

South Asia

Setbacks in a small area can go unnoticed if there are what?

Large improvements in another region

Countries with highest percentage of undernutrition are where ?

In Africa (Especially Sun Saharan Africa)

What are the 4 most affected African counties in undernutrition?

Burundi Chad DRC Eritrea

What are the 4 most affected counties by undernutrition in Asia ?

Bangladesh Nepal North Korea Cambodia

What are 3 of the principal contributory factors of malnutrition in Asia ?

Poor education Gender inequality Poverty

What are 3 of the principal contributory factors of malnutrition in Africa ?

Conflict Government ineffectiveness High rates of HIV/AIDS

Countries with the highest level of malnutrition is prolonged what 2 things? What are examples of 4 counties?

Humanitarian or natural disasters North Korea Afghanistan Sudan Haiti

On what two people does the burden fall most heavily on?

Women and small children

First two targets of SDG on hunger is by 2030 end what?

End Hunger and Malnutrition

How many ppl suffer from malnutrition globally and what percentage are preschool kids

795 million, 20-25% preschool

What is the case mortality of severe malnutrition

1 in 4 die

What is the most obvious and easily measurable result of malnutrition

Poor growth

Why is BMI not used

Harder to calculate

Marasmus vs Kwashiorkor

Marasmus: very wasted, symmetrically small, no edema Kwashiorkor: less growth failure, poor skin, edema

Why does one get kwashiorkor or marasmus ?

Abnormal hormone/immune response to starvation Alfatoxins in grain Micronutrient deficiencies

When does the child’s brain grow most rapidly?

Conception to the 2nd or 3rd bday

Malnutrition in early school years causes what 3 things that will reduce the child’s ability to learn

Apathy Reduced activity Lack of curiosity

Severe malnutrition has profound adverse effects on what?

A child’s immune system

Of the 10 mill kids that die a year from major killers (respiratory infections, diarrhea etc), what % of deaths were from malnutrition

25-50%

It is possible to have micronutrient deficiencies despite what?

A normal diet

What is micronutrient deficiency often referred to as

Hidden hunger

Regular Provision of micronutrient ROI = what 3 things

improved growth, development, and survival

How much of the worlds population live in areas where there’s little iodine in soil

1/3

Iodine is an essential factor in what hormone, which is an essential factor needed for early what?

Thyroid hormone, early brain development

How does the subtle problem of iodine deficiencies manifest itself?

As poor school performance and lack of energy

Iodine deficiencies is the single most common cause of preventable what?

Mental retardation and brain damage

The average IQ is how many points higher in an iodine supplemented pop?

13 points

Before vitamin A supplementation and measles vaccine how many kids were blinded per year

250k

What happened to the Morality rate from measles with the addition of vitamin A?

Rate was halved

What are examples of Food fortification with iodine and vitamin A

Iodine: salts and cooking oil Vit A: maize, wheat, sugar

What is the most common micronutrient deficiency in the world?

Iron

What happens to children who are born to iron deficient mothers

Breast milk is low in iron Baby has Marginal storage of iron at north to deal with a period of rapid physical and neurological growth

How many children in the developing world between 6mo-2yr are iron deficient

At least half

Worst affected children in iron deficiency are found in countries where children are weaned onto what?

A rice porridge low in iron

What are the effects of iron deficiency in adults?

Reduced ability to work Increases risks during childbirth

Zinc is necessary for what 2 things? Zinc deficient women have a higher rate of what?

Brain development Normal labour Higher rate of obstructed labour

Acute and longer term use of zinc does what with gastroenteritis?

Acute use shortens duration of illness Long term use reduces risk of pneumonia, malaria, and recurrent gastroenteritis

Folate is essential for what 2 things?

Fetal growth & development Production of red blood cells

Folate deficiency during pregnancy is associate with what for the mother, and what for the baby?

Anemia for mom Fetal defects for baby esp Spina Bifida

Folate during pregnancies reduces what?

Developmental abnormalities particularly congenital heart defects

Combined what supplementation is essential for prenatal care

Folate - iron supplements

What is the longest lasting uncontrolled experiment lacking informed consent

Formula feeding

In 19th century dry nursing with other animal milk, what milk was the best option?

Donkey milk

Children in 19th century who weren’t breastfed suffered what?

Much higher mortality

Nestle and Von Leibig breast milk substitutes were based on what 4 ingredients?

Cows milk Wheat Malt Sugar

Baby formulas started during American Civil war by adding ___ to ___ which extended its storage life

Sugar to evaporated cows milk

Cookbooks included recipes for milk formula which additives included what

Cows milk Cod liver oil Orange juice Sugar

By WWII ____ recipes became the most common form of infant nutrition

Evaporated milk recipes

By the 1970s what % of 2-3 month old babies in the US were breastfed

25%

What was a major factor behind the popularity of commercial formulas

Aggressive marketing by baby food industries

Breastfeeding delivery isn’t complicated by malnutrition and infection resulting from incorrect ____ by a mother who has not had any access to ___

Incorrect **mixing of powder with dirty water** by a mom who hasn’t had access to **education**

Commerciogenic malnutrition pamphlet “Child nutrition in developing countries” and “The Baby Killer” campaign led to what?

International boycott of Nestle products in 1977

Code of conduct by WHO in 1981 and Innocenti Declaration in 1990 places restrictions on what?

Advertising of baby formulas and requires sales ppl to not provide milk or promotional gifts in hospitals

Exclusive breastfeeding in the first 6 months of life protects the child from what?

Wide range of diseases Particularly **gastroenteritis and malnutrition**

How many deaths of children / year can be prevented from exclusive breast feeding

Over a million

First large attempt to repopularize breast feeding was in 1989 by WHO and UNICEF creating a pamphlet called

Protecting, promoting, and supporting breastfeeding: the special role of maternity service

The baby friendly hospital initiative in 1991 includes what strategies?

Extra training for health care staff Promotion of breastfeeding before and after pregnancy Support for breastfeeding by trained lactation consultants

Food security exists when all people at all times have ___ access to what?

**Physical, social, and economic** access to **sufficient, safe, and nutritious food** to meet their dietary needs and food preferences for an active and healthy life

What are the 4 pillars of food security

Availability Access utilization stability

1974 world food conference declared “every man woman and child has the inalienable right to be ….”

Free from hunger and malnutrition

Food aid was first provided to developing countries in 1950s was a way for developed countries to do what?

Dispose of grain surpluses

What are some of the controversies/criticism food aid has attracted?

Creating disincentives Depressing food prices Distorting markets Delaying need for policy reform

Chapter 6: Malnutrition Flashcards

(100 cards)