According to World Food Programme (WFP) figures, there are 1.02 billion undernourished people in the world today. That means one in nearly six people do not get enough food to be healthy and lead an active life. In fact, hunger and malnutrition are the number one risk to the health worldwide greater than AIDS, malaria and tuberculosis combined. While natural disasters, conflict, poverty, poor agricultural infrastructure and over-exploitation of the environment remain the key causes of hunger, the recent economic slowdown in many countries have pushed more people into hunger.
Besides the obvious sort of hunger resulting from an empty stomach, there is also the hidden hunger of micronutrient deficiencies which make people susceptible to infectious diseases, impair physical and mental development, reduce their labour productivity and increase the risk of premature death. Economists estimate that every child whose physical and mental development is stunted by hunger and malnutrition stands to lose 5-10 per cent in lifetime earnings.
Acute hunger or starvation, as often highlighted on TV screens, is the result of high profile crises like war or natural disasters, which starve a population of food, yet emergencies account for less than eight percent of hunger’s victims. The less visible form of hunger or daily undernourishment affects many more people, especially in developing countries. For these people, hunger is much more than an empty stomach. Its victims must live for weeks, even months, on significantly less than the recommended 2,100 kilocalories that the average person needs to lead a healthy life.
The lack of energy is then compensated by the body by slowing down its physical and mental activities. Since a hungry mind cannot concentrate, and a hungry body does not take initiative, a hungry child loses all desire to play and study. Hunger also weakens the immune system. Deprived of the right nutrition, hungry children are especially vulnerable and become too weak to fight off disease and may die from common infections like measles and diarrhea. Each year, almost 11 million children die before reaching the age of five and malnutrition is associated with 53 per cent of these deaths.
According to the Food and Agriculture Organization (FAO) statistics, more than 90 per cent of the 1.2 billion hungry people in the world live in developing countries. They are distributed like this: 642 million in Asia and the Pacific, 265 million in Sub-Saharan Africa, 53 million in Latin America and the Caribbean, and 42 million in the Near East and North Africa.
The bodies of malnourished people struggle to do normal things such as grow and resist disease. For them, physical work becomes very difficult and even learning abilities can be diminished. For women, pregnancy becomes risky and they cannot be sure of producing nourishing breast milk.
Malnutrition is the largest single contributor to disease as when a person is not getting enough food or not getting the right sort of food, malnutrition is just around the corner. Disease is often a factor, either as a result or contributing cause. People who get enough to eat may also become malnourished if the food they eat does not provide the proper amounts of micronutrients vitamins and minerals to meet daily nutritional requirements. Iodine deficiency is the world’s greatest single cause of mental retardation and brain damage.
Eliminating malnutrition involves sustaining the quality and quantity of food a person eats, as well as adequate health care and a healthy environment. Malnutrition has to be fought by treating the malnourished people by giving them the food and nutrients they need, and also by preventing it. There are several types of malnutrition and each form of malnutrition depends on what nutrients are missing in the diet, for how long and at what age.
The most basic kind is called protein energy malnutrition which results from a diet lacking in energy and protein because of a deficit in all major macronutrients, such as carbohydrates, fats and proteins. Marasmus, another type of malnutrition, is caused by a lack of protein and energy with sufferers appearing skeletally thin. In extreme cases, it can lead to kwashiorkor, in which malnutrition causes swelling including a so-called ‘moon face’. Other forms of malnutrition though less visible, but equally deadly are usually the result of vitamin and mineral deficiencies that can lead to anemia, scurvy, pellagra, beriberi and exophthalmia and, ultimately, death.
Deficiencies of iron, vitamin A and zinc are ranked among the World Health Organization’s (WHO) top 10 leading causes of death through disease in developing countries. Iron deficiency is the most prevalent form of malnutrition worldwide, affecting millions of people. Iron forms the molecules that carry oxygen in the blood, so symptoms of a deficiency include tiredness and lethargy. Vitamin A deficiency weakens the immune systems of a large proportion of under-fives in poor countries, increasing their vulnerability to disease.
Affecting 140 million preschool children in 118 countries and more than seven million pregnant women, it is also a leading cause of child blindness across developing countries. Iodine deficiency affects 780 million people worldwide. The clearest symptom is a swelling of the thyroid gland called goiter. But the most serious impact is on the brain, which cannot develop properly without iodine. Zinc deficiency contributes to growth failure and weakened immunity in young children. It is linked to a higher risk of diarrhea and pneumonia, resulting in nearly 800,000 deaths per year.
In recent years, new ready-to-use therapeutic foods (RUTFs) have been developed for treating severely malnourished children. The progress in foods for severe malnutrition has worked as a catalyst for the development of special foods for other forms of malnutrition. The WFP nutrition toolbox already includes fortified staples, fortified condiments and fortified blended foods including the corn soya blend (CSB). The toolbox also includes new strategies such as home-fortification with multi- micronutrient powder (MNP, also known as ‘sprinkles’). Home fortification means that beneficiaries themselves sprinkle the powder onto food after they have cooked it. It is a viable option when households already have some food but it lacks important micronutrients.
Other new strategies include ready-to-use supplementary foods (RUSFs), for treating children with moderate acute malnutrition, and complementary food supplements, to complement the diet of young children (6-24 months) with the highest nutritional needs. Some other key products that improve beneficiaries’ nutritional intake are High Energy Biscuits (HEBs) and Compressed Food Bars (CFBs).
HEBs are wheat-based biscuits which provide 450kcal with a minimum of 10 grams and max of 15 grams of protein per 100 grams, fortified in vitamin and minerals. These are easy to distribute and provide a quick solution to improve the level of nutrition, especially during the first days of emergency when cooking facilities are scarce. CFBs are bars of compressed food, composed of baked wheat flour, vegetable fat, sugars, soya protein concentrate and malt extract.
These can be eaten as a bar straight from the package or crumbled into water and eaten as porridge. These can be used in disaster relief operation when local food cannot be distributed or prepared. However, it is not advisable to use these for children under 6 months and in the first 2 weeks of treatment of severe malnutrition.