Transcript Developing a Framework for Understanding Hunger

The Physical Side of Hunger
Concepts & Measurements
First Steps:
Define Interrelationships
• Food Insecurity
• Hunger
• Under-nutrition
Three Nested Concepts
Food
Insecurity
Hunger
Under-nutrition
Food Insecurity
Food Security vs. Food INsecurity
• Food security: A condition that exists when
all people at all times are free from hunger.
It has four elements:
-
Availability
-
Access
Utilization
Vulnerability
• Food insecurity = absence of food security
Food Security Framework
Hunger status
Inadequate food
Availability
Inadequate food
access
Elements of vulnerability
• Physical and environmental risks
• Economic and market risks
• Social and health risks
Inappropriate food
utilization
Hunger
Hunger
• A condition in which people lack the required
nutrients, both:
• Macronutrients (protein, carbohydrates, & fats)
AND
• Micronutrients (vitamins & minerals), for fully
productive, active, & healthy lives
Hunger
• Short term
• Chronic, Acute, or Hidden
• Physical & Mental Hunger Sensation
Short-term Hunger
A transitory, mild form
of hunger that
temporarily affects
mental and physical
capacity (i.e. school
children)
Chronic, Acute, & Hidden Hunger
Chronic Hunger
• Occurs when people
suffer from hunger for
long periods. Hunger
becomes their normal
condition.
Chronic, Acute, & Hidden Hunger
Acute Hunger
• Occurs when people
suffer from hunger
for short periods,
usually due to shocks
such as drought or
conflict
Chronic, Acute, & Hidden Hunger
Hidden Hunger
• Occurs when people
lack essential
micronutrients, even
if the consume
adequate amounts of
calories and protein
Physical Side of the Hunger
Sensation
2. Hypothalamus
creates hunger
sensation
3. You eat food
5. Hypothalamus
creates satiation
sensation
1. Gherlin
released in
stomach and/or
glycogen levels in
blood go down
4. Leptin
and
other
hormones
released in
stomach
Gherlin Helps Trigger Hunger Sensation
• Gherlin levels rise
before meals, but fall
after them
• Gherlin has been
called the ‘hunger
hormone,’ but in fact,
a number of
hormones are
involved
Mental Side of the Hunger
Sensation
• Cultural/Societal Factors
– Meal times
– Preferred foods
– Appropriate color of
food
• Emotional Factors
– Stress
– Repulsion
– Anger
Under-Nutrition
Malnutrition vs. Under-Nutrition
• Often used loosely &
Interchangeably
• Malnutrition refers to all
deviations from adequate
and optimal nutritional
status, including energy
under-nutrition and overnutrition (obesity is a form
of malnutrition)
Malnutrition vs. Under-Nutrition
• Under-nutrition is used to
refer to generally poor
nutritional status, but also
implies underfeeding
Malnutrition
• Nutritional
deficiencies (undernutrition)
OR
• An excess of certain
nutrients (overnutrition)
Under-Nutrition
• A form of hunger that
results from serious
deficiencies in one or
more essential
nutrients and that can
have lasting mental
and physical impacts
• Mild
• Moderate
• Severe
Under-Nutrition
Two Principal Types
• Protein Energy Malnutrition
(PEM)
– A result of deficiencies in any
or all nutrients (in particular
macronutrients)
• Micronutrient Deficiency
Diseases (MDD’s)
– A result of deficiencies in
specific micronutrients (such
as vitamins or minerals)
Measurements of Under-Nutrition
STUNTING
(shortness – height for age)
CHRONIC UNDER-NUTRITION
WASTING
(thinness – weight for height)
ACUTE UNDER-NUTRITION
UNDER-WEIGHT
(thinness/shortness
– weight for age)
Occurs as a result of
inadequate nutrition over
a long period of time
Occurs as a result of
recent rapid weight loss
or a failure to gain weight
Occurs as a result of
weight loss
or inadequate nutrition
over a long period of time
Who is stunted & who is wasted?
A
A:
B:
C:
D:
B
C
D
Healthy
Stunted
Wasted
Stunted & Wasted
Malnutrition
Forms of
Protein Energy Malnutrition (PEM)
• Marasmus
– Severe loss of body weight
• Kwashiorkor
– Swelling (oedema)
• Marasmic Kwashiorkor
– Combines symptoms of
Marasmus & Kwashiorkor
Marasmus
Marasmus
Marasmic child
Same child
after refeeding
Kwashiorkor
Note the peeling
of the skin around
The stomach area
Kwashiorkor
Kwashiorkor
Same child after refeeding
Kwashiorkor
Three Most Common
Micronutrient Deficiency Diseases
• Iron Deficiency
– Anemia
• Vitamin A Deficiency
– VAD
• Iodine Deficiency
– Goitre
Iron Deficiency
• Iron is essential for
transport of oxygen in
blood
• Iron deficiency leads to
poor cognitive
development of
children, contributes to
maternal death, &
causes fatigue
Iron Deficiency
• 3 to 5 billion people are
affected by this disease
in the world,
particularly:
– Pregnant women
– Children 5-14 years and
pre-school age
– Older adults
Symptoms of Iron Deficiency
Approaches to Anemia
• Access to fortified
foods (e.g. cereallegume blends, wheat,
maize flour, etc.)
• Access to dietary
sources of iron &
Vitamin C
Approaches to Anemia
• Iron/folate
supplements for
pregnant & lactating
women, infants
(especially with low
birth weight), and
young children
• Control of infections
(such as malaria,
worms, etc.)
Vitamin A Deficiency (VAD)
• VAD is the leading
cause of preventable
blindness among preschool children
• VAD weakens the
immune system and
increases clinical
severity and mortality
risk from measles and
diarrhea
Vitamin A Deficiency (VAD)
• WHO estimates that
21% of all children
suffer from VAD, mostly
in Africa & Asia
Symptoms of Vitamin A Deficiency
Approaches to Address
Vitamin A Deficiency
• Vitamin A supplements
for children 6 months to
5 years and women after
delivery
• Access to dietary
sources of Vitamin A
(orange and red fruits &
vegetables)
Approaches to Address
Vitamin A Deficiency
• Promotion and support
of breastfeeding
• Access to fortified
commodities: oil, cereallegume blends
Iodine Deficiency
• Single most common
preventable cause of
mental retardation and
brain damage
Iodine Deficiency
• 1 billion people are
estimated to have some
degree of goitre (mostly in
Africa, Middle-East and
Asia, but also in Europe)
Symptoms of Iodine Deficiency
Approaches to Address
Iodine Deficiency
• Fortification (iodization of
salt)
• Access to iodine rich foods
(seafish, seaweed, etc.)
Conclusion: Three Nested Concepts
No current hunger, but vulnerability to it
Food
Insecurity
Hunger
Under-nutrition
It can take many forms, including
Protein Energy Malnutrition and micronutrient deficiencies