Malnutrition
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2008-07-14T10:53:54Z
MER-C
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Reverted edits by [[Special:Contributions/122.53.47.225|122.53.47.225]] ([[User talk:122.53.47.225|talk]]) to last version by 152.23.91.24
[[Image:Percentage population undernourished world map.PNG|right|300px|thumb|Percentage of population affected by malnutrition by country, according to United Nations statistics.]]
'''Malnutrition''' is a general term for a medical condition caused by an improper or insufficient [[diet (nutrition)|diet]]. It most often refers to '''undernutrition''' resulting from inadequate consumption, poor absorption, or excessive loss of nutrients, but the term can also encompass [[overnutrition]], resulting from overeating or excessive intake of specific nutrients. An individual will experience malnutrition if the appropriate amount of, or quality of [[nutrient]]s comprising a [[healthy diet]] are not consumed for an extended period of time. An extended period of malnutrition can result in [[starvation]], disease, and infection.
Malnutrition is the lack of sufficient nutrients to maintain healthy bodily functions and is typically associated with [[extreme poverty]] in economically [[developing country|developing countries]]. It is a common cause of [[mental retardation|reduced intelligence]] in parts of the world affected by [[famine]]. <ref>[http://www.nytimes.com/2006/12/28/world/africa/28malnutrition.html "Malnutrition Is Cheating Its Survivors, and Africa’s Future"] article in the [[New York Times]] by Michael Wines, December 28, 2006</ref> Malnutrition as the result of inappropriate [[dieting]], [[overeating]] or the absence of a "balanced diet" is often observed in economically [[developed country|developed countries]] (eg. as indicated by increasing levels of [[obesity]]).
Most commonly, malnourished people either do not have enough [[calorie]]s in their [[diet (nutrition)|diet]], or are eating a diet that lacks [[protein]], [[vitamin]]s, or trace [[mineral]]s. Medical problems arising from malnutrition are commonly referred to as [[deficiency disease]]s. [[Scurvy]] is a well-known and now rare form of malnutrition, in which the victim is deficient in [[vitamin C]].
[[Image:Scurvy Victims.jpg|thumb|200px|right|Prisoners who died from the malnutrition in [[Gulag]]. Painting by [[Nikolai Getman]], provided by [[Jamestown Foundation]] ]]
Common forms of malnutrition include [[protein-energy malnutrition]] (PEM) and [[micronutrient malnutrition]]. PEM refers to inadequate availability or [[absorption (digestive)|absorption]] of [[energy]] and [[proteins]] in the body. [[Micronutrient]] malnutrition refers to inadequate availability of some essential nutrients such as [[vitamin]]s and [[mineral|trace elements]] that are required by the body in small quantities. Micronutrient deficiencies lead to a variety of diseases and impair normal functioning of the body. Deficiency in micronutrients such as Vitamin A reduces the capacity of the body to resist diseases. Deficiency in [[iron]], [[iodine]] and [[vitamin A]] is widely prevalent and represent a major [[public health]] challenge. An array of afflictions ranging from stunted growth, reduced intelligence and various cognitive abilities, reduced sociability, reduced leadership and assertiveness, reduced activity and energy, reduced muscle growth and strength, and poorer health overall are directly implicated to nutrient deficiencies. Also, another, although rare, effect of malnutrition is black spots appearing on the skin.
[[Hunger]] is the normal psychological response brought on by the physiological condition of needing food. Hunger can also affect the mental state of a person, and is often used as a [[metonymy|metonym]] for general undernourishment.
==Politics==
{{Unreferencedsection|date=May 2007}}
[[Image:Orange ribbon.svg|thumb|100px|The orange ribbon—an [[awareness ribbon]] for malnutrition.]]
[[As of 2008]], malnutrition continues to be a worldwide problem, particularly in [[lesser developed countries]]<ref>http://www.who.int/child_adolescent_health/topics/prevention_care/child/nutrition/malnutrition/en/</ref>. According to the [[Food and Agriculture Organization]] of the [[United Nations]], "850 million people worldwide were undernourished in 1999 to 2005, the most recent years for which figures are available" and the number of malnourished people has recently been increasing. An orange [[awareness ribbon]] is used to raise awareness of malnutrition in the world.<ref>{{cite web |url=http://www.un.org/Pubs/chronicle/2003/issue4/0403p66.asp |title=FoodWatch Setback in the War Against Hunger |accessdate=2007-05-14}}</ref> The FAO calculates undernourishment by comparing the amount of food available in a country at national level with how many people live in the country.
Some environmentalists claim that the fundamental issue causing malnutrition is that the [[overpopulation|human population exceeds]] the Earth's [[carrying capacity]];<ref>Ron Nielsen, ''The Little Green Handbook: Seven Trends Shaping the Future of Our Planet'', Picador, New York (2006) ISBN 978-0312425814</ref> however, [[Food First]] raises the issue of [[food sovereignty]] and claims that every country (with the possible minor exceptions of some city-states) has sufficient agricultural capacity to feed its own people, but that the "[[free trade]]" economic order associated with such institutions as the [[International Monetary Fund]] (IMF) and the [[World Bank]] prevent this from happening. At the other end of the spectrum, the World Bank itself claims to be part of the solution to malnutrition, asserting that the best way for countries to succeed in breaking the cycle of poverty and malnutrition is to build export-led economies that will give them the financial means to buy foodstuffs on the world market.
[[Amartya Sen]] won a [[1998]] [[Nobel Prize]] in part for his work suggesting that [[famine]] is not typically the product of a lack of food; rather, famine may arise from problems in food distribution networks or from governmental policies in the developing world.
The politics of food trade and food security are often difficult to grasp. Many people believe that sending food aid to the poor of the world is a worthy idea, but that each country should produce its own food.
Countries that have become more open to international trade in recent years (e.g. China, Vietnam or Peru) have greatly reduced the prevalence of undernourishment as measured by the [[FAO]] (food energy consumption below acceptable minimum) or as measured by the [[World Health Organization]] by the percentage of children under five who are stunted, wasted or underweight. Countries that remained closed to external trade (e.g. [[North Korea]]) have not improved or have worsened their food situation.{{Unreferenced|date=May 2007}} Some anti-globalization groups advocate "food sovereignty", stating that each country should be physically self sufficient in every food item consumed by their people; by this measure the United States, United Kingdom, Sweden, Belgium, and in fact almost all other countries in the world would be food insecure, and a desert nation like Saudi Arabia (with its current population) would not be viable as a country at all.
One policy adopted in recent decades to alleviate world malnutrition is [[food aid]], i.e. the physical donation of food from rich to poor countries. From the rich donor countries' point of view, this is a suitable way to reduce excess supply created by domestic [[agricultural subsidies]], stabilizing farm prices in rich countries, even if the cost of supplying the food to its final beneficiaries is often disproportionately high. Food aid may be provided for short-term emergencies ([[natural disaster]]s like earthquakes, tsunamis, droughts and floods, or human-made like [[war]] and refugee flows) or in the form of a long-term program for an extended period. From the viewpoint of recipient countries, the value of food-aid depends on the form it takes. Emergency food aid is welcome, though aid in cash may also be welcome because the food may often be purchased locally in zones not affected by the emergency, thus benefitting local farmers. Long-term foreign food aid has been criticized as discouraging local production and distorting [[market]]s. Instead, [[population control]] has been advocated as a much better approach to solve malnutrition/famine than merely providing food. <ref>[http://www.utilitarian.net/singer/by/1972----.htm Population control as better approach for fighting famines and malnutrition]</ref>
[[Image:ToastsAsCheapFoodPerCalorie.JPG|thumb|right|150px|A pack of toasted bread is a cheap/high nutrient food source (which too has long shelf life) and may be used (as too dehulled [[rice]]) to combat famines.]]
In recent years many foods, such as [[Spirulina]] and [[peanut butter]], have been developed or refined for mass-production in hopes of combatting malnutrition and its effects. See [[IIMSAM]] and [[Plumpy'nut]] for more on these efforts.
==Statistics==
Number of undernourished people (million) in [[2001]]-[[2003]], according to the [[Food and Agriculture Organization|FAO]], the following countries had 5 million or more undernourished people [http://www.fao.org/faostat/foodsecurity/Files/NumberUndernourishment.xls]:
{| class="wikitable"
!Country !!Number of Undernourished (million)
|-
|India
| 212.0
|-
|China
| 150.0
|-
|Bangladesh
| 43.1
|-
|Democratic Republic of Congo
| 37.0
|-
|Pakistan
| 35.2
|-
|Ethiopia
| 31.5
|-
|Tanzania
| 16.1
|-
|Philippines
| 15.2
|-
|Brazil
| 14.4
|-
|Indonesia
| 13.8
|-
|Vietnam
| 13.8
|-
|Thailand
| 13.4
|-
|Nigeria
| 11.5
|-
|Kenya
| 9.7
|-
|Sudan
| 8.8
|-
|Mozambique
| 8.3
|-
|North Korea
| 7.9
|-
|Yemen
| 7.1
|-
|Madagascar
| 7.1
|-
|Colombia
| 5.9
|-
|Zimbabwe
| 5.7
|-
|México
| 5.1
|-
|Zambia
| 5.1
|-
|Angola
| 5.0
|----
|}
Note: This table measures "undernourishment", as defined by [[FAO]], and represents the number of people consuming (on average for years 2001 to 2003) less than the minimum amount of food energy (measured in kilocalories per capita per day) necessary for the average person to stay in good health while performing light physical activity. It is a conservative indicator that does not take into account the extra needs of people performing extraneous physical activity, nor seasonal variations in food consumption or other sources of variability such as inter-individual differences in energy requirements.
Malnutrition and undernourishment are cumulative or average situations, and not the work of a single day's food intake (or lack thereof). This table does not represent the number of people who "went to bed hungry today."
The U.S. Department of Agriculture reported that in 2003, only 1 out of 200 U.S. households with children became so severely food insecure that any of the children went hungry even once during the year. A substantially larger proportion of these same households (3.8 percent) had adult members who were hungry at least one day during the year because of their households' inability to afford enough food.[http://www.ers.usda.gov/AmberWaves/April05/DataFeature/]
===Overnourished vs undernourished===
In 2006, Professor Popkin from the [[University of North Carolina at Chapel Hill|University of North Carolina]], said there were now more overweight people across the world than undernourished people.<ref>[http://news.bbc.co.uk/1/hi/health/4793455.stm Overweight 'top world's hungry']</ref> He told the International Association of Agricultural Economists the number of [[overweight]] people had topped one billion (of which 300 million are [[obesity|obese]]), compared with 800 million undernourished.<ref>[http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2006/08/15/wfat15.xml Overweight people now outnumber the hungry]</ref> He added this transition from a starving world to an obese one was accelerating.
===Mortality due to malnutrition===
According to Jean Ziegler (the United Nations Special Rapporteur on the Right to Food for 2000 to March 2008), mortality due to malnutrition accounted for 58% of the total mortality in 2006: "In the world, approximately 62 millions people, all causes of death combined, die each year. In 2006, more than 36 millions died of hunger or diseases due to deficiencies in micronutrients"<ref>[[Jean Ziegler]], ''L'Empire de la honte'', Fayard, 2007 {{ISBN|978-2-253-12115-2}} p.130.</ref>.
==Effects==
An extended period of malnutrition can result in [[starvation]] or [[deficiency disease]]s such as [[scurvy]]. Malnutrition increases the risk of infection and infectious disease; for example, it is a major risk factor in the onset of active [[tuberculosis]].<ref>{{cite journal |journal= PLoS Med |year=2007 |volume=4 |issue=5 |pages=e115 |title= Malnutrition and infection: complex mechanisms and global impacts |author= Schaible UE, Kaufmann SH |doi=10.1371/journal.pmed.0040115 |pmid=17472433 |url=http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0040115}}</ref>
Malnutrition appears to increase activity and movement in many animals - for example an experiment on [[spider]]s showed increased activity and [[predation]] in starved spiders, resulting in larger weight gain.<ref>Provencher, L.; Riechert, S.E. (1991) Short-Term Effects of Hunger Conditioning on Spider Behavior, Predation, and Gain of Weight ''Oikos'' 62:160-166</ref> This pattern is seen in many animals, including [[human]]s while sleeping.<ref name="Wald">[[George Wald|Wald, G.]]; Jackson, B. (1944) Activity and Nutritional Deprivation ''Proceedings of the National Academy of Sciences of the United States of America'' 30:255-263</ref> It even occurs in [[rat]]s with their [[cerebral cortex]] or stomachs completely removed.<ref>{{citeweb|url=http://www.elijahwald.com/origin.html|title=George Wald: The Origin of Death|accessdate=2007-05-14}}</ref> Increased activity on [[hamster wheel]]s occurred when rats were deprived not only of food, but also water or [[B vitamins]] such as [[thiamine]]<ref>Guerrant, N.B., Dutcher, R.A. (1940) ''Journal of Nutrition'' 20:589.</ref> This response may increase the animal's chance of finding food, though it has also been speculated the emigration response relieves pressure on the home population.<ref name="Wald" />
==See also==
* [[List of countries by percentage of population suffering from undernourishment]]
* [[Anorexia nervosa]]
* [[Auxology]]
* [[Cachexia]]
* [[Copenhagen Consensus]]
* [[Dehydration]]
* [[Essential nutrient]]
* [[Famine]]
* [[Famine response]]
* [[Food price crisis]]
* [[Hunger]]
* [[Illnesses related to poor nutrition]]
* [[Nutrition]]
* [[NutritionDay]]
* [[Plumpy'nut]]
* [[Poverty]]
* [[List of famines]]
* [[United Nations World Food Programme]]
* [[Food]]
== References==
{{reflist}}
==External links==
{{Wiktionarypar|malnutrition|undernutrition}}
*[http://www.aahuk.org Action Against Hunger - Giving the most basic of Human Rights - The right to Food]
* [http://www.cedat.be The CE-DAT Complex Emergency Database - A source of data on malnutrition and mortality in conflict-affected populations]
*[http://www.cbsnews.com/stories/2007/10/19/60minutes/main3386661.shtml A Life Saver Called "Plumpynut"], CBS 60 Minutes, October 21, 2007
*[http://www.doctorswithoutborders.org/news/malnutrition/ MSF Warns More Food Will Not Save Malnourished Children] Group Calls for Increased and Expanded Use of New, Innovative Nutritional Products
* [http://www.algosophette.com Micro-algae Algosophette]
*[http://www.pomun.org Intergovernmental Institution for the use of Micro-algae Spirulina Against Malnutrition (IIMSAM)]
*[http://www.unsystem.org/scn/Publications/html/RWNS.html Reports on World Nutrition Situation] The annual reports prepared by UN Standing Committee on Nutrition contain detailed information on common challenges, extent of malnutrition, efforts being taken to address them, and a wealth of other useful information.
*[http://www.merck.com/mrkshared/mmanual/section1/chapter2/2a.jsp The Merck Manual - Malnutrition]
*[http://medind.nic.in/icb/t05/i7/icbt05i7p573.pdf Physical Growth & Nutritional status]
*[http://www.wfp.org/country_brief/hunger_map/map/hungermap_popup/map_popup.html World Hunger Map] (from [[United Nations World Food Programme]])
*[http://www.fao.org/ag/agn/nutrition/profiles_by_country_en.stm FAO country statistics]
*[http://www.hungrykids.org HungryKids] Info on malnutrition from HungryKids
*[http://www.reliefweb.int/library/documents/2005/wb-eth-28feb.pdf Fighting Hunger and poverty in Ethiopia] ([[Peter Middlebrook]])
*[http://www.medsandfoodforkids.org Meds & Food for Kids] - Fighting malnutrition in Haiti one child at a time.
*[http://www.nutrition-malnutrition.org Malnutrition]
*[http://www.algosophette.com And why not Spirulina as solution?]
*[http://www.gainhealth.org/malnutrition GAIN - Global Alliance for Improved Nutrition]
{{Nutritional pathology}}
[[Category:Malnutrition| ]]
[[Category:Public health]]
[[Category:Humanitarian aid]]
[[Category:Nutrition]]
[[Category:Poverty]]
[[Category:Health problems in India]]
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