E-Book, Englisch, 934 Seiten
Reihe: Nutrition and Health
Semba / Bloem / Piot Nutrition and Health in Developing Countries
2. Auflage 2008
ISBN: 978-1-59745-464-3
Verlag: Humana Press
Format: PDF
Kopierschutz: 1 - PDF Watermark
E-Book, Englisch, 934 Seiten
Reihe: Nutrition and Health
ISBN: 978-1-59745-464-3
Verlag: Humana Press
Format: PDF
Kopierschutz: 1 - PDF Watermark
This updated and expanded book was written with the underlying conviction that global health and nutrition problems can only be solved through a firm understanding of the different levels of causality and the interactions between the various determinants. This volume provides policy makers, nutritionists, students, scientists, and professionals with the most recent and up-to-date knowledge regarding major health and nutritional problems in developing countries.
Autoren/Hrsg.
Weitere Infos & Material
1;Dedication;6
2;Series Editor’s Introduction;7
3;Foreword;11
4;Preface;13
5;Table of Contents;17
6;Contributors;21
7;Chapter 1;24
7.1;Nutrition and Development: A Historical Perspective;24
7.1.1;1.1 Introduction;24
7.1.2;1.2 The Idea of Progress in Public Health;24
7.1.3;1.3 The Rise of Statistics and Probability;27
7.1.4;1.4 Early Foundations of Preventive Medicine;28
7.1.5;1.5 The Sanitary Idea;29
7.1.6;1.6 Contagion Versus Miasma;30
7.1.7;1.7 Advances in Microbiology;31
7.1.8;1.8 Nutritional Science in the 19Th Century;32
7.1.9;1.9 Infant Mortality and Social Reform;33
7.1.10;1.10 The Emergence of the Vitamins;34
7.1.11;1.11 Further Research on Nutritional Deficiency Diseases;37
7.1.12;1.12 Nutritional Immunology;38
7.1.13;1.13 Vitamin a and Reduction of Child Mortality;38
7.1.14;1.14 Growth in Food Production;40
7.1.15;1.15 Long-Term Trends in Diet;41
7.1.16;1.16 The Decline of Mortality;43
7.1.17;1.17 Graduate Education in Public Health;44
7.1.18;1.18 International Organizations;44
7.1.19;1.18 Conclusions;46
7.1.20;References;47
8;Chapter 2;56
8.1;Maternal Mortality in Developing Countries;56
8.1.1;2.1 Introduction;56
8.1.2;2.2 Magnitude and Causes of Maternal Mortality;57
8.1.2.1;2.2.1 Measuring Maternal Mortality;57
8.1.2.2;2.2.2 Medical Causes of Maternal Mortality;59
8.1.3;2.3 Strategies to Reduce Maternal Mortality;61
8.1.4;2.4 Socioeconomic Development, Women’s Education, and Maternal Mortality;62
8.1.5;2.5 Family Planning and Maternal Mortality;63
8.1.6;2.6 Nutrition and Maternal Health;64
8.1.6.1;2.6.1 Direct Effects of Energy or Micronutrient Defi ciency on Maternal Mortality;65
8.1.6.2;2.6.2 Malnutrition and the Risk of Obstructed Labour;67
8.1.6.3;2.6.3 Calcium Defi ciency and the Risk of Preeclampsia;68
8.1.6.4;2.6.4 Iron Defi ciency and Anemia;69
8.1.6.5;2.6.5 Vitamin A Defi ciency and the Risk of Anemia or Infection;71
8.1.6.6;2.6.6 Zinc Defi ciency and the Risk of Haemorrhage or Infection;72
8.1.6.7;2.6.7 Multiple Micronutrients;73
8.1.7;2.8 Antenatal Care;74
8.1.8;2.9 Training of Traditional Birth Attendants;75
8.1.9;2.10 Access to Professional Delivery Care;75
8.1.10;2.11 Summary and Conclusions;77
8.1.11;References;78
9;Chapter 3;86
9.1;Low Birth Weight and Neonatal Mortality;86
9.1.1;3.1 Introduction;86
9.1.2;3.2 Historical Background;86
9.1.3;3.3 Definitions;87
9.1.3.1;3.3.1 Neonatal Mortality;87
9.1.3.2;3.3.2 Perinatal Mortality;87
9.1.3.3;3.3.3 Low Birth Weight and Intrauterine Growth Restriction;88
9.1.4;3.4 Descriptive Epidemiology;89
9.1.5;3.5 Causes Of Neonatal Death;93
9.1.6;3.6 Influence Of Maternal Factors;93
9.1.6.1;3.6.1 Maternal Factors and Intrauterine Growth Restriction;93
9.1.6.2;3.6.2 Maternal Stature and Preterm Birth;94
9.1.6.3;3.6.3 Maternal Nutrition and Fetal Death;94
9.1.6.4;3.6.4 Maternal Factors and Early Neonatal Death;95
9.1.7;3.7 Interventions To Improve Neonatal Survival;95
9.1.7.1;3.7.1 Folic Acid Supplementation;95
9.1.7.2;3.7.2 Tetanus Toxoid Immunization;96
9.1.7.3;3.7.3 Syphilis Screening and Treatment;96
9.1.7.4;3.7.4 Preeclampsia and Eclampsia Prevention (Calcium Supplementation);96
9.1.7.5;3.7.5 Intermittent Presumptive Treatment for Malaria;96
9.1.7.6;3.7.6 Detection and Treatment of Asymptomatic Bacteriuria;97
9.1.7.7;3.7.7 Antibiotics for Preterm Premature Rupture of Membranes;97
9.1.7.8;3.7.8 Corticosteroids for Preterm Labor;97
9.1.7.9;3.7.9 Detection and Management of Breech;98
9.1.7.10;3.7.10 Labor Surveillance;98
9.1.7.11;3.7.11 Clean Delivery Practice;98
9.1.7.12;3.7.12 Resuscitation of Newborn Baby;98
9.1.7.13;3.7.13 Breast-feeding;98
9.1.7.14;3.7.14 Prevention and Management of Hypothermia;99
9.1.7.15;3.7.15 Kangaroo Mother Care;99
9.1.7.16;3.7.16 Community-Based Pneumonia Case Management;99
9.1.8;3.8 Nutritional Interventions;99
9.1.8.1;3.8.1 Protein-Energy Supplementation;99
9.1.8.2;3.8.2 Maternal Iron Supplementation;100
9.1.8.3;3.8.3 Maternal Iodine Supplementation;100
9.1.8.4;3.8.4 Antenatal Vitamin A or b-Carotene Supplementation;101
9.1.8.5;3.8.5 Antenatal Zinc Supplementation;101
9.1.8.6;3.8.6 Multiple Micronutrient Supplementation;101
9.1.8.7;3.8.7 Reduction in Childhood Stunting;101
9.1.8.8;3.8.8 Prevention of Maternal Obesity;102
9.1.9;3.9 Implementation of Interventions To Reduce Low Birth Weight and Neonatal Mortality;102
9.1.10;3.10 Conclusions;102
9.1.11;3.11 Recommendations;103
9.1.12;References;103
10;Chapter 4;110
10.1;Infant Mortality;110
10.1.1;4.1 Introduction;110
10.1.2;4.2 Global Trends;111
10.1.2.1;4.2.1 Historical Trends: United States;111
10.1.2.2;4.2.2 Decline in Infant Mortality in Developing Countries;111
10.1.3;4.3 Determinants of Infant Mortality;114
10.1.3.1;4.3.1 Macrofactors: Socio-Politico-Economic Dimensions;114
10.1.3.2;4.3.2 Gender;115
10.1.3.3;4.3.3 Household Socioeconomic Factors;116
10.1.3.4;4.3.4 Maternal Age, Parity, and Birth Spacing;117
10.1.3.5;4.3.5 Maternal Nutrition and Infant Mortality;117
10.1.3.6;4.3.6 Breast-feeding;118
10.1.4;4.4 Direct and Underlying Causes of Infant Mortality;120
10.1.5;4.5 Contributions of Neonatal Mortality To Infant Mortality: Causes and Risk Factors;122
10.1.6;4.6 Interventions For Reducing Infant and Neonatal Mortality;124
10.1.7;4.7 Future Actions;126
10.1.8;References;127
11;Chapter 5;136
11.1;Child Growth and Development;136
11.1.1;5.1 Introduction;136
11.1.2;5.2 Measuring Impaired Growth: Concepts and Indicators;138
11.1.2.1;5.2.1 Fetal Growth;138
11.1.2.2;5.2.2 Child Growth Indicators and Their Interpretation;140
11.1.2.3;5.2.3 The International Reference Population;141
11.1.2.4;5.2.4 Issues in the Interpretation of Growth Data;142
11.1.3;5.3. Prevalence of Growth Retardation in Developing Countries;144
11.1.4;5.4 Health and Social Consequences of Impaired Growth;151
11.1.5;5.5 Interventions Aimed at Promoting Healthy Growth and Development;154
11.1.6;5.6 Conclusions;157
11.1.7;References;158
12;Chapter 6;162
12.1;Diarrheal Diseases;162
12.1.1;6.1 Introduction;162
12.1.2;6.2 Public Health Importance;162
12.1.3;6.3 Historical Background;163
12.1.4;6.4 Epidemiology;163
12.1.4.1;6.4.1 Geographical Distribution;163
12.1.4.2;6.4.2 Risk Factors;163
12.1.4.3;6.4.3 Incidence;165
12.1.4.4;6.4.4 Seasonality;166
12.1.4.5;6.4.5 Duration;166
12.1.5;6.5 Clinical Features/Pathophysiology;167
12.1.5.1;6.5.1 Major Pathogens Involved in Diarrheal Diseases in Children;167
12.1.5.2;6.5.2 Pathophysiology;167
12.1.5.3;6.5.3 Effects of Malnutrition on Mortality;167
12.1.5.4;6.5.4 Effects of Malnutrition on Morbidity;168
12.1.5.5;6.5.5 Effects on Growth of Children;169
12.1.5.6;6.5.6 Effect on Dietary Intake;169
12.1.5.7;6.5.7 Effects on Nutrient Absorption and Intestinal Function;170
12.1.5.8;6.5.8 Relationship with Nutrition and Immunity;170
12.1.5.8.1;6.5.8.1 Undernutrition;170
12.1.5.8.2;6.5.8.2 Vitamin A;170
12.1.5.8.3;6.5.8.3 Zinc;171
12.1.5.8.4;6.5.8.4 Other Micronutrients;171
12.1.6;6.6 Diagnosis;171
12.1.7;6.7 Treatment;172
12.1.7.1;6.7.1 Oral Rehydration Therapy;172
12.1.7.2;6.7.2 Nutritional Management;172
12.1.7.2.1;6.7.2.1 Timing of Feeding;172
12.1.7.2.2;6.7.2.2 Lactose;173
12.1.7.2.3;6.7.2.3 Mixed Diets;173
12.1.7.2.4;6.7.2.4 Fiber;174
12.1.7.2.5;6.7.2.5 Probiotics;175
12.1.7.2.6;6.7.2.6 Prebiotics;176
12.1.7.2.7;6.7.2.7 Epidermal Growth Factor;177
12.1.7.2.8;6.7.2.8 Short-Chain Fatty Acids;177
12.1.7.2.9;6.7.2.9 Glutamine;178
12.1.7.2.10;6.7.2.10 Nucleotides;178
12.1.7.2.11;6.7.2.11 Lectins;179
12.1.7.3;6.7.3 Micronutrient Supplementation;179
12.1.7.3.1;6.7.3.1 Zinc;179
12.1.7.3.2;6.7.3.2 Vitamin A;180
12.1.7.4;6.7.4 Dietary Management of Persistent Diarrhea;181
12.1.8;6.8 Prevention;181
12.1.8.1;6.8.1 Breast-Feeding;181
12.1.8.2;6.8.2 Improved Weaning Practices;182
12.1.8.3;6.8.3 Use of Safe Water;182
12.1.8.4;6.8.4 Hand Washing;182
12.1.8.5;6.8.5 Latrines and Proper Disposal of Human Waste;183
12.1.8.6;6.8.6 Measles Immunization;183
12.1.8.7;6.8.7 Nutritional Interventions;183
12.1.8.7.1;6.8.7.1 Zinc;183
12.1.8.7.2;6.8.7.2 Vitamin A;184
12.1.8.7.3;6.8.7.3 Nucleotides;185
12.1.8.8;6.8.8 Vaccines;185
12.1.8.9;6.8.9 Other Potential Interventions;186
12.1.9;6.9 Future Directions;186
12.1.10;6.10 Conclusions;187
12.1.11;References;187
13;Chapter 7;202
13.1;Acute Lower Respiratory Infections;202
13.1.1;7.1 Introduction;202
13.1.2;7.2 Public Health Importance;202
13.1.3;7.3 Historical Background;202
13.1.4;7.4 Epidemiology;203
13.1.4.1;7.4.1 Risk Factors;203
13.1.4.1.1;7.4.1.1 Low Birth Weight;203
13.1.4.1.2;7.4.1.2 Lack of Breast-Feeding;205
13.1.4.1.3;7.4.1.3 Malnutrition;205
13.1.4.1.4;7.4.1.4 Micronutrient Status;206
13.1.4.1.5;7.4.1.5 Decreased Immunity;207
13.1.4.1.6;7.4.1.6 Environmental and Socioeconomic Factors;207
13.1.4.1.7;7.4.1.7 Prior Infections;209
13.1.4.1.8;7.4.1.8 Other Factors;210
13.1.4.2;7.4.2 Incidence;210
13.1.4.3;7.4.3 Seasonality;211
13.1.4.4;7.4.4 Duration;212
13.1.4.5;7.4.5 Case Fatality Ratios;212
13.1.5;7.5 Clinical Features/Pathophysiology;213
13.1.5.1;7.5.1 Clinical Presentation;213
13.1.5.2;7.5.2 Major Pathogens Involved in Acute Lower Respiratory Diseases in Children;213
13.1.5.3;7.5.3 Pathophysiology;215
13.1.5.4;7.5.4 Impact of Acute Respiratory Infections on Nutrition and Growth;217
13.1.6;7.6 Treatment;218
13.1.6.1;7.6.1 Case Management of Pneumonia;218
13.1.6.2;7.6.2 Nutritional Interventions for Treatment of Acute Respiratory Infections;218
13.1.6.2.1;7.6.2.1 Zinc;218
13.1.6.2.2;7.6.2.2 Vitamin A;219
13.1.6.2.3;7.6.2.3 Selenium;219
13.1.7;7.7 Prevention;219
13.1.7.1;7.7.1 Immunization;220
13.1.7.2;7.7.3 Nutrition;221
13.1.7.2.1;7.7.3.1 Breast-Feeding;221
13.1.7.2.2;7.7.3.2 Prevention of LBW;221
13.1.7.2.3;7.7.3.3 Reduction of Malnutrition;221
13.1.7.2.4;7.7.3.4 Zinc Supplementation;221
13.1.7.2.5;7.7.3.5 Vitamin A Supplementation;222
13.1.7.2.6;7.7.3.6 Selenium Supplementation;222
13.1.7.3;7.7.4 Other Measures;222
13.1.8;7.8 Future Directions;222
13.1.8.1;7.8.1 Risk Factors for Pneumonia and Acute Lower-Respiratory Infection;222
13.1.8.2;7.8.2 Clinical Aspects;223
13.1.8.3;7.8.3 Prevention;223
13.1.9;7.9 Conclusions;224
13.1.10;References;225
14;Chapter 8;238
14.1;Measles;238
14.1.1;8.1 Introduction;238
14.1.2;8.2 Definition;238
14.1.3;8.3 Public Health Importance;238
14.1.4;8.4 Historical Background;239
14.1.5;8.5 Epidemiology;239
14.1.6;8.6 Pathophysiology;240
14.1.7;8.7 Interaction With Nutrition;241
14.1.7.1;8.7.1 Effect of Measles on Nutrition;241
14.1.7.2;8.7.2 Effect of Malnutrition on Measles;241
14.1.8;8.8 Clinical Features;241
14.1.9;8.9 Diagnosis;242
14.1.10;8.10 Treatment;243
14.1.10.1;8.10.1 Nutritional Support;243
14.1.10.2;8.10.2 Vitamin A Therapy;244
14.1.10.3;8.10.3 Vitamin A Dosage;246
14.1.11;8.11 Prevention;246
14.1.11.1;8.11.1 Measles Vaccine;246
14.1.11.2;8.11.2 Improving Vitamin A Status of Children;247
14.1.12;8.12 Research Needs;247
14.1.13;8.13 Conclusions;248
14.1.14;References;248
15;Chapter 9;252
15.1;Malaria and Nutrition;252
15.1.1;9.1 Introduction;252
15.1.2;9.2 Historical Background;253
15.1.2.1;9.2.1 Historical Overview of Malaria;253
15.1.2.2;9.2.2 Attempts to Eradicate Malaria;253
15.1.2.3;9.2.3 Modern Approaches to Malaria Control;254
15.1.2.3.1;9.2.3.1 Insecticide-Treated Bed Nets;254
15.1.2.3.2;9.2.3.2 Vaccine Development;254
15.1.3;9.3 Epidemiology;255
15.1.3.1;9.3.1 Geographic Distribution and Disease Burden;255
15.1.3.2;9.3.2 Life Cycle of the Malaria Parasite;256
15.1.3.3;9.3.3 Classifi cation Schemes of Malaria Endemnicity;258
15.1.3.4;9.3.4 Clinical Disease;258
15.1.3.5;9.3.5 Epidemiology of Severe Malaria;259
15.1.3.6;9.3.6 Diagnosis and Drug Treatment of Malaria;259
15.1.3.6.1;9.3.6.1 Diagnosis;259
15.1.3.6.2;9.3.6.2 Drug Treatments;259
15.1.3.7;9.3.7 Host-Parasite Interactions and Immunity;260
15.1.3.8;9.3.8 Modulating Factors of Malaria Morbidity and Mortality;262
15.1.4;9.4 Effects of Nutrition on Malaria;262
15.1.4.1;9.4.1 Early Perceptions of the Impact of Nutrition on Malaria;262
15.1.4.2;9.4.2 Malnutrition and Malaria: Synergism or Antagonism?;263
15.1.4.2.1;9.4.2.1 Malnourished Individuals and Malaria Morbidity and Mortality;263
15.1.4.2.1.1;9.4.2.1.1 Clinic-Based Studies.;263
15.1.4.2.1.2;9.4.2.1.2 Early Hospital-Based Studies of Severe Malaria.;263
15.1.4.2.1.3;9.4.2.1.3 Critical Analysis of the Early Hospital-Based Studies.;272
15.1.4.2.1.4;9.4.2.1.4 Modern Hospital-Based Studies of Severe Malaria.;272
15.1.4.2.1.5;9.4.2.1.5 Cross-Sectional Studies of Malariometric Indicators.;273
15.1.4.2.1.6;9.4.2.1.6 Longitudinal Cohort Studies and Effects of Nutrition on Drug-Resistant Malaria.;273
15.1.4.2.2;9.4.2.2 Studies in Famine Relief;274
15.1.4.2.3;9.4.2.3 Studies in Animals;275
15.1.4.2.4;9.4.2.4 Synthesis of Data Concerning Effects of Protein-Energy Malnutrition on Malaria;275
15.1.4.3;9.4.3 Impact of Malaria on Growth;276
15.1.4.4;9.4.4 Infl uence of Specific Nutrients on Malaria Morbidity;277
15.1.4.4.1;9.4.4.1 Iron;277
15.1.4.4.2;9.4.4.2 Zinc;278
15.1.4.4.3;9.4.4.3 Vitamin A;279
15.1.4.4.4;9.4.4.4 B Vitamins;280
15.1.4.4.4.1;9.4.4.4.1 Folate.;280
15.1.4.4.4.2;9.4.4.4.2 Riboflavin.;281
15.1.4.4.4.3;9.4.4.4.3 Thiamine.;282
15.1.4.4.5;9.4.4.5 Vitamin E and Other Antioxidants;282
15.1.5;9.5 Conclusions and Recommendations;283
15.1.6;References;284
16;Chapter 10;298
16.1;Tuberculosis;298
16.1.1;10.1 Introduction;298
16.1.1.1;10.1.1 Definitions;298
16.1.1.2;10.1.2 Public Health Importance;298
16.1.2;10.2 Historical Background;299
16.1.2.1;10.2.1 Antiquity;299
16.1.2.2;10.2.2 Early Ideas About Tuberculosis;300
16.1.2.3;10.2.3 Tuberculosis as an Infectious Disease;301
16.1.2.4;10.2.4 Cod-Liver Oil Therapy;301
16.1.2.5;10.2.5 BCG Vaccine and Tuberculosis Chemotherapy;302
16.1.2.6;10.2.6 The Decline of Tuberculosis in Industrialized Countries;302
16.1.3;10.3 Epidemiology;303
16.1.3.1;10.3.1 Geographic Distribution;303
16.1.3.2;10.3.2 High-Risk Groups and Risk Factors;304
16.1.3.3;10.3.3 Incidence and Prevalence of Tuberculosis in Vulnerable Populations;304
16.1.3.3.1;10.3.3.1 HIV Infection;304
16.1.3.3.2;10.3.3.2 Children;305
16.1.3.3.3;10.3.3.3 Older Adults;305
16.1.3.3.4;10.3.3.4 Other Populations at Risk;305
16.1.3.4;10.3.4 Drug-Resistant Tuberculosis;306
16.1.4;10.4 Clinical Features/Pathophysiology;306
16.1.4.1;10.4.1 Clinical Features of Tuberculosis;306
16.1.4.2;10.4.2 Pathophysiology;307
16.1.4.3;10.4.3 Role of Nutrition;308
16.1.4.3.1;10.4.3.1 Protein and Energy Status;308
16.1.4.3.2;10.4.3.2 Vitamin A;309
16.1.4.3.3;10.4.3.3 Vitamin D;310
16.1.4.3.4;10.4.3.4 B Complex Vitamins;310
16.1.4.3.5;10.4.3.5 Vitamin C;310
16.1.4.3.6;10.4.3.5 Other Nutritional Problems;311
16.1.4.4;10.4.4 Strength of Evidence Regarding Role of Nutrition;311
16.1.5;10.5 Diagnosis;313
16.1.5.1;10.5.1 Clinical Diagnosis of Latent Tuberculosis Infection;313
16.1.5.2;10.5.2 Clinical and Laboratory Diagnosis of Active Tuberculosis;313
16.1.5.2.1;10.5.2.1 Staining Techniques;314
16.1.5.2.2;10.5.2.2 Mycobacterial Culture;314
16.1.5.2.3;10.5.2.3 Molecular Methods;314
16.1.5.2.4;10.5.2.4 Histopathology;314
16.1.5.2.5;10.5.2.5 Specimen Collection and Laboratory Safety;314
16.1.5.3;10.5.3 Differential Diagnosis;315
16.1.6;10.6 Treatment and Prevention;315
16.1.6.1;10.6.1 General Considerations;315
16.1.6.2;10.6.2 Treatment of Active Tuberculosis;315
16.1.6.2.1;10.6.2.1 General Treatment Regimens;315
16.1.6.2.2;10.6.2.2 Special Circumstances;317
16.1.6.3;10.6.3 Treatment of Latent Tuberculosis Infection;318
16.1.6.4;10.6.4 BCG Vaccination;318
16.1.6.5;10.6.5 Environmental Measures;319
16.1.7;10.7 Summary and Conclusions;319
16.1.8;10.8 Recommendations;319
16.1.9;References;320
17;Chapter 11;330
17.1;Human Immunodeficiency Virus Infection;330
17.1.1;11.1 Introduction;330
17.1.2;11.2 Historical Background;331
17.1.3;11.3 Epidemiology;332
17.1.3.1;11.3.1 Highest-Risk Groups;332
17.1.3.2;11.3.2 Prevalence and Incidence;332
17.1.3.3;11.3.3 Risk Factors;333
17.1.3.3.1;11.3.3.1 Transmission of HIV;333
17.1.3.3.2;11.3.3.2 Progression of the Disease;334
17.1.4;11.4 Clinical Features/Pathophysiology;334
17.1.4.1;11.4.1 Clinical Features;334
17.1.4.1.1;11.4.1.1 Primary HIV Infection;336
17.1.4.1.2;11.4.1.2 Asymptomatic HIV Infection;336
17.1.4.1.3;11.4.1.3 Symptomatic HIV Infection;336
17.1.4.1.4;11.4.1.4 Acquired Immune Defi ciency Syndrome;336
17.1.4.2;11.4.2 Pediatric HIV Infection;337
17.1.4.2.1;11.4.2.1 Factors Affecting Disease Progression in Children;337
17.1.4.2.2;11.4.2.2 Classifi cation of HIV Infection in Children;338
17.1.4.3;11.4.3 Pathogenesis;339
17.1.4.4;11.4.4 Role of Nutrition;340
17.1.4.4.1;11.4.4.1 The Role of Nutritional Factors in HIV Progression and Transmission;340
17.1.4.4.2;11.4.4.2 The Impact of HIV Infection on Nutritional Status;347
17.1.5;11.5 Diagnosis;349
17.1.6;11.6 Treatment;350
17.1.7;11.7 Prevention;350
17.1.8;11.8 Summary and Conclusions;351
17.1.9;References;352
18;Chapter 12;364
18.1;Malnutrition;364
18.1.1;12.1 Introduction;364
18.1.1.1;12.1.1 Defi nitions and Historical Overview;364
18.1.2;12.2 Measuring Physical Status and Growth;367
18.1.2.1;12.2.1 Anthropometric Indices of Nutritional Health;367
18.1.2.2;12.2.2 Growth References;368
18.1.2.3;12.2.3 Expression of Anthropometry;369
18.1.2.4;12.2.4 Severe Malnutrition;369
18.1.3;12.3 Patterns and Timing of Growth Retardation;370
18.1.3.1;12.3.1 Prevalence and Patterns of Global Anthropometric Status;370
18.1.3.2;12.3.2 Timing of Growth Faltering and Potential for Catch-Up Growth;370
18.1.4;12.4 Epidemiologic Evidence;373
18.1.4.1;12.4.1 Conceptual Diagram;373
18.1.4.2;12.4.2 Consequences of Malnutrition;373
18.1.4.2.1;12.4.2.1 Mortality;373
18.1.4.2.2;12.4.2.2 Infection and Disease;376
18.1.4.2.3;12.4.2.3 Functional Outcomes;377
18.1.4.2.4;12.4.2.4 Summary;379
18.1.4.3;12.4.3 Causes of Malnutrition and Poor Growth;379
18.1.4.3.1;12.4.3.1 Infection;380
18.1.4.3.2;12.4.3.2 Diet;382
18.1.4.3.3;12.4.3.3 Relative and Combined Effects of Infection and Poor Diet on Child Growth;385
18.1.4.4;12.4.4 The Underlying Determinants: Food, Care, and Heath;387
18.1.4.4.1;12.4.4.1 Programmatic Implications;387
18.1.5;12.5 Nutrition-Oriented Interventions and Programs: Necessary Elements and Optimal Designs;387
18.1.5.1;12.5.1 Manuals and Guides to Assist with Designing Programs;389
18.1.5.2;12.5.2 Treatment of Severe Malnutrition;389
18.1.6;12.6 Research Needs and Priorities;390
18.1.7;12.7 Summary and Conclusions;392
18.1.8;References;392
19;Chapter 13;400
19.1;Vitamin A Deficiency;400
19.1.1;13.1 Introduction;400
19.1.2;13.2 The Nutrient: Vitamin A;400
19.1.2.1;13.2.1 Structure and Nomenclature;401
19.1.2.2;13.2.2 Absorption and Transport;402
19.1.2.3;13.2.3 Metabolism and Functions;402
19.1.2.3.1;13.2.3.1 Visual Cycle;402
19.1.2.3.2;13.2.3.2 Gene Regulation;404
19.1.2.4;13.2.4 Dietary Sources and Intake Recommendations;404
19.1.3;13.3 Public Health Significance of Vitamin a Deficiency;408
19.1.3.1;13.3.1 Prevalence;408
19.1.3.1.1;13.3.1.1 Preschool-Aged Children;409
19.1.3.1.2;13.3.1.2 Newborns and Neonates;412
19.1.3.1.3;13.3.1.3 School-Aged Children;413
19.1.3.1.4;13.3.1.4 Women of Reproductive Age;413
19.1.3.2;13.3.2 Effects on Child Morbidity and Mortality;413
19.1.3.3;13.3.3 Effects on Infant Morbidity and Mortality;416
19.1.3.4;13.3.4 Effects on Maternal Morbidity and Mortality;417
19.1.4;13.4 Historical Background;418
19.1.5;13.5 Epidemiology;422
19.1.5.1;13.5.1 Location;422
19.1.5.2;13.5.2 Persons at Risk;424
19.1.5.2.1;13.5.2.1 Age;424
19.1.5.2.2;13.5.2.2 Gender;425
19.1.5.2.3;13.5.2.3 Socioeconomic status;425
19.1.5.3;13.5.3 Periodicity;426
19.1.5.4;13.5.4 Proximal Causes;427
19.1.5.4.1;13.5.4.1 Breast-Feeding;427
19.1.5.4.2;13.5.4.2 Complementary Feeding;428
19.1.5.4.3;13.5.4.3 Infectious Disease Morbidity;429
19.1.6;13.6 Clinicopathological Features;431
19.1.6.1;13.6.1 Xerophthalmia;431
19.1.6.1.1;13.6.1.1 Night Blindness (XN);431
19.1.6.1.2;13.6.1.2 Conjunctival Xerosis with Bitot’s Spots (X1B);431
19.1.6.1.3;13.6.1.3 Corneal Xerosis (X2), Ulceration, and Necrosis (X3);432
19.1.6.2;13.6.2 Infection;433
19.1.7;13.7 Treatment;434
19.1.8;13.8 Prevention;435
19.1.8.1;13.8.1 Dietary Diversifi cation;436
19.1.8.2;13.8.2 Fortification;437
19.1.8.3;13.8.3 Supplementation;438
19.1.9;13.9 Conclusion;440
19.1.10;References;441
20;Chapter 14;458
20.1;Nutritional Rickets and Vitamin DDeficiency;458
20.1.1;14.1 Introduction;458
20.1.2;14.2 Definition;458
20.1.3;14.3 Public Health Importance;459
20.1.4;14.4 Historical Background;460
20.1.5;14.5 Epidemiology;461
20.1.6;14.6 Pathophysiology/Clinical Features;467
20.1.7;14.7 Diagnosis;467
20.1.8;14.8 Treatment;469
20.1.9;14.9 Prevention;470
20.1.10;14.10 Future Directions;472
20.1.11;14.11 Conclusions;472
20.1.12;References;473
21;Chapter 15;478
21.1;Zinc Deficiency;478
21.1.1;15.1 Introduction;478
21.1.2;15.2 Public Health Significance;478
21.1.3;15.3 Historical Background;479
21.1.4;15.4 Epidemiology;479
21.1.5;15.5 Metabolism of Zinc;480
21.1.5.1;15.5.1 Zinc Absorption;480
21.1.5.2;15.5.2 Zinc Transport;481
21.1.5.3;15.5.3 Zinc Storage;481
21.1.5.4;15.5.4 Zinc Excretion;481
21.1.6;15.6 Biological Functions of Zinc;482
21.1.6.1;15.6.1 Zinc Metalloenzymes;482
21.1.6.2;15.6.2 Zinc Fingers;482
21.1.6.3;15.6.3 Zinc and Biomembranes;482
21.1.6.4;15.6.4 Zinc and Immune Function;482
21.1.6.5;15.6.5 Other Functions of Zinc;483
21.1.7;15.7 Pathophysiology of Zinc Deficiency;483
21.1.7.1;15.7.1 Dietary Sources and Intake of Zinc;483
21.1.7.2;15.7.2 Absorption and Bioavailability of Zinc;484
21.1.7.3;15.7.3 Zinc Dietary Requirements;485
21.1.8;15.8 Clinical Manifestations of Zinc Deficiency;486
21.1.9;15.9 Assessment of Zinc Status;487
21.1.9.1;15.9.1 Plasma or Serum Zinc Concentrations;487
21.1.9.2;15.9.2 Dietary Assessment;488
21.1.9.3;15.9.3 Other Methods;488
21.1.10;15.10 Zinc Supplementation as a Public Health Intervention;489
21.1.10.1;15.10.1 Diarrheal Disease in Children;489
21.1.10.2;15.10.2 Respiratory Disease in Children;489
21.1.10.3;15.10.3 Malaria in Children;490
21.1.10.4;15.10.4 Growth and Development of Children;490
21.1.10.5;15.10.5 Maternal Health;491
21.1.10.6;15.10.6 Human Immunodefi ciency Virus Infection;492
21.1.11;15.11 Prevention of Zinc Deficiency;492
21.1.12;15.12 Conclusions;494
21.1.13;15.13 Recommendations;494
21.1.14;References;495
22;Chapter 16;502
22.1;Iron Deficiency and Anemia;502
22.1.1;16.1 Introduction;502
22.1.2;16.2 Defining Anemia and Iron Deficiency;502
22.1.3;16.3 Historical Background;503
22.1.4;16.4 Epidemiology;503
22.1.4.1;16.4.1 Prevalence of Iron Deficiency and Anemia;503
22.1.4.2;16.4.2 Risk Factors for Iron Deficiency;504
22.1.5;16.5 Metabolism of Iron;505
22.1.5.1;16.5.1 Absorption of Iron;505
22.1.5.2;16.5.2 Transport of Iron;507
22.1.5.3;16.5.3 Storage of Iron;507
22.1.5.4;16.5.4 Iron Turnover and Loss;507
22.1.5.5;16.5.5 Iron-Nutrient Interactions;508
22.1.6;16.6 Role of Iron in Biological Functions;508
22.1.6.1;16.6.1 Hemoglobin;508
22.1.6.2;16.6.2 Myoglobin;508
22.1.6.3;16.6.3 Cytochromes;508
22.1.6.4;16.6.4 Other Iron-Containing Enzymes;509
22.1.6.5;16.6.5 Iron and Immune Function;509
22.1.7;16.7 Pathogenesis of Iron Deficiency and Anemia;509
22.1.7.1;16.7.1 Increased Requirement for Iron;509
22.1.7.2;16.7.2 Poor Dietary Intake;510
22.1.7.3;16.7.3 Abnormal Iron Loss;510
22.1.8;16.8 Functional Consequences of Iron Deficiency;510
22.1.8.1;16.8.1 Anemia and Mortality;511
22.1.8.2;16.8.2 Birth Outcomes;511
22.1.8.3;16.8.3 Child Behavior and Development;512
22.1.8.4;16.8.4 Work Performance and Productivity;512
22.1.8.5;16.8.5 Heavy Metal Absorption;512
22.1.8.6;16.8.6 Iron and Infection;513
22.1.9;16.9 Assessment of Iron Nutritional Status;516
22.1.9.1;16.9.1 Tests for Iron Deficiency;516
22.1.9.2;16.9.2 The Meaning of Anemia;516
22.1.9.3;16.9.3 Field Testing for Hemoglobin;517
22.1.9.4;16.9.4 Detection of Anemia by Clinical Examination;517
22.1.9.5;16.9.5 Use of Frequency Distributions of Hemoglobin in Assessing Iron Status;517
22.1.9.6;16.9.6 The Diagnosis of Multiple Conditions Contributing to Anemia;518
22.1.10;16.10 Control of Iron Deficiency;518
22.1.10.1;16.10.1 Primary Health Care-Based Approaches;518
22.1.10.1.1;16.10.1.1 Iron Supplementation;518
22.1.10.1.2;16.10.1.2 Control of Intestinal Helminth Infection;520
22.1.10.2;16.10.2 Nutrition Education and Promotion;520
22.1.10.3;16.10.3 Fortification;520
22.1.10.4;16.10.4 Iron Overload;521
22.1.11;16.11 Conclusions;522
22.1.12;16.12 Recommendations;522
22.1.13;References;523
23;Chapter 17;530
23.1;Iodine Deficiency Disorders;530
23.1.1;17.1 Introduction;530
23.1.2;17.2 Public Health Significance;530
23.1.3;17.3 Historical Background;530
23.1.4;17.4 Epidemiology;532
23.1.4.1;17.4.1 Geographical Distribution;532
23.1.4.2;17.4.2 Prevalence;533
23.1.4.3;17.4.3 Risk Factors;534
23.1.5;17.5 Metabolism of Iodine;534
23.1.5.1;17.5.1 Iodine Absorption and Transport;534
23.1.5.2;17.5.2 Iodine Storage;534
23.1.5.3;17.5.3 Synthesis of Thyroid Hormones;535
23.1.5.4;17.5.4 Transport and Turnover of Thyroid Hormones;535
23.1.5.5;17.5.5 Thyroid Hormones and Gene Expression;535
23.1.6;17.6 Role of Iodine in Biological Functions;536
23.1.6.1;17.6.1 Metabolism;536
23.1.6.2;17.6.2 Growth and Development;536
23.1.6.3;17.6.3 Brain Development;536
23.1.6.4;17.6.4 Iodine and Immune Function;537
23.1.7;17.7 Pathophysiology of Iodine Deficiency;537
23.1.7.1;17.7.1 Dietary Sources and Intake of Iodine;537
23.1.7.2;17.7.2 Goitrogens;537
23.1.7.3;17.7.3 Iodine Dietary Requirements;538
23.1.8;17.8 Clinical Manifestations of Iodine Deficiency Disorders;538
23.1.8.1;17.8.1 Goiter;538
23.1.8.2;17.8.2 Cretinism;539
23.1.8.3;17.8.3 Growth and Development;539
23.1.8.4;17.8.4 Reproductive Failure;540
23.1.8.5;17.8.5 Perinatal, Infant, and Child Mortality;540
23.1.9;17.9 Assessment of Iodine Status;540
23.1.9.1;17.9.1 Goiter Rate;541
23.1.9.2;17.9.2 Urinary Iodine Concentrations;543
23.1.9.3;17.9.3 Blood Thyroid-Stimulating Hormone;543
23.1.10;17.10 Prevention of Iodine Deficiency Disorders;543
23.1.10.1;17.10.1 Iodized Salt;544
23.1.10.2;17.10.2 Oral Iodized Oil;544
23.1.10.3;17.10.3 Iodized Oil Injections;545
23.1.10.4;17.10.4 Other Strategies;545
23.1.11;17.11 Conclusions;546
23.1.12;References;546
24;Chapter 18;554
24.1;Multiple Micronutrient Malnutrition;554
24.1.1;18.1 Introduction;554
24.1.2;18.2 Prevalence of Multiple-Micronutrient Malnutrition;556
24.1.2.1;18.2.1 Women of Reproductive Age;556
24.1.2.2;18.2.2 Children;557
24.1.3;18.3 Consequences of Multiple-Micronutrient Malnutrition During the Life Cycle;558
24.1.3.1;18.3.1 Pregnancy;558
24.1.3.1.1;18.3.1.1 Two-Way Micronutrient Interactions in Pregnancy;559
24.1.3.1.2;18.3.1.2 Prenatal Multivitamin-Mineral Supplements;560
24.1.3.2;18.3.2 Lactation;567
24.1.3.3;18.3.3 Childhood;568
24.1.3.3.1;18.3.3.1 Growth;568
24.1.3.3.2;18.3.3.2 Micronutrient Status;569
24.1.3.3.3;18.3.3.3 Morbidity;569
24.1.3.3.4;18.3.3.4 Motor and Mental Development;576
24.1.3.3.5;18.3.4 Adult Morbidity;578
24.1.4;18.4 Programmatic Implications;579
24.1.4.1;18.4.1 Improving Dietary Intake;579
24.1.4.1.1;18.4.1.1 Behavior Change Programs;579
24.1.4.1.2;18.4.1.2 Promoting Animal Production and Home Gardening;581
24.1.4.2;18.4.2 Fortification;581
24.1.4.3;18.4.3 Multiple-Micronutrient Supplements;585
24.1.5;18.5 Conclusions;587
24.1.6;References;588
25;Chapter 19;600
25.1;Nutrition in the Elderly in Developing Countries;600
25.1.1;19.1 The Biology of Human Aging and Survival: an Evolutionary Perspective;600
25.1.1.1;19.1.1 Overview;600
25.1.1.2;19.1.2 Evolutionary Perspective on Aging;601
25.1.1.3;19.1.3 The Evolutionary Paradoxes;601
25.1.1.4;19.1.4 The Biology of Aging;602
25.1.2;19.2 Senescence of Tissue and Organ Function with Aging;602
25.1.2.1;19.2.1 Function of the Alimentary and Digestive Tract in Aging;604
25.1.3;19.3 Successful Aging, Normative Aging, and Frail Aging of Individuals Within a Population;604
25.1.4;19.4 Demography of Aging of Populations in Developing Countries;604
25.1.5;19.5 The Burden of Chronic Diseases in the Aging;605
25.1.5.1;19.5.1 Nontransmissible Disease Epidemiology in Developing Country Populations;605
25.1.5.2;19.5.2 Relationship of Chronic Disease to Diet and Nutrition in Developing Countries;606
25.1.6;19.6 Nutritional Requirements, Nutrient Intake Recommendations, and Guidelines for Healthful Eating for the Elderly;606
25.1.7;19.7 Dietary Intake and Eating Behavior by Elderly in Developing Countries;613
25.1.7.1;19.7.1 Assessing Dietary Intakes in Older Subjects: Caveats for Developing Countries;613
25.1.7.2;19.7.2 Patterns of Dietary Consumption in Later Life;614
25.1.8;19.8 Nutritional Deficiency and Excess and its Assessment in the Elderly of Developing Countries;615
25.1.8.1;19.8.1 Deficiency and Undernutrition States in Developing Country Elderly;615
25.1.8.1.1;19.8.1.1 Diagnosing Undernutrition;616
25.1.8.2;19.8.2 Excess and Overnutrition States in Developing Country Elderly;617
25.1.8.2.1;19.8.2.1 Diagnosing Overnutrition;618
25.1.9;19.9 Conclusions;618
25.1.10;References;619
26;Chapter 20;624
26.1;The Nutrition Transition and Its Relationship to Demographic Change;624
26.1.1;20.1 Introduction;624
26.1.2;20.2 Background: Patterns of the Nutrition Transition;625
26.1.3;20.3 Economic Change and the Nutrition Transition;628
26.1.4;20.4 Demographic Change and the Nutrition Transition;630
26.1.4.1;20.4.1 Key Dimensions of World Urbanization;630
26.1.4.2;20.4.2 Proportion Living in Cities;631
26.1.4.3;20.4.3 Concentrated Population Growth;632
26.1.4.4;20.4.4 Shift in the Proportion of Poor Living in Cities;632
26.1.5;20.5 The Nature and Pace of the Nutrition Transition;633
26.1.5.1;20.5.1 Japanese and Korean Accelerated Model;633
26.1.5.2;20.5.2 Low-Income Countries with Rapid Income Increases: The Case of China;634
26.1.5.3;20.5.3 Degenerative Dietary and Epidemiologic Transition with Limited or No Economic Improvement;634
26.1.5.4;20.5.4 Other Low-Income Countries;636
26.1.6;20.6 Conclusion;636
26.1.7;References;637
27;Chapter 21;640
27.1;The Rapid Emergence of Obesity in Developing Countries;640
27.1.1;21.1 Introduction;640
27.1.2;21.2 Methods;641
27.1.2.1;21.2.1 Survey Design and Sample;641
27.1.2.2;21.2.2 Measures;641
27.1.3;21.3 Results;642
27.1.3.1;21.3.1 The Prevalence in Lower- and Middle-Income Countries;642
27.1.3.1.1;21.3.1.1 Latin America;642
27.1.3.1.2;21.3.1.2 Asia;642
27.1.3.1.3;21.3.1.3 Western Pacific;649
27.1.3.1.4;21.3.1.4 Middle East;649
27.1.3.1.5;21.3.1.5 Sub-Saharan Africa;650
27.1.3.2;21.3.2 Obesity Trends in Lower- and Middle-Income Countries;650
27.1.3.2.1;21.3.2.1 Brazil;653
27.1.3.2.2;21.3.2.2 China;654
27.1.3.2.3;21.3.2.3 Indonesia;654
27.1.3.2.4;21.3.2.4 Vietnam;655
27.1.3.2.5;21.3.2.5 Kuwait;655
27.1.3.2.6;21.3.2.6 Mauritius;655
27.1.3.2.7;21.3.2.7 Russia;655
27.1.3.2.8;21.3.2.8 Western Pacific;656
27.1.4;21.4 Implications for Public Health;656
27.1.4.1;21.4.1 Obesity;656
27.1.4.2;21.4.2 Physical Activity;657
27.1.4.3;21.4.3 Interactions of Obesity and Activity;657
27.1.4.4;21.4.4 Genetic Component;657
27.1.5;21.5 Research and Policy Implications;657
27.1.6;References;658
28;Chapter 22;662
28.1;Rapid Urbanization and the Challenges of Obtaining Food and Nutrition Security;662
28.1.1;22.1 Introduction;662
28.1.2;22.2 Increasing Urban Poverty and Undernutrition;663
28.1.2.1;22.2.1 Poverty Data;664
28.1.2.2;22.2.2 Nutrition Data;664
28.1.3;22.3 Challenges to Obtaining Food, Nutrition, and Health Security in an Urban Environment;665
28.1.3.1;22.3.1 The Importance of Cash, Employment, Food Prices, and Agriculture for Urban Livelihood and Food Security;665
28.1.3.1.1;22.3.1.1 Dependence on Cash for Food;665
28.1.3.1.2;22.3.1.2 Urban Marketing Systems, Supermarkets, and Food Price Policies;665
28.1.3.1.3;22.3.1.3 Urban Employment;666
28.1.3.1.4;22.3.1.4 Urban Food Production;667
28.1.3.2;22.3.2 Stronger Formal Safety Nets and Weaker Informal Safety Nets?;667
28.1.3.3;22.3.3 The Increased Labor Force Participation of Women and Its Consequences for Child Care;668
28.1.3.3.1;22.3.3.1 Women’s Work Patterns and Child Care Use in Urban and Rural Areas;668
28.1.3.3.2;22.3.3.2 Impact of Maternal Work on Child Care Practices;669
28.1.3.4;22.3.4 Lifestyle Changes;670
28.1.3.4.1;22.3.4.1 Dietary Patterns;670
28.1.3.4.2;22.3.4.2 Activity Patterns;671
28.1.3.4.3;22.3.4.3 Health Implications;671
28.1.3.5;22.3.5 Increased Availability of Services, But Questionable Accessby Poor Households;672
28.1.3.6;22.3.6 Environmental Contamination;672
28.1.3.6.1;22.3.6.1 Air Pollution;672
28.1.3.6.2;22.3.6.2 Water and Food Contamination;673
28.1.3.7;22.3.7 Legal Rights;673
28.1.3.7.1;22.3.7.1 Urban Agriculture;673
28.1.3.7.2;22.3.7.2 Informal Marketing Activities Such as Street Foods;674
28.1.3.7.3;22.3.7.3 Insecurity of Tenure and Development Activity;674
28.1.4;22.4 Implications for Policy and Research;674
28.1.5;22.5 Conclusions;676
28.1.6;References;677
29;Chapter 23;680
29.1;Impact of Parental Tobacco Use on Child Malnutrition and Survival;680
29.1.1;23.1 Introduction;680
29.1.2;23.2 Historical Background;681
29.1.3;23.3 Epidemiology of Tobacco Use;681
29.1.3.1;23.3.1 World Health Organization Conceptual Framework for the Tobacco Epidemic;681
29.1.3.2;23.3.2 The African Region;683
29.1.3.3;23.3.3 The Region of the Americas;684
29.1.3.4;23.3.4 The Eastern Mediterranean Region;685
29.1.3.5;23.3.5 The European Region;685
29.1.3.6;23.3.6 The Southeast Asia Region;686
29.1.3.7;23.3.7 The Western Pacific Region;686
29.1.4;23.4 Tobacco Use and Child Malnutrition;687
29.1.4.1;23.4.1 Indonesia;688
29.1.4.2;23.4.2 Bangladesh;689
29.1.4.3;23.4.3 India;690
29.1.4.4;23.4.4 “Going Up in Smoke”: Tobacco Versus Food;690
29.1.5;23.5 Other Adverse Effects of Parental Smoking on Child Health;691
29.1.5.1;23.5.1 Respiratory Health;691
29.1.5.2;23.5.2 Low Birth Weight;691
29.1.5.3;23.5.3 Circulating Antioxidants;692
29.1.5.4;23.5.4 Increased Health Care Utilization;692
29.1.6;23.6 Parental Tobacco Use and Child Mortality;692
29.1.7;23.7 Tobacco Control;693
29.1.7.1;23.7.1 Indirect Advertising and Trademark Diversification;694
29.1.7.2;23.7.2 Industry Programs to Counter Antitobacco Science;694
29.1.7.3;23.7.3 Offshore Strategies;696
29.1.7.4;23.7.4 Industry-Funded Youth Smoking Prevention Programs;696
29.1.7.5;23.7.5 Appeals to International Trade Organizations and Representatives;696
29.1.8;23.8 Conclusions;696
29.1.9;23.9 Recommendations;697
29.1.10;References;697
30;Chapter 24;700
30.1;Humanitarian Emergencies;700
30.1.1;24.1 Introduction;700
30.1.1.1;24.1.1 Defi nitions and History;700
30.1.1.2;24.1.2 Objective of the Chapter;702
30.1.2;24.2 Epidemiology of Humanitarian Emergencies;702
30.1.2.1;24.2.1 Global Trends in Number of Conflicts, Refugees, and Internally Displaced Persons;702
30.1.2.2;24.2.2 Main Causes of Morbidity and Mortality;704
30.1.2.3;24.2.3 Communicable Diseases, with Specific Focus on HIV/AIDS/STI;705
30.1.2.4;24.2.4 Malnutrition and Food Security;706
30.1.2.5;24.2.5 Reproductive Health;707
30.1.2.6;24.2.6 Mental Health;708
30.1.3;24.3 Programming;709
30.1.4;24.4 New Developments and Challenges;711
30.1.4.1;24.4.1 New Humanitarianism and Humanitarian Reform;711
30.1.4.2;24.4.2 Other Initiatives for Improvement of Accountability and Quality;713
30.1.4.3;24.4.3 Health, Nutrition, and Conflicts in a Changing Global Environment;713
30.1.5;24.5 Summary Recommendations for The Way Forward;714
30.1.5.1;24.5.1 Policy Recommendations;715
30.1.5.2;24.5.2 Technical Recommendations;715
30.1.5.3;24.5.3 Training Recommendations;716
30.1.6;References;716
31;Chapter 25;722
31.1;Tackling Nutrient Deficiencies and Life-Threatening Disease;722
31.1.1;25.1 Introduction;722
31.1.2;25.2 Food and Disease, Cause and Effect;723
31.1.3; 25.3 Nutrient-Disease Synergies and Nutrient Deficiencies;724
31.1.4;25.4 Responding to Malnutrition and Disease Through Food;726
31.1.4.1;25.4.1 General Food Distribution;729
31.1.4.2;25.4.2 Supplementary Feeding;734
31.1.4.3;25.4.3 Therapeutic Feeding;736
31.1.4.4;25.4.4 Addressing Micronutrient Deficiencies;737
31.1.5;25.5 Conclusions and Future Directions;738
31.1.6;References;739
32;Chapter 26;744
32.1;The Indian Ocean Tsunami of December 26, 2004;744
32.1.1;26.1 Introduction;744
32.1.2;26.2 Loss and Damage Caused by the Tsunami;745
32.1.3;26.3 Response to the Tsunami;746
32.1.3.1;26.3.1 Relief and Recovery Phase;746
32.1.3.2;26.3.2 Coordination of Response;747
32.1.3.3;26.3.3 Financial Support;748
32.1.3.4;26.3.4 Lessons Learned for Next Disaster Response;748
32.1.4;26.4 Impact of Tsunami on Health and Nutrition: Focus on Indonesia;749
32.1.4.1;26.4.1 Preexisting Health and Nutrition Situation;749
32.1.4.2;26.4.2 Impact on Health and Nutrition;750
32.1.4.2.1;26.4.2.1 Communicable Diseases;750
32.1.4.2.2;26.4.2.2 Handling Dead Bodies;751
32.1.4.2.3;26.4.2.3 Injuries;751
32.1.4.2.4;26.4.2.4 Mental Health Problems;752
32.1.4.3;26.4.3 Interventions for Health and Nutrition;753
32.1.4.3.1;26.4.3.1 Disease and Health and Nutrition Surveillance Systems;753
32.1.4.3.2;26.4.3.2 Improving Health and Nutritional Status of the Affected Population;754
32.1.4.3.3;26.4.3.3 The Need for Micronutrients in Emergencies;754
32.1.4.3.4;26.4.3.4 Example of Distributing Vitamin and Mineral Preparations: Tsunami Relief in Indonesia;756
32.1.5;26.5 Conclusions and Recommendations;757
32.1.6;References;758
33;Chapter 27;762
33.1;The Impact of Supermarkets on Farmers, Consumers, and Food Security in Developing Countries;762
33.1.1;27.1 Introduction;762
33.1.2;27.2 The Supermarket Revolution: What’s Happening?;763
33.1.3;27.3 An Analytical Perspective on the Impact of Supermarkets;766
33.1.3.1;27.3.1 Consumers and Public Health;768
33.1.3.2;27.3.2 Small Farmers;768
33.1.3.3;27.3.3 Food Security;769
33.1.4;27.4 The Development Dimensions of the Supermarket Revolution;769
33.1.4.1;27.4.1 Supermarkets: Complements or Substitutes for a Public Role in Marketing?;770
33.1.4.2;27.4.2 Macroeconomic and Growth Issues;770
33.1.5;27.5 Putting Supermarkets in a Food Policy Framework;771
33.1.6;27.6 Conclusions;772
33.1.7;References;773
34;Chapter 28;776
34.1;Homestead Food Production for Improving Nutritional Status and Health;776
34.1.1;28.1 Introduction;776
34.1.2;28.2 The Contribution of Homestead Food Production to Increasing Food Security.;779
34.1.3;28.3 Is Homestead Food Production Economically Viable for Households and Communities?;781
34.1.4;28.4 Assessing the Impact of Homestead Food Production on Nutrition and Health: the Case of Vitamin a Deficiency;782
34.1.4.1;28.4.1 Conceptual Framework for Impact of Food-Based Programs on Nutritional Status and Health;782
34.1.4.2;28.4.2 How Food Consumption Can Increase Vitamin A Status;783
34.1.4.2.1;28.4.2.1 Studies of Plant Foods for Combating Vitamin A Deficiency;785
34.1.4.2.2;28.4.2.2 Factors Determining Bioavailability and Bioconversion of Carotenoids Studies;786
34.1.4.2.2.1;28.4.2.2.1 Host-Related Factors.;786
34.1.4.2.2.2;28.4.2.2.2 Food-Related Factors.;787
34.1.4.2.2.3;28.4.2.2.3 Meal-Related Factors.;788
34.1.4.2.3;28.4.2.3 Guidelines for Maximizing Vitamin A Intake from Plant Foods;788
34.1.4.3;28.4.3 Health Effects of Increased Consumption of Vitamin A-Rich Foods;790
34.1.4.3.1;28.4.3.1 How the Consumption of Vitamin A-Rich Foods Can Affect Health;790
34.1.4.3.2;28.4.3.2 Evidence of Impact of Vitamin A-Rich Foods on Health in Developing Countries Beyond a Vitamin A Effect;790
34.1.4.3.3;28.4.3.3 Summary of Role of Foods for Health;791
34.1.4.4;28.4.4 Impact of Homestead Food Production on Nutritional Status and Health;791
34.1.4.4.1;28.4.4.1. Example of Impact of Homestead Food Production on Nutritional Status or Health;793
34.1.4.4.2;28.4.4.2 Approaches for Assessing Impact of HFP on Nutritional Status or Health;794
34.1.5;28.5 Homestead Food Production Contributes to Development Through Empowerment of Women;796
34.1.6;28.6 A Programmatic Approach to Increase and Improve Homestead Food Production Practices;796
34.1.7;28.7 Conclusions and Recommendations;798
34.1.8;References;799
35;Chapter 29;804
35.1;Food Policy;804
35.1.1;29.1 Introduction;804
35.1.2;29.2 Definitions;804
35.1.3;29.3 Food Policy: What’s Different?;806
35.1.3.1;29.3.1 The Food and Health Dimension;806
35.1.3.2;29.3.2 The Poverty and Development Dimension;807
35.1.4;29.4 Food Policy in Historical Perspective;808
35.1.5;29.5 The Sectoral Perspective;810
35.1.6;29.6 Lessons for Food Policy;813
35.1.6.1;29.6.1 Three Things Not to Do;813
35.1.6.2;29.6.2 Three Things to Do;813
35.1.7;References;814
36;Chapter 30;816
36.1;Need, Efficacy, and Effectiveness of Multiple Vitamin/Mineral Supplements for Young Children and Considerations for Programs;816
36.1.1;30.1 Introduction;816
36.1.2;30.2 Existence and Consequences of Multiple Vitamin and Mineral Deficiencies;818
36.1.2.1;30.2.1 Vitamin and Mineral Deficiencies in Infants and Young Children;818
36.1.2.2;30.2.2 Why Supply a Combination of Vitamins and Minerals?;819
36.1.2.3;30.2.3 Need for Vitamins and Minerals is Particularly High in Emergencies;819
36.1.3;30.3 Methods Used for Reviewing Impact of Increased Intake of Vitamins and Minerals by Children;820
36.1.4;30.4 Vitamin and Mineral Supplements, Recommended Intake, and Composition of Supplements Used;820
36.1.5;30.5 Efficacy of Multimicronutrient Supplements for Children;828
36.1.5.1;30.5.1 Micronutrient Status;828
36.1.5.1.1;30.5.1.1 Hemoglobin and Anemia;828
36.1.5.1.2;30.5.1.2 Ferritin and Iron Deficiency;832
36.1.5.1.3;30.5.1.3 Serum Retinol, Vitamin a Deficiency;832
36.1.5.1.4;30.5.1.4 Serum Zinc and Zinc Deficiency;832
36.1.5.1.5;30.5.1.5 Iron and Zinc Interaction;836
36.1.5.1.6;30.5.1.6 Other Micronutrients;836
36.1.5.2;30.5.2 Growth;837
36.1.5.3;30.5.3 Morbidity and Mortality;840
36.1.5.3.1;30.5.3.1 Evidence from Reviewed Studies;840
36.1.5.3.2;30.5.3.2 Could Vitamin and Mineral Supplementation Increase Morbidity?;841
36.1.5.3.3;30.5.3.3 Other Ways to Reduce Morbidity;842
36.1.5.4;30.5.4 Development (Cognitive, Learning Ability);843
36.1.6;30.6 Effectiveness of Multivitamin and Mineral Supplements for Children;843
36.1.7;30.7 Issues to be Considered for Programs That Provide Vitamins and Minerals;844
36.1.7.1;30.7.1 Dosage and Kind of Preparation;844
36.1.7.2;30.7.2 Duration and Frequency of Distribution;845
36.1.7.3;30.7.3 Supplementation in the Case of Infectious Diseases, Including Malaria;845
36.1.7.4;30.7.4 Concurrent Supplementation with Other Vitamin and Mineral Supplements or Fortified Foods;846
36.1.8;30.8 Conclusions and Recommendations;846
36.1.9;References;848
37;Chapter 31;854
37.1;How Much Do Data Influence Programs for Health and Nutrition?;854
37.1.1;31.1 Introduction;854
37.1.1.1;31.1.1 Paradigm Shifts in the Field of Public Health/Nutrition;855
37.1.1.2;31.1.2 Data to Inform Public Health/Nutrition Programming;857
37.1.2;31.2 Design and Implementation of a Surveillance System;858
37.1.2.1;31.2.1 Conceptual Model, Indicators, and Questionnaire;860
37.1.2.2;31.2.2 Sampling;862
37.1.2.3;31.2.3 Quality Control;863
37.1.2.4;31.2.4 Data Entry, Data Cleaning, and Data Analysis;864
37.1.3;31.3 Communicating the Results;865
37.1.4;31.4 Identifying Priorities for and Monitoring of Programs: Use of Surveillance Data;866
37.1.4.1;31.4.1 Vitamin A Capsule Distribution;866
37.1.4.2;31.4.2 Vaccination Programs;867
37.1.4.3;31.4.3 Food Fortification;868
37.1.4.4;31.4.4 Assessing a Program’s Impact Under Real-Life Circumstances;869
37.1.5;31.5 Understanding Causes of Malnutrition: Surveillance Findings;870
37.1.5.1;31.5.1 Factors Related to Child Malnutrition in Bangladesh;870
37.1.5.2;31.5.2 Effectiveness of Homestead Food Production;871
37.1.5.3;31.5.3 Macroeconomic Policies and Malnutrition;872
37.1.5.4;31.5.4 Indicators for Impact of Crises on Health and Nutrition;872
37.1.5.5;31.5.5 Dual Burden of Overweight and Obesity;874
37.1.5.6;31.5.6 Effects of Parental Smoking on Malnutrition and Childhood Mortality;875
37.1.5.7;31.5.7 Parental Education: Every Year Counts;876
37.1.6;31.6 Conclusions and Recommendations;876
37.1.7;References;877
38;Chapter 32;882
38.1;The Economics of Nutritional Interventions;882
38.1.1;32.1 Introduction;882
38.1.2;32.2 The Costs of Undernutrition;883
38.1.3;32.3 The Costs of Nutrition Interventions;888
38.1.4;32.4 Cost-Effectiveness and Benefit: Cost of Nutrition Interventions;890
38.1.5;32.5 Conclusions;891
38.1.6;References;893
39;Chapter 33;896
39.1;Ethics in Public Health Research;896
39.1.1;33.1 Introduction;896
39.1.2;33.2 Basic Ethical Principles;897
39.1.2.1;33.2.1 Respect for Persons;897
39.1.2.2;33.2.2 Beneficence;898
39.1.2.3;33.2.3 Justice;898
39.1.3;33.3 Application of Ethical Principles;899
39.1.3.1;33.3.1 Informed Consent;899
39.1.3.1.1;Case Study 33.1;900
39.1.3.2;33.3.2 Confidentiality;902
39.1.3.2.1;Case Study 33.2;902
39.1.3.3;33.3.3 Standards of Care;903
39.1.3.3.1;Case Study 33.3;904
39.1.3.4;33.3.4 Responsibility to the Study Community After Completion of Research;905
39.1.3.4.1;Case Study 33.4;906
39.1.4;33.4 Ethical Review Processes;908
39.1.5;33.5 Conclusions;909
39.1.6;References;909
40;Chapter 34;910
40.1;Beyond Partial Analysis;910
40.1.1;34.1 Introduction;910
40.1.2;34.2 Public Policy Analysis;912
40.1.2.1;34.2.1 The Technical Frame;913
40.1.2.1.1;34.2.1.1 Causal Analysis;913
40.1.2.1.2;34.2.1.2 Analysis of Interventions;915
40.1.2.2;34.2.2 The Economic Frame;916
40.1.2.3;34.2.3 The Social/Normative Frame;919
40.1.2.4;34.2.4 The Political Frame;922
40.1.2.5;34.2.5 The Administrative/Organizational Frame;924
40.1.2.6;34.2.6 The Legal Frame;927
40.1.2.7;34.2.7 Multiple/Integrative Frames;928
40.1.3;34.3 Implications for Truly "Public" Health and Nutrition;929
40.1.3.1;34.3.1 Implications for Practice;930
40.1.3.2;34.3.2 Implications for Research;931
40.1.3.3;34.3.3 Implications for Training;933
40.1.4;34.4 Conclusions;934
40.1.5;References;935
41;Index;938
