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MALNUTRITION

For example, depigmentation of the hair is indicative of undernutrition, and a body weight that is 20 percent above the average desirable body weight as determined by insurance company standardized charts would indicate overnutrition. A triceps skinfold test may be utilized to determine the body’s energy stores. Laboratory tests are used to reveal the extent to which amino acid nutrition is meeting the body’s needs to determine undernutrition, or plasma lipids in the diagnosis of overnutrition. In the field when assessing nutritional status, the medical and diet history and physical examination may be the only tools accessible to the physician or nurse, particularly in developing countries.

Who is at Increased Risk for Malnutrition?

The risk for malnutrition is increased for a variety of rea- sons. Increased nutritional needs during growth, preg- nancy, lactation, old age, infection, certain cancer therapies, or immune deficiency disorders increase the risk of malnutrition. Diets that focus on a narrow range of foods may not provide the variety of nutrients required and lead to deficiencies. Those experiencing famine, with the accompanying reduction in available food, are at great risk for malnutrition in the form of undernutrition. Lack of money to purchase an adequate diet or cultural prac- tices that dictate which members in the family get a large or small amount of food may also lead to malnutrition. Any medical condition that effects the absorption of nu- trients from foods, or requires medication that has ad- verse consequences on appetite, may cause malnutrition if the condition is long term. Taking megadoses of vita- min/mineral supplements may result in toxic levels of the substances taken in the body with the outcome being a state of overnutrition.

Correcting Malnutrition in the United States

Since the Great Depression of the 1930s, the federal gov- ernment of the United States has undertaken the task of alleviating and/or preventing malnutrition. In the 1960s, President John F. Kennedy reestablished the federal gov- ernment’s efforts to end debilitating hunger. Individuals and families who have low incomes may take advantage of several federally sponsored programs to ensure a bet- ter quality of nutrient intake. Food stamps are available to those who are usually employed but having difficulty purchasing an adequate food supply by using coupons to purchase food from grocery stores. The Commodity Supplemental Food Program distributes U. S. Depart- ment of Agriculture surplus foods through county agen- cies to such low-income populations as pregnant women and families with young children. The School Lunch and Breakfast Programs offer free or reduced-priced meals based on the Food Guide Pyramid to children of low- income families, with the cost of the reduced-priced meals being based on family income. The Summer Food Service Program offers free, nutritious meals and snacks to low-income children and distributes the meals from

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a central location during lower and secondary school va- cations. There are also programs targeted specifically at different age groups. Preschool children enrolled in or- ganized child-care programs receive meals at no cost, and the child-care program receives reimbursement for the meals through participation in the Child-Care Food Program. For individuals 60 years or older, a free noon meal is provided at centralized sites as part of the Con- gregate Meals for the Elderly Program. Homebound in- dividuals over 60 years of age can take advantage of home-delivered meals at no cost or for a fee, depending on income, at least five days per week.

World Hunger: Addressing a Global Problem

In 1798 the English clergyman and political economist Thomas Malthus suggested that the world’s population was growing at a rate faster than the food supply. The year 2002 finds world population growth exceeding eco- nomic growth, and poverty on the rise. Globally less than one-half of 1 percent of the world’s yearly production of goods and services goes exclusively to economic devel- opment assistance, yet 6 percent goes to support the world’s military operations. Civil wars in some countries have substantially retarded progress of the poor and con- tinue to contribute to massive undernutrition. Environ- mental factors such as soil erosion or lack of fresh water for irrigation of crops exacerbate the problem of provid- ing sufficient quantities of foods for many countries. What is being done to overcome all of these detriments to feeding the world’s hungry? Since the 1960s, an Amer- ican program, the Peace Corps, has been instrumental in providing education, distributing food and medical sup- plies, and building structures for locals to use in devel- oping nations. National surveys such as the National Family Health Survey conducted in India are valuable tools in the determination of whether any progress is be- ing made to improve the nutritional status of the nation. Advances in biotechnology to genetically alter plants and animals to improve the nutritive quality of the foods pro- duced from them may help to meet increasing food needs both now and in the future. The United Nations and the World Health Organization cry out for governments in developed countries to facilitate greater strides in im- provements in malnutrition in undeveloped countries by financial, educational, and scientific interventions. What will be required to eradicate malnutrition in this world is a coming together of the leaders of rich and poor na- tions to the same degree. Globally, there is an adequate food supply and the technical expertise necessary to ad- dress the problems and complications of malnutrition. All that is lacking is the political cooperation to address this devastating situation.

See also Anorexia, Bulimia; Aversion to Food; Body Com- position; Caloric Intake; Disease: Metabolic Dis- eases; Eating: Anatomy and Physiology of Eating; Fasting and Abstinence; Fluoride; Food Politics: United States; Hunger, Physiology of.

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