Food and Health

Question 1

global pattern in nutrition indicator: The Global food security index

Answer 1

Considers the affordability, availability and quality of food across 113 countries
The index is based on 28 indicators that measure food security in high, middle and low-income countries
The index looks beyond hunger to study the underlying factors affecting food security
In 2015, food security improved in almost every region of the world
High income countries still dominate the top of the rankings but lower middle income countries made the biggest gains
The middle east and north africa made the largest strides in food security
Euprope is the only region where food security worsened
Diet diversification and access to high-quality protein are increasing rapidly in low-income countries.
Nutritional standards have improved substantially in almost every region

Question 2

global pattern in nutrition indicator: The global hunger index

Answer 2

The global hunger index ranks countries on a 100-point scale, with 0 being the best score and 100 being the worst
Values lower than 10 reflect low hunger
Values of 10 - 19.9 is described as moderate hunger
Values 20 - 34.9 indicates serious hunger
Values 35-49.9 is alarming hunger
Values 50 or more is extremely alarming hunger
The GHI is based on 4 component indicators
Undernourishment - the proportion of undernourished people as a percentage of the population (the share of the population with insufficient caloric intake )
Child wasting - the proportion of children under the age of 5 who suffer from wasting (that is, low weight for their height, reflecting acute undernutrition)
Child stunting - the proportion of children under the age of 5 who suffer from stunting (that is, low height for their age, reflecting chronic undernutrition)
Child mortality - the mortality rate of children under the age of five (partially reflecting the fatal synergy if inadequate nutrition and unhealthy environments)
Trends
Hunger is the highest in Africa south of the Sahara and South Asia

Question 3

Calories per capita

Answer 3

Caloric intake is the amount of food (measured in calories) a person consumes
It shows the average daily caloric intake per person by country
The world average is about 2780 kcal/person/day and the minimum recommended is around 1800 kcal/person/day
However, this varies with age, gender, type of work, amount of physical activity and climate
Countries with the highest daily caloric intake include Austria and USA (3800 and 3750 kcal/person/day
In contrast low income countries have an intake of around 2600 Kcal/person/day
In sub saharan africa, central africa, burundi(1680) and eritrea the caloric intake is even lower

Question 4

Indicators of Malnutrition

Answer 4

Malnutrition means poor nourishment, and refers to a diet lacking (or with too many) nutrients.
There are many types of malnutrition:
Deficiency diseases such and pellagra result from lack of specific vitamins or minerals
Kwashiorkor is a lock of protein in the diet
Marasmus is a lack of calories/energy
Obesity results from eating too many energy/protein foods
Starvation refers to limited or non-existent intake of food
Temporary hunger is a short-term decline in the availability of food to a population in an area
Famine occurs when there is a long-term decline in the availability of food in a region

Question 5

nutrition transition pattern 1

Answer 5

hunter gather society(paleoletic human)
plants + animals
water was the drink of choice
labour intensive
diet generally high carbs, low fat
lean + robust
high disease rate
low fertility
low life expectency
obestity is rare

Question 6

nutrition transition pattern 2

Answer 6

settlements began
early argiculture
cultivation of a single crop
cereals dominare
water
labour + intensive
famine emergence
nutritional deficiences began
less lean + robust
high fertility
high mortality
low life expectancy
stage one of the demographic transition model

Question 7

nutrition transition pattern 3

Answer 7

Industrialization + Receding Famine
Foods
Starchy, fruits, vegetables, animal protein
Low variety
High fibre
Labor intensive
Work life + home life
Weaning
Child stunting
Slow decline in mortality
Falling death rates
Falling birth rates

Question 8

nutrition transition pattern 4

Answer 8

Non-communicable diseases
Shift from communicable disease to non communicable disease
Covid is communicable
Increased fat + sugar
Processed food
Overeating
People have access to a lot of high calorie foods
Shifts in technology of work + leisure
People are less active
Leads to increase in obesity and obesity related diabetes
Diabetes
Heart disease
Larger life expectancy

Question 9

nutrition transition pattern 5

Answer 9

Behavioral patterens
Individuals + communities change their behavior in response to the obesity related chronic diseases:
Decrease in high fat
Less sugary drinks
Increase in fruits + veggies
Decease in body fatness
Decrease in non communicable disease
Extended health
Aging reduced

Question 10

Global pattern in health indicators: life expectancy

Answer 10

Average age of death in a population
Societies that are more developed have a significantly larger life expectancy (Canada, Australia, Finland, UK, etc.)
Societies tend to have a higher life expectancy
With better hygiene, healthier lifestyles, sufficient food and improved medical care and reduced child mortality
All which helps people live longer than our ancestors

Question 11

Global pattern in health indicators: HALE

Answer 11

Indicator of the overall health of a population
Combines measures of sex specific and age health data and sex specific and age mortality data into a single statistic
Average number of years that individual is expected to live in a healthy state
Indicates the number of expected years of life equivalent to years lived in full health, based on average experience in a population
HALE is not only a measure of quantity of life but also quality of life

Question 12

Global pattern in health indicators: child mortality rates

Answer 12

Also known as the under 5 mortality rate
The probability that per 1000 births that a child will die before reaching the age of 5
Calculated by: Number of deaths in children under the age of 5 / number of children under the age if 5 years x 1 000
Extremely high rates of child mortality are found in Angola, Sierra Leone, Chad and Somalia
All countries with over 10.1% child mortality rates are in sub-Saharan Africa
Only 2 countries with child mortality rates over 7.5 % are not in sub-Saharan Africa (Afghanistan and Sri Lanka).
Countries with low child mortality rate (0-1 percent) mainly in southern and eastern Europe

Question 13

Global pattern in health indicators: infant mortality rates

Answer 13

Number of deaths in children under the age of 1 per 1000 live births
age -specific mortality rate that is comparing the death rates among the same ages, making it more useful than crude death rate
Afghanistan and Mali have high infant mortality rates (100 per thousand)
After Afghanistan, the next 24 highest IMRs are all from sub-saharan Africa
Countries with a high human development index have a low IMR and those with low HDI have high IMRs
The region with the highest IMRs is Central Africa, with on average an IMR of 96 per thousand in 2015 (In contrast the world average was 37 per thousand)

Question 14

Global pattern in health indicators: Maternal mortality rates

Answer 14

Annual number of female deaths per 100 000 live births from any cause related to or aggravated by pregnancy or its management
In 2016 South Sudan had the highest MMR followed by Chad then Somalia.
The highest MMRs are found in sub-saharan Africa, parts of South Asia, Haiti anf Guyana
Lowest MMrs are found in high-income countries if Europe, Australia and Singapore
High mortality in sub-Saharan Africa and moderate mortality in South eastern and eastern Asia in the oceania

Question 15

Global pattern in health indicators: access to sanitation

Answer 15

According to the World Health Organization 68 percent of the world’s population now uses an improved sanitation facility
Due to a combination of population growth and slow progress the number of people on sub-Saharan Africa without access to sanitation has increased since 1990
There are rural and urban disparities
While 80 percent of the urban population has access to improved sanitation facilities
51 percent have it in rural areas
Population without sanitation access lives primarily in Asia, sub-Saharan Africa, Latin America, and the Caribbean

Question 16

Global pattern in health indicators: access to healthcare services

Answer 16

Usually measured by the number of people per doctor or per hospital
One doctor per 100 000 in Burundi, one doctor per 50 000 people in Mozambique, one doctor per 280 people in hungary and iceland

Question 17

Epidemiological transition: Phase 1

Answer 17

Pestilence + Famine
Infectious disease
War
Famine

Prehistoric - 1750’s
People started living in close proximity in city states

Travel + trade between city states allowed for disease to spread
Eg. The Plague

Devastating effect on human population
Plague killed approx. 25 million ppl
⅓ of Europe’s population in 5 years

War, famine, low living standards, poor hygiene, no access to health care

Question 18

Epidemiological transition: Phase 2

Answer 18

Receding Pandemics
Nutrition
Sanitation
Medical Care

1750s - 1950s
Industrial Revolution improved nutrition, sanitation + medical care

Massive decrease in the spread of infectious diseases + epidemic

People living in poor areas in the city still died of infectious diseases

Great innovation in medicine

Question 19

Epidemiological transition: Phase 3

Answer 19

Degenerative Disease
Cardiovascular Disease
Strokes
Obesity
Diabetes
Cancer

1950’s - Present
Due to vaccines, antibiotics, and improvements in the social determinants of health

Increase in life expectancy
Increase in diseases that are prevalent among the elderly

More sedentary lifestyle with dietary changes that contributed to an increase in obesity

Question 20

The Epidemiological Transition is Going to Continue

Answer 20

Going to see the re-emergence of infectious ideas, even in high income countries
Driven by 2 things
Increase in microbial resistance
Seeing infectious diseases that are difficult (and in some cases impossible) to treat with antibiotics + other microbials
Ongoing race between humans trying to develop new drugs to treat infectious diseases and microbes developing new resistant strategies
Microbes have evolved over billions of years to be very good at adapting to changes in micro-chemical environments
2016 approx 500,000 new cases of a drug resistant tuberculosis
Seeing resistance merging in HIV treatments, malaria, to other resistant organisms in hospital
Increase emergence of novel zoonotic infections
Zoonotic: Infections when a microbe jumps from an animal to infect humans
Last few decades we’ve seen:
HIV
MERS
Covid
Sars
Ebola
Given the increase in population density + that in any one year approximately 1 billion people move from one place to another, were likely to see more + more infectious disease spread

Question 21

Managing NCDs in Poor Countries

Answer 21

Patients require ongoing treatment
Prevention requires lifestyle changes
Multidisciplinary teams are needed
Self management + education are difficult

Question 22

double burden of disease

Answer 22

In many developing countries this process is taking place very quickly and at a time where there are existing social disparities
We are seeing a double burden of disease
Infectious disease
Emergent of huge numbers of chronic disease
Has huge impacts on health systems because of resource constraints, health care systems are not geared up to deal with this double burden

Question 23

diffusion

Answer 23

spread of something more widely. This spread cab be related to disease diffusion of agriculture innovations. Disease/agriculture innovation can be classified into a number of types

Question 24

Expansion Diffusion

Answer 24

occurs when a disease or agriculture innovation spreads from one place to another. In the is expansion process the disease often intensifies in the originating region. as the disease expands to new areas, its likely to weaken, This type of diffusion was recognized in the recent H1N1 flu that had its source in Mexico

Question 25

Relocation Diffusion

Answer 25

spatial/geographic process, whereby the disseas leaves the areas in which it orginated as it moves to new areas. An example is the migration of people with HIV or measles. The spread of cholera in Hati in 2010 was to be brought by aid workers from Nepal.

Question 26

Contagious Diffusion

Answer 26

spread of disease that depends on direct contant. most applicable to disease diffusion. Type of diffusion whereby the process is strongly influenced by distance because nearby induviduals or regions tend to have a much higher probabiltity of contact or infection than remote induviduals or regions

Question 27

Hierarchical Diffusion

Answer 27

involves the spread of disease through an ordered structure of classes or places, for example from large cities to remote villages. Cascade of diffusion is a tern used to describe a process assumed to be downwards from larger cities to smaller centers.

Question 28

Network Diffusion

Answer 28

occurs when the disease spreads through transportation and social networks. Example is diffusion of HIV which spread along important transport routes in Southern African countries with devolped road networks, as well as social networks.

Question 29

Natural/physical Barriers in diffusion

Answer 29

Natural/physical Barriers Distance Decay The further a place is away from the source of incidence the lower the occurrence of disease Rural Peripheries Affected by the spread of certain diseases as a result of the remoteness of the rural area and the unlikely event that many people will be affected by the disease, which lowers the possibility of diffusion. Mountainous Regions Mountains and oceans act as major natural barriers to the spread of disease as they contain people and restrict migration Regions of Extreme Climate Experience relatively small amounts of in and out‐ migration As a result the spread of disease into these regions is less likely.

Question 30

Human Measures Barriers in diffusion

Answer 30

Human Measures Socio‐political Structures Political borders and migration control and restrict or prevent the movement of people US migration policy specifically prevents the immigration of foreigners who carry infectious diseases Borders can be completely closed but would need to be an extreme case because of economic impacts Management of disease is directly related to the way in which a disease is transmitted In the case of the H1N1 flu virus many measures were adapted in the UK Initially, people who contracted the flu were isolated in their homes This later became a bit of a problem as these they were giving media interviews from their house windows Isolation is an important management measure and is essential for highly infectious diseases such as cholera. Awareness of Improved Hygiene in UK Advised to stop typical greeting customs (kisses + hand shakes) and to wash their hands In public places like airports and railway stations people wore face masks In Catholic ceremonies people didnt from drinking directly from the chalice during the celebration of the Eucharist Authorities canceled larger public events (sports events and concerts)