NutriSci 203 Exam #1 UW Madison

momentum

Tendency for a population to continue growing even after fertility falls to replacement level; high birth rates mean large increases in women of childbearing age - even if fertility stabilizes, population will increase due to sheer volume of women.

Hunger

An involuntary painful or uneasy sensation due to lack of food

Global Health

The study, research and practice on health issues that transcend national or socioeconomic boundaries with an emphasis on equity in health

Under 5 mortality rate

The probability that a newborn baby will die before reaching age five, expressed as a number per 1000 live births. It is used by the WHO in developing policies. 58 countries are on track to reach target, 33 are insufficient, 18 no progress. Things are getting better, but not enough

infant mortality rate

The number of deaths of infants in less than one year old; expressed as a #/1000 live births

Urbanization

When the population shifts from living in rural areas to urban areas and is taking place worldwide.

Fertility

Total number of children a woman would have in her reproductive years. Small differences in fertility assumptions make large differences in population projections

Environmental Health

The theory and practice of assessing, correcting, controlling and preventing environmental factors that can adversely affect the health of present and future generations (Lecture 1) Environmental health includes looking at issues like air pollution and climate change, water,

sanitation and hygiene, community noise and occupational risks, and the use of radiation, pesticides and biological agents.

Compare and contrast public health and medicine

Medicine: Involves treatment of diseases in individuals and emphasizes disease diagnosis and treatment

Public Health: Focuses on the population and prevention of disease at a population level, which means that their interventions may NOT always benefit everyone in the population

Overlap: Both work on/with treatment and prevention of disease, vaccines, etc.

What is sustainability/sustainable agriculture and what are the 3 key aspects/'dimensions' involved?

Sustainability is the ability to continue/endure/improve life for the future. Sustainable agriculture means producing food with the goal of improving both humans and ecosphere health. The three dimensions involved are Economic, Social and Ecological.

What are the Sustainable Development Goals? How did they come about? What is their purpose?

What did they replace? Who started them?

The United Nations set up The Millennium Development Goals in 2000, which were later replaced by the Sustainable Development Goals in 2015. The SDG’s consist of 17 goals that were developed to not only succeed the MDG’s but apply more sustainability aspects as well. The plan is to reach all goals by 2030. They were made to help lead to global health initiatives and to guide international development.

SDG 1

END POVERTY in all its forms everywhere;

Extreme poverty means living on less than $1.25/day. Want

to HALVE the number of people living in poverty by 2030.

SDG 2

END HUNGER, achieve food security and improved nutrition and promote sustainable agriculture; End by 2030 through advancing sustainable agriculture and achieving food security. Want to double the agricultural productivity and incomes of small-scale food producers, in particular women, indigenous peoples, family farmers, pastoralists and fishers. By 2020, want to maintain the genetic diversity of seeds, cultivated plants and farmed/domesticated animals, etc.

SDG 3

ENSURE HEALTHY LIVES and promote well-being for all at all ages; 11 children die every minute from preventable diseases

SDG 4

ENSURE INCLUSIVE AND EQUITABLE QUALITY EDUCATION and promote lifelong learning opportunities for all; 170 million people could be lifted out of poverty if all students learned basic reading skills [example: Kerala state in India]

SDG 5

ACHIEVE GENDER EQUALITY and empower all women and girls;

women work 70% of the world’s working hours, yet earn only 10% of the world’s income

SDG 6

ENSURE AVAILABILITY AND SUSTAINABLE MANAGEMENT OF WATER AND SANITATION for all; Need to shift focus to making sure all are able to have access to sanitation and clean water. More people in the world have a mobile phone than a working toilet.

SDG 7

ENSURE ACCESS TO AFFORDABLE, RELIABLE, SUSTAINABLE and MODERN ENERGY for all: 1.1 billion people live without electricity.

SDG 8

PROMOTE SUSTAINED, INCLUSIVE and SUSTAINABLE ECONOMIC GROWTH, full and productive employment and decent work for all;

64 cents is the minimum hourly wage for garment workers in Haiti

SDG 9

BUILD RESILIENT INFRASTRUCTURE, promote inclusive and sustainable industrialization and foster innovation. Building a simple footbridge between rural communities can increase new business growth by 15%. Can be promoted by increasing access of small-enterprises to financial services and to increase access to the Internet in less developed countries.

SDG 10

REDUCE INEQUALITY WITHIN AND AMONG COUNTRIES;

The 85 richest people in the world own the same amount as the 3.5 billion poorest people

SDG 11

MAKE CITIES AND HUMAN SETTLEMENTS INCLUSIVE, SAFE, RESILIENT and SUSTAINABLE; ½ of humanity lives in urban areas.

SDG 12

ENSURE SUSTAINABLE CONSUMPTION AND PRODUCTION PATTERNS; 5 = the number of earths it would take to support the world population if everyone lived like Americans

SDG 13

TAKE URGENT ACTION TO COMBAT CLIMATE CHANGE and its impacts; 1-4 feet: how much sea levels will rise by 2100

SDG 14

CONSERVE AND SUSTAINABLY USE THE OCEANS, SEAS AND MARINE RESOURCES for sustainable development; 2.6 billion people rely on seafood as their main source of protein.

SDG 15

PROTECT, RESTORE AND PROMOTE SUSTAINABLE USE OF TERRESTRIAL ECOSYSTEMS, sustainably manage forests, combat desertification and halt and reserve land degradation and halt

biodiversity loss; We are using 25% more resources than our planet can sustain each year.

SDG 16

PROMOTE PEACEFUL AND INCLUSIVE SOCIETIES for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels; last year, the world cost of violence was $14.3 trillion.

SDG 17

Strengthen the means of implantation and revitalize the GLOBAL PARTNERSHIP FOR SUSTAINABLE DEVELOPMENT; ½ the people living in extreme poverty in 1990 are not anymore. Partnerships for the SDGs include finance, trade, capacity building, and technology

How should the issue of overpopulation be addressed? How are fertility and momentum involved? What are the current global trends of fertility? How is fertility related to poverty?

even if fertility falls to replacement level, there is a tendency for

populations to continue growing.

Birth rates change based on momentum and fertility

small differences in fertility rate can have large differences in population projections/total numbers.

As a global trend, fertility rates have declined in all regions of the world, but it still remains above replacement rate.

informing women/families why it may be beneficial to have fewer children, etc. it is still possible to address, and if we can focus on both fertility and momentum, overpopulation may be able to be addressed.

What are some factors linked to under-nutrition? How is it possible for even those who are well-off/in high socioeconomic status to be malnourished?

People can become malnourished from living in poverty where they do not have the means or access to continuous/daily meals, which leaves them hungry and without proper nutrients for long periods of time.

What are HALEs and DALYs? What are they used for and what are their leading causes?

HALE: Health-Adjusted Life Expectancy – Number of years to be lived in the equivalent of good health

DALY: Disability Adjusted Life Year – Number of premature deaths and losses due to illness and disabilities in a population

Causes:

-High Income: Perinatal conditions, lower respiratory infections, ischemic heart disease

-Low income: Ischemic heart disease, cerebrovascular disease, Unipolar depressive disorder

-Both are used as measurements that scientists use to determine if an intervention(s) will work

Which countries have lower infant mortality rates than the US? Why?

Singapore (currently the lowest). It is possible for countries to have lower IMR even if they are not as well off, because they may have better health care/prenatal care, less premature births, less tobacco/alcohol use, etc.

What is the global trend for life expectancy in most areas of the world?

Life expectancy has improved in all regions of the world since 1990, except in Europe and Central Asia and in Sub-Saharan Africa.

Which countries have a LONGER life expectancy than the US? Why?

Japan and Singapore both do. It is possible for countries to have longer life expectancies than others because they may have better health care/better access, better disease prevention/control, better

diet, etc.

How are CO2 levels involved in climate change and agriculture? What will happen to the crop AND crop yields with increased temperatures?

Due to increased/rising temperatures, there will be decreases in crop yield due to climate change, which may disproportionately affect the poor living in developing countries that rely on agriculture. The increases in CO2 may also cause a decrease in the nutritional quality of crops as well.

Describe a few examples of how wealth and health are related. (Who has better health care, wealthier/poorer/healthier/etc.? Who has more access to better food? Etc.)

USUALLY – The trend is that the more wealth, the better health.

Those who are wealthier tend to have access to better, more nutritional food. Those who do not have a lot of money or are in food insecure communities are often unable to have the same level of health and nutrition. Healthier people tend to earn higher incomes, generally have better access to nutritious diets and are

often better nourished. may face eating too much. Poverty often results in diminished access to sanitary living conditions, limits work options to jobs with greater associated health risks, may result in reduced access to education about health issues and often results in an over-reliance on staple food grains and compromised nutrition

Describe what a staple food/crop is, and the cost differences between each group

General cost per serving of staple foods: Grains, Vegetables, Fruit, Dairy, Proteins

Staple foods are foods that are eaten one or more times daily, and in such quantities that it makes up a dominant portion of a standard diet for a given people, We talked most specifically about staple foods when talking about raising food prices/social unrest. When there is a lack of access to these foods it can lead to social unrest.

How is increased population numbers related to global demand for food?

Having more people to feed combined with rising incomes will eventually lead to growing per capita demand for food, especially meat and dairy products.

Some say that in order to adjust for monetary losses/expenditures, we should just increase food prices. Why isn't this the best idea?

Sudden increases in food prices have often and historically been correlated with social unrest. On average, a family in the US spends a smaller portion of their disposable income on food, but many of the world’s poor spend a relatively large amount of their

income on food and any change in price may cause many families problems. With climate change and more frequent extreme weather, there may be more frequent food price spikes and social unrest.

How do we even know climate change exists? What evidence do we have/patterns are we following?

Scientists’ predictions may not be 100% certain, but a majority of the evidence/analyses have shown a very high probability to the occurrence of large global climate changes, especially rising

temperatures. Recent droughts and heat waves have shown devastating effects on both agricultures and human populations and are expected to be common by 2090.

Describe who Norman Borlaug was, and his role in global health issues. What was the Green Revolution? How was he involved?

Saw agriculture as one component contributing to the total economic development and well-being of all people. Challenged young people to be effective leaders to help convert potential into real benefits for humankind and believed that agricultural productivity and sustainability must BOTH be increased. Won Nobel Prize for Peace in 1970. Scientist that “turned pessimism into optimism”

**Started Green Revolution

As discussed in lecture, what are the core concepts of global health?

Global health is...

1- Using a Public health approach to address underlying causes of global health issues

2- About addressing health inequities anywhere including the US

3- Multi-sectoral (eg. Involves agriculture, education, policy, engineering, etc.)

4- Participatory (eg. Engaging citizens, governments, private sector, NGOs, etc.)

5- Culturally sensitive and always evolving

What are they ways discussed in lecture of categorizing countries? What are some pros/cons? How were they created/who used them?

First World/Third World

-Came about during cold war, term is outdated

-First world: US, W Europe and their allies

-Second world: Soviet Union, China, Cuba, and their allies

-Third world: everyone else..

*Really just a political term, can be construed negatively

*Not an accurate portrayal of current situations; can be viewed as discriminatory, rigid and as a ranking system; no longer used by NGOs or govt orgs

Developed/Developing

-Most commonly used, but without an official definition

*Confusing and can be viewed negatively, but others see as positive (developing=moving forward)

Global South

-Geographic generalization based on many poorer countries being in the southern hemisphere

Western Countries

-Generally referring to W Europe and countries whose populations are largely descendants of W Europe

Income

-Low income, Lower middle income, Middle income, High income

-Used by World Bank and WHO

-Classified based on GDP which is difficult to calculate and doesn’t factor in wealth distribution

Human Develop Index

-Low Human Development, Medium, Very High

-Looks at both economic and quality of life factors

What is CIMMYT? What is their mission? Who started it?

Maize and Wheat Science for Improved Livelihoods, started by Norman Borlaug International organization that has developed over half of the maize varieties in the developing world. CIMMYT utilizes a FARMER approach in order to really develop and grow maize and wheat that farmers can actually use and have success with. Most of the electrical energy is supplied by solar panels and the company provides work for thousands.

What is a germplasm BANK? What is the importance of one? How does CIMMYT utilize them for maize and wheat research?

Germplasm banks or ‘genebanks’ are ‘supermarkets’ of various genotypes of plants. They contain tens of thousands of seed samples that are available to researchers worldwide and contains biodiversity that may hold the solution to future challenges for reducing yield gaps and increasing yield potential of maize and wheat. Keeping the seeds in a bank allow us to go back to different genotypes/phenotypes of interest to make different crosses to develop desired genotypes/phenotypes. CIMMYT spends more than $1 million a year to maintain genebank but is worth it because can look into and compare many geno/phenotypes.

What is agroecology and how is it related to improving global health?

The study of ecological processes applied to agricultural production systems. Bringing ecological principles to bear in agroecosystems can suggest management approaches that may help with sustainability and food security.

What are perennial crops?

Plants that grow year-round and often have more than a single-season lifespan. They have long roots that allows them greater access to underground water and along with being a source of food for people, perennials can be used for animal feed and grazing pastures. They are good for sustainability due to their life cycle as well as less water consumption, less soil erosion and leaching and do not require annual cultivation

Compare and contrast the 'agroecology model' and 'industrial model' of agriculture.

Agroecology: Employs strategies such as polycultures that increase heterogeneity and biodiversity and it aims to benefit the well-being of humans.

Industrial: Emphasizes making crop fields more homogenous and does not specifically aim to benefit the health of the environment but does produce food that benefits human health.

According to Dr. Reed, what factors of agriculture are livestock important for? How is livestock used different between different countries/regions around the world? What factors influences the demand of animal products?

Low income countries use: Animal Traction, Manure for soil management, Using resources, which would not contribute to farm production in their absence, Provide income and savings

Developed regions consume much more meat than developing regions and over time, developing regions have increasing trend in meat consumption Lots of meat and milk per capita in developed countries, but lower total consumption Overall, as wages increase, so does demand.

What types of negative effects on human health can come from alleviating poverty?

May reduce human fertility rates because wealth affords some financial security and decreased dependence on children for support in old age and more women will participate in the work force and may elect to have fewer children. Alleviating poverty also will mean committing more land to agriculture which can cause changes in the structure of ecosystems and ultimately leading to loss of ecosystem services.

Even if you are not in an area of poverty, why would it still be a good idea to invest in agricultural research that is looking to alleviate poverty and improve the economy in other agriculture-based

countries? Why should the US government and taxpayers invest?

It is in the US’s economic interest because it creates and strengthens trading partners as well as makes it cheaper to improve agricultural productivity than provide emergency food assistance or send US armed forces in response to civil crises. It also benefits national security, because a well-fed world is much safer than a hungry world.

What are mycotoxins and are they good or bad for humans? Animals? The fungus itself?

Human/animal TOXIN produced by fungi. Bad for humans and animals, but protect fungus from microbes

What types of mycotoxins were discussed in class and

briefly how are they different?

Alfatoxins – Most regulated toxin in the world

-causes hepatic cancer

Trichothecenes- Mycotoxins more commonly found in Midwest that interfere with protein synthesis

Fusarium head blight- Small grains called “scab” that affects corn and has a toxic affect that swine are very susceptible to.

Fumonisins- Toxin that interferes with lipid metabolism

Patulin- Fruit pathogens, worst on apples

"Food Security: The Challenge of Feeding 9 Billion People"

What was the main idea of this paper? What solution(s) was/were proposed by the author? According to Joffe (2007), what are the 3 parts of the 'self-reinforcing cycle'?

Proposed; reducing waste and yield gaps, changing diets and expanding aquaculture Nutrition, Wealth and Health

Describe the 3 myths that were discussed in the Gates Annual Letter. Why would people believe them? What are the Gates' arguments against the myths?

1. Poor countries are doomed to stay poor

2. Foreign aid is a big waste

3. Saving lives leads to over population.

KERALA, INDIA: CASE STUDY

What was the main message of this article? How was Kerala state so successful and what can we learn from it?

Kerala state has produced one of the best health indicators in India despite their low income levels. They did so by providing free primary and secondary education and gave access to health care to all through extensive network of health centers.

International health

the study of health issues that affect people living in the developing world or outside one's own country

Domestic public health:

issues that affect people living in the US or within a country

Environmental health:

The theory and practice of assessing, correcting, controlling, and preventing environmental factors that can adversely affect the health of present and future generations.

What is health?

a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity

Public health code of ethics

-Prevention of disease

-Respect for the rights of individuals

-Commitment to developing public health efforts in conjunction with communities

-Attention to disenfranchised people and communities

-Appreciate values, beliefs, and cultures of diverse groups

-Enhance the physical and social environment

Public health:

-focus is on the population and public service

-emphasizes disease prevention and health promotion for communities

-interventions have a broad spectrum and may target the environment, human behavior, lifestyle, and medical care

Medicine:

-focus is on the individual and personal service

-emphasis is on disease diagnosis, treatment, and care for individuals

-interventions are for medical care

Low-income ranges:

Less than 1145

Lower-middle income:

1145-4515

Upper-middle income

4516-14005

High-income

More than 14005

What is food security?

The access by all people at all times to sufficient food for an active, healthy life*; the ready availability of nutritionally adequate & safe foods & an assured ability to acquire them in a socially acceptable manner (without resorting to emergency food programs, stealing, scavenging, etc)

What is food insecurity?

limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways

What is hunger?

The uneasy or painful sensation caused by a lack of food. The recurrent and involuntary lack of access to food.

Maternal mortality ratio

The number of women who die as a result of pregnancy and childbirth complications per 100,000 live births in a given year

Neonatal mortality rate

the number of deaths to infants under 28 days of age in a given year per 1000 live births in that year

HALE:

health adjusted life expectancy: numbers of years to be lived in the equivalent of good health

DALY

disability adjusted life years: measure of premature deaths and losses due to illness and disabilities in a population.

What are the leading cause of Dalys for low and middle income countries?

-Perinatal conditions

- Lower respiratory infections

- Ischemic heart disease

Leading cause of DALYs for high-income countries:

-Ischemic heart disease

- Cerebrovascular disease

- Unipolar depressive disorders

What is the relationship between weather and nutrition?

Wealth improves nutrition or poverty breeds undernutrition

-wealth extends life expectancy

What's the relationship between wealth and infant mortality:

Wealth decreases infant mortality

Strauss and Thomas (1998)

State that there is a relationship between wealth, education and height.

Nutrition—> height—> income

-Height, which is an indicator of investments in human

capital made during childhood, is also related to

educational attainment.

-There is a powerful association between height and

wages in Brazil. Taller men earn more

-Taller men tend to be better educated in both USA and

Brazil, although the correlation is substantially larger in

Brazil.

Relationship between health,nutrition and economic productivity:

Health status affects labor productivity—> labor productivity affects nutritional intake—> nutritional intake affects health status.

Impacts of poor nutritional intake:

The effect of undernutrition spans at least three generations, as suggested by the small but significant association between grandmother's height and birthweight of children born from five cohorts

Interventions that take into account socioeconomic and gender inequalities (nutrition)

Labor reduction (water and fuel availability)

-micronutrient-dense crops

-Education about consumption

-improved infant feeding

-nonpolluting fuels

Impacts of access to health care: fees at public health clinics in Indonesia

-User fees were raised in randomly selected "treatment"

districts

-Prices were held constant in neighboring "control"

districts

-Baseline household survey prior to the intervention;

resurveyed two years later.

-Utilization of clinics declined in the treatment areas,

relative to controls

-Labor force participation also declined in the treatment

areas, relative to controls

- Effects were largest for men and women at the bottom of the

education distribution

Before the affordable care act:

50 million uninsured, access to acute care without regard to ability to pay, financial hardship, potential adverse effects on health and longevity, risk selection and preexisting conditions

Obamacare

Coverage until 26

-After 26, you can enter your state's

Exchange and purchase low(er) cost

catastrophic plans until age 30

-Required to enroll - or pay a fine

-Objective: spreads the risk if everyone is

involved

-Easier to get coverage - cannot be

denied for preexisting conditions

Improve the affordable care act:

What next? Improve, or repeal universal health care?

-"Single-payer" system = government pays for all

-Universal health care: rich, young and healthy subsidize poor, old and sick

-Start by covering all people with a limited range of benefits

-Mexico, Rwanda, Thailand...

Oaxacan Village

remote; poor access; maize culture

Nutritonalist: psychomotor development evaluation:

A child develops many skills as he grows in his psychomotor

development.

-Pediatricians measure these skills as milestones to track

development.

-A three-year-old can ride a tricycle,

- A four-year-old can throw and catch a ball,

- A five-year-old can tie shoelaces

Relationship between women's health and stunting:

No education led to about twice the amount of stunting in children

Relationship between wealth and under-5 mortality and underweight prevalence

The poorer areas have higher rates of under-5 mortality and underweight prevalence.

What are recent trends in the international poverty line:

It's getting better!!!

Population growth: challenge to food security

Day of Eight Billion, 2022 (11 yrs)

Day of Nine Billion, 2037 (15 yrs)

Day of Ten Billion, 2058 (19 yrs)

Demographic transition- Mexico

Many more women of childbearing age.

-Fertility rate is stable or down: fewer 0-4 year olds

- In transition!

Demographic transition-USA:

-fertility rates declines: fewer 0-4 year olds

-gradually fewer women of childbearing age

-in transition!

Small changes in fertility lead to a large changes in population:

-small differences in fertility assumptions make large differences in population projections

Relationship between education and fertility rate:

-Few things have a stronger influence over fertility rates than education.

-There is a 20-year lag between changes in education and changes in fertility

-Falling birth rates, when accompanied by rising literacy, can help kick-start

growth.

-Lower fertility can also start a virtuous cycle in which families with fewer

children can invest more in educating them...

-The big problem is continuing to get children into schooling.

-In Ghana, children in families who get help from abroad are 54% more likely to attend secondary school

Why choose many children?

-labor, especially on farms

-care in old age

-replace dying children

-culture

-religion

-government exhortation and rewards

Why choose fewer children?

- Labor no longer need on farm

- U-5 mortality declines (no longer need worry about replacing dying children)

- Women want to study and/or work

- Women want more control of their lives

- Ability to give kids a better life

- Other sources of old age security - savings, gov

- Gov policies

- Decrease risk of maternal mortality

One more challenge

climate change