Chapter Eight

Chapter Eight

Nutrition and Global Health

The Importance of Nutrition

• Nutritional status is intimately linked with health status

• Nutrition is the leading risk factor for loss of health in low- and middle-income countries

• Low-cost, highly effective interventions are available to improve nutrition status

Definitions and Key Terms

• Malnutrition - refers to those who do not get proper nutrition, whether too little, too much, or the wrong kind

• Undernourished - refers to those who lack sufficient energy or nutrients

• Underweight - refers to those who have low weight for their height or age

• Overweight or obese - refers to those who are nourished to the point of being too heavy for their height or age

Table 8.3: Key Terms and Definitions

Source: Adapted with permission from The World Bank. Repositioning Nutrition as Central to Development. Washington, DC: The World Bank;2006:xvii.

Table 8.3: Key Terms and Definitions (cont.)

Source: Adapted with permission from The World Bank. Repositioning Nutrition as Central to Development. Washington, DC: The World Bank;2006:xvii.

The Determinants of Nutritional Status

Immediate causes of malnutrition: • Inadequate dietary intake- weakens the body

and opens it up to infection• Illness- makes it harder for people to eat,

absorb the nutrients they take in, and raises the need for some nutrients

Relationship creates a cycle of illness and infection

Figure 8.1: The Determinants of Nutritional Status: The UNICEF Framework

Gauging Nutritional Status

• Nutritional status of infants and children is gauged by measuring and weighing them, then plotting weight and height on a growth chart

• Child’s position on growth curve indicates if they are developing normally

• Large share of nutritional deficits are mild, but still have negative consequences on development

Key Nutritional Needs

Undernutrition• Outcome of insufficient food intake and repeated

infectious disease • Includes underweight, stunted, wasted, and

micronutrient malnutrition• Raises risk of illness and decreased intellectual

capacity in children • Raises risk of pregnancy-related death and delivering

prematurely in women


Vitamin A • Deficiency associated with night blindness and

eventually, permanent blindness• Important to growth and the proper

functioning of the immune system • Impact on severity of illness and chance of

survival from several causes, including diarrhea, malaria, and pneumonia


Iodine • Deficiency associated with a growth on the

thyroid called a goiter and the failure to develop full intellectual potential

• Occurs in people who live in mountainous regions where less seafood is consumed and the soil is deficient in iodine


Iron• Deficiency causes iron deficiency anemia

which is associated with fatigue and weakness• Iron-deficient pregnant women have an

increased risk of giving birth to a premature or low birthweight baby or hemorrhaging and dying in child birth


Zinc• Deficiency is associated with growth

retardation, impaired immune function, skin disorders, hypogonadism, and cognitive dysfunction

• Deficiency is a major risk factor for morbidity and mortality from diarrhea, pneumonia, and malaria

Nutritional Needs Throughout the Life Cycle

Pregnancy and Birthweight • Pregnant women need a sufficient amount of

protein and energy as well as iron, iodine, folate, zinc, and calcium

• Fetuses that do not get sufficient nutrition from the mother may suffer from stillbirth, mental impairment or birth defects


Infancy and Young Childhood• Children need sufficient protein and energy as well as

iodine, iron, vitamin A, and zinc• Nutritional gaps during this time can cause problems

with stature and mental development, and frequent infection

• Grow best and stay healthiest if exclusively breastfed for first 6 months

• “Window of opportunity” is in utero to two years of age


• Adolescents need protein and energy to grow as well as iron, iodine, folic acid, and calcium

• Adolescent girls who are poorly nourished are much more likely to give birth to an underweight child and experience complications during pregnancy than well-nourished girls


Adulthood and Old Age• Adults need a well-balanced diet with protein,

energy, and iron• Foods that contain too much fat, cholesterol,

sugar, or salt can be harmful• Older adults need calcium to reduce risk of

osteoporosis

Nutritional State of the World

Undernutrition• 26% of under-5 children are underweight

according to most recent estimates• Rates of underweight vary considerably by region • Only about 0.5% of total deaths in low- and

middle-income countries are directly due to undernutrition

• Deaths are usually “nutrition related”


Low Birthweight• 11% of babies in low- and middle-income

countries are born low birthweight according to recent estimates

• About 3% of DALYs lost in low- and middle-income countries are attributable to low birthweight


Vitamin A• About 250 million children suffer from

vitamin A deficiency worldwide • 6.5% of all deaths of children under-5 in low-

and middle-income countries are due to vitamin A deficiency


Iodine• About 70 million people worldwide are

affected by iodine deficiency• Associated with substantial DALYs lost in

low- and middle-income countries

Nutritional State of the WorldIron

• About 1.6 billion people were affected by anemia between 1993 and 2005

• Substantial public health problem for children under 5 and pregnant women, especially in low- and middle-income countries

• 0.7% of DALYs lost in low- and middle-income countries is related to iron deficiency anemia


Zinc• Second most important micronutrient

responsible for death and DALYs in children under 5

• About 4% of DALYs lost in children under 5 years of age are due to zinc deficiency

Nutrition, Health, and Economic Development

• Nutrition impacts health and human development• Link to what people learn and their productivityPoor nutrition: • Impacts maternal health, which affects household

income and health of children• Affects children’s ability to learn in school,

which impacts their future prospects • Leads to lower productivity in adult workers

Documents

Chapter Eight