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Flashcards in International Nutrition Deck (16)
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1

3 Nutrition-related MDGs

  • Eradicate extreme poverty and hunger (“Halve between 1990 & 2015 the proportion of people who suffer from hunger”)
  • reduce child mortality 
  • Improve maternal health

2

Current prognosis for acheiving MDGs

  • “Though progress has been made, it is uneven...without a major push forward, many of the MDG targets are likely to be missed in most regions.”
  • Reaching goals has become more challenging:
    • Global economic slowdown ==> ↓ income of poor
    • Food security crisis ==> ↑ hunger
    • Climate change disproportionately impacts the poor

3

Groups at risk for malnutrition

  • Women of childbearing age
  • Infants
  • Children (esp “under 5’s”)

4

Contextual factors that ==> malnutrition

  • social, economic, politcal context
    • poor infrastructure, isolation
    • lack of access to resources
    • lack of clean water
  • income poverty
    • lack of capital
    • dwellings w/out electricity
  • lack of access/availability to health care

5

Immediate causes of malnurition

  • Inadequate intake
  • Monotonous diet
  • Food insecurity
  • Disease/illness
     

6

3 major nutrition problems in developing countries

  • maternal undernutrition
  • stunting
  • wasting

7

Consequences of maternal undernutrition

  • Underweight & short stature = independent risk factors for poor reproductive outcomes
  • > 500,000/yr women die in childbirth
  • Undernutrition ==> ↑↑ risk of death (~20% of maternal mortality)
  • ==> growth problems/faltering in children
     

8

Malnutrition in children

  • wasting = acute energy deficit
  • stunting = chronic malnutrition
    • micronutrient deficiencies
    • inflammation, recurrent infection
    • intergeneration effects
    • often have no outward signs of illness of vulnerability

9

Consequences of malnutrition in children

  • Malnutrition = largest percentage of any risk factor for mortality
    • Stunting:  26%
    • Wasting:    8%
    • Severe wasting:    3%
  • Undernourished children…
    • ↓ resistance to infection
    • ↑ mortality from common ailments
    • For survivors, each illness saps nutritional status ® vicious cycle
       

10

Critical periods of growth

  • most critical: first 1000 after conception (conception ==> 2 yrs)
  • other critical periods:
    • pre-conception
    • 2 yrs ==> school age
    • puberty

11

Myths about malnurtion

“Malnutrition is primarily a matter of inadequate food intake”

“Improved nutrition can only come as by-product of poverty reduction”
 

“Broad based action to improve nutrition not feasible”

12

Implications of "inadequate food intake" myth

  • Actually, under-nutrition is not simply result of food insecurity
  • Inappropriate feeding & care practices
    • Exclusive breastfeeding = single most important factor in prevention of deaths in < 5 yo
  • Poor sanitation & disease 
     

13

Implications/challenges to "poverty reduction" myth

  • Education and focused action by parents & communities
  • Use resources available
  • Positive deviance
  • Water/sanitation
     

14

Implications/challenges to "not feasible" myth

  • Fortification programs (selected) cheap
    • E.g. Iodized salt
  • Promotion/support of breastfeeding & Comp Fdg
  • Vitamin A supplements: large dose q 6 mo
  • Zn supplements – for mgt of diarrhea
  • Good management of common illness (ORS, “feed through” diarrhea, etc)
     

15

Approaches to improving nutritional status

  • Supplements
  • fortification
  • technology
  • education
     

16

Pros and cons of supplementation programs