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© T. M. Whitmore
TODAY
•Synergy between nutrition and disease continued
•Especially vulnerable populations
•Four faces of hunger
•Global Hunger
© T. M. Whitmore
Questions?•Human Nutrition
© T. M. Whitmore
Synergy: nutrition and disease• Poor nutrition (protein-calorie or other
nutrient shortages) => reduced ability to fend off new infections or makes existing ones more severe
• Diseases interfere with nutrient absorption and/or actively deplete nutrients from our bodies
© T. M. Whitmore
How poor nutrition => disease• Reduction in the body's innate immunities
(that react to general patterns of proteins in pathogens)
• Reduction in ability to generate acquired immunities - the specific immunities one acquires to a particular disease pathogen
© T. M. Whitmore
How disease => poor nutrition• Most infections interfere with the body's
ability to absorb nutrition and/or actively deplete nutrients
• Predominantly diarrheas, but also intestinal parasites, cholera, & various types of dysentery (1.8 billion cases/yr of infant weanling GI diseases ) – oral rehydration
© T. M. Whitmore
Especially vulnerable populations
• Increased likelihood of malnutrition and more serious consequencesWomen in general Pregnant womenLactating womenElderlyChildren
© T. M. Whitmore
Especially vulnerable populations- children
• Malnutrition in infants and children very problematic if timing coincides with critical growth processes Up to age 5 risk is greatest
• Especially at weaning age (approx 2 yrs)• Due to impure water used to make
weaning foods (not sufficiently boiled due to lack of fuel) and general low hygiene => Kids die from diarrheal diseases and
dehydration and malnutrition• Weaning foods are typically
not nutrient-rich enough (e.g., maize gruels)
© T. M. Whitmore
Four Faces of Hunger I Starvation/Famine
• Widespread to complete lack of protein/calorie nutrition
• A small percentage of global hunger – perhaps 1% at risk annually
• Leads to increased mortality (usually to infectious diseases not starvation per se)
• Great social disruption => increased problems with diseases and access to food
• In any famine not all starve – the well off can buy food -- thus NOT usually only a simple shortage
© T. M. Whitmore
Four Faces of Hunger IIMalnutrition/Undernutrition
• Seasonal or periodic P/C under-nutrition
• Most serious effects on kids and special needs adults (pregnant and lactating women, the elderly)
• Measures of undernutrition in childrenStunting - stature too short for age/sex
(adjusted for local norms) => chronicWasting – weight too light for age/sex
(adjusted for local norms) => acute
© T. M. Whitmore
Four Faces of Hunger IIIMicro-nutrient deficiencies
•Vitamin and mineral shortages
•Sometimes called “hidden hunger”
© T. M. Whitmore
Four Faces of Hunger IVNutrition-depleting illnesses
•Secondary malnutrition
•Most common nutrient depleting diseases are infant/weanling diarrheas – 5 million deaths annually world wide
© T. M. Whitmore
Global Hunger• Global situation late 1990s
• Data drawn from FAO’s SOFA report 2002
• The International Food Policy Research Institute
• The concept of “food security”
© T. M. Whitmore
Global Trajectories of Hunger I• Proportions undernourished (or food
insecure) in global southLate 1970s ~ 28%Late 1990s ~17%Thus, real progressLess progress in absolute numbers
• Micro-nutrient deficienciesIron: 40% of global southIodine: 12% of global southVitamin A: 14% of kids in global south
© T. M. Whitmore
Global Trajectories of Hunger II• Absolute numbers undernourished (or food
insecure)1970s ~ 900m; 2000 ~ > 800 m => decrease of ~ 100m in absolute
numbers (but smaller %)
• Children 1993 ~ 200 m; now ~ 175 m
• World food summit target in 2015 => 400mCurrent trajectory => 475-500m by 2015
© T. M. Whitmore
Regional differences malnourished or food insecure
• Global SouthSub-Saharan AfricaE. Asia, SE Asia, & PacificSouth AsiaLatin America & CaribbeanNear East & N. Africa
• Developed Economies (mostly N America)
Source: FAO
Source: FAO
IFPA 2005
IFPA 2005
Source: FAO
Source: FAO
Number of malnourished children, 1993, 2010, and 2020
Source: IFPRI IMPACT simulations.
IFPA 2005
© T. M. Whitmore
Sen’s Entitlement Concept
•Famines/malnutrition/food scarcity/food insecurity are NOT caused by simple food shortages alone (production shortfalls)
•The ability of people to command or acquire food is what is key (entitlement shortfalls)
© T. M. Whitmore
Sen’s Entitlement Concept II•Ways to command/acquire food
Via capital (money or goods [e.g., cattle] exchanged for food)
Via income from labor/work (exchanged for food)
Via assistance (State or NGO) (could be money or food directly)
Via own production (requires access or ownership of enough quality land)
•Most households do not rely on a single source or type
A week’s food for family in Chad – virtually all from own production© Peter Menzel (in Hungry Planet, 2005 Ten Speed Press)
A week’s food for family in NC – virtually all purchased© Peter Menzel (in Hungry Planet, 2005 Ten Speed Press)
A week’s food for refugee family from Darfur, Sudan – virtually all from aid© Peter Menzel (in Hungry Planet, 2005 Ten Speed Press)
© T. M. Whitmore
The “Geographical Hunger Model”
•Underlying ProcessesWorks at all scales
• Immediate CausesRegional/household/individual
scales
•Hunger SituationsRegional/household/individual
scales•Direct Consequences
Regional/household/individual scales
© T. M. Whitmore
Irish “hunger” of 1846-51 an example of Underlying Processes
& background • Surplus production and appropriation &
resource competition
• The potato
• Population growth
• Crop failures and subsistence crisis throughout the nineteenth century
• Racist views toward the Irish (probably delayed help)
© T. M. Whitmore
Irish “hunger” an example of Immediate/Proximate Causes &
Processes •Environmental Fluctuation – infection
of potato crop with Phytophthora infestons a fungal infection (late potato blight) spread by the wind
•Socio-Economic policies that deprived millions of entitlements to food
•Process – not a single event
© T. M. Whitmore
Irish “hunger” Process• Blight 1845 => 40% loss and famine in 1846
• 1846 => near 100% loss + severe winter => severe famine & disease in 1847
• 1847 - 1850 potato crop not blighted but output low due to small planting (people expected blight)
• approximately 500,000 people were evicted, many of whom died of starvation or disease or relocated to mismanaged and inadequate poor houses (could not pay rent)
© T. M. Whitmore
Irish “hunger” Process II
•Eventually the English government also initiated relief schemesWorkhouses as centers of
contagion
• It was at this juncture that the Duke of Norfolk suggested that the Irish should substitute curry powder for the potato and nourish themselves on curry powder mixed with water.
© T. M. Whitmore
Irish “hunger” Process III• Peel was replaced in office in 1846 by Lord
John Russell and a Whig administration dedicated to a laissez-faire policyCharles Trevelyan, Assistant Secretary to
the Treasury under Russell, oversaw famine relief efforts. a “blame the victim” mentality: Irish
were at fault for over-dependence on potatoes and high fertility (too many kids)
The British also saw it as a “natural disaster”: blamed it on the weather and the potato fungus
• Wheat, oats, barley, butter, eggs, beef and pork were exported from the large estates Ireland in large quantities - as many as eight ships left Ireland daily carrying foodstuffs
© T. M. Whitmore
Irish “hunger” Consequences • Starvation and disease became epidemic
More died of disease than of starvation. Most were weakened from long starvation
when they finally succumbed to typhus, cholera, dysentery, and scurvy.
At least 1 million perished• 1 – 2 + million emigrated (mostly to US and
England)• Population of Ireland
1850 = 6.5 m (from 8.5m 5 yrs earlier)1900 4.5 m => longer-term emigration,
much to US