Malnutrition: a deficiency or an excess in the intake of nutrients and other dietary elements needed for healthy living.

Dietary Components Macronutrients provide the basic building blocks and energy for cellular growth; carbohydrates, fat, and proteins. Micronutrients are vitamins and minerals Some other components include fiber and cholesterol

Global Malnutrition Three major groups: –the hungry, lacking in calories (1.2 billion) –the overfed (1.2 billion) –Those lacking vitamins and minerals (several billion)

Hunger Both the total number and the share of total children in developing countries that is hungry has improved overall in past century However, Africa is an exception (~29% of children are underweight) Hunger and food insecurity in developed countries…

Vitamin and Mineral Malnutrition Can be found in overfed, underfed, or those who do not appear to have a macronutrient deficit Iron deficiency is most widespread globally (~80% of humans), with women and children in poor countries most afflicted Iodine deficiency (leading cause of mental retardation) and vitamin A deficiency (causes blindness, death) Can be due to lack of dietary diversity, such as too much reliance on one grain (poor countries), or processed foods (especially urban societies)

Why so many underfed? 1.Continued, acute caloric deficits are concentrated in rural areas of poor countries, where the poor lack sufficient farmland and/or income to purchase enough food, or are displaced by violence. 2.The rise in cash cropping has displaced small farmers into wage labor in many poor countries – even when total nat’l food production may rise. 3.The transition from subsistence farming to cash cropping often means that the control over household food resources shifts from women to men. As a group, women’s cash management is focused on household needs, men are more likely to spend part on vices.

The Overfed Most found in developed countries, share of total populations there is rising in most countries – though is increasing in urban areas throughout the world The US has highest incidence of overweight and obesity, but many countries are “contenders” Some who are overfed in macronutrients can be simultaneously suffer from micronutrient malnutrition (obesity can mask micronutrient deficiencies)

Why the rise in the overfed? Changes from traditional diets and eating patterns to less nutritional alternatives, and changing livestyles. 1. Healthy traditional diets were generally plant based (vegetables, fruits, whole grains, nuts, and moderate amounts of animal products)

Why the rise in the overfed? (con’t) 2. Modern diets contain more fats and sugars (which we crave), as the industrial food system has promoted processed foods which often rely on low cost fatty and starchy additives. Cheap, empty calories is the result. (Quality foods may thus appear relatively more expensive) 3. Rising urbanization - humans are less physically active in employment and in general. 4. Women’s increased entry into labor force: a) less time for food prep., b) rising demand for convenience (processed) foods, and c) less breastfeeding

Why the rise in the overfed? (con’t) 5.The role of advertising & marketing, including making unhealthy foods ubiquitous supersizing “toxic food environments”: where unprecedented access to high-calorie foods that are low in cost, promoted heavily, and good tasting

Diet and Health Hunger and micronutrient deficiencies increase vulnerability to disease – and have greatest effects on the young and even en utero Overeating increases the risks of certain chronic diseases included most cancers, coronary heart disease, stroke, and type 2 diabetes A combination of healthy diet and adequate exercise can reduce the risk of cancer by 40%.

Social Costs of Malnutrition Scholastic performance Worker productivity: due to both macronutrient deficiencies and obesity National health expenditures

Nutritional Policy Education Limits on advertising to children Promotion of breastfeeding Poverty reduction