Saturday, July 16, 2011

facts on starvation and hunger

Hunger


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facts about hunger

Hunger concepts and definitions
Number of hungry people in the world
Does the world produce enough food to feed everyone?
Causes of hunger
Progress in reducing the number of hungry people
Micronutrients

Hunger concepts and definitions

Hunger is a term which has three meanings (Oxford English Dictionary 1971)

the uneasy or painful sensation caused by want of food; craving appetite. Also the exhausted condition caused by want of food
the want or scarcity of food in a country
a strong desire or craving

World hunger refers to the second definition, aggregated to the world level. The related technical term (in this case operationalized in medicine) is malnutrition.1

Malnutrition is a general term that indicates a lack of some or all nutritional elements necessary for human health (Medline Plus Medical Encyclopedia).

There are two basic types of malnutrition. The first and most important is protein-energy malnutrition--the lack of enough protein (from meat and other sources) and food that provides energy (measured in calories) which all of the basic food groups provide. This is the type of malnutrition that is referred to when world hunger is discussed. The second type of malnutrition, also very important, is micronutrient (vitamin and mineral) deficiency. This is not the type of malnutrition that is referred to when world hunger is discussed, though it is certainly very important.

[Recently there has also been a move to include obesity as a third form of malnutrition. Considering obesity as malnutrition expands the previous usual meaning of the term which referred to poor nutrition due to lack of food inputs.2 It is poor nutrition, but it is certainly not typically due to a lack of calories, but rather too many (although poor food choices, often due to poverty, are part of the problem). Obesity will not be considered here, although obesity is certainly a health problem and is increasingly considered as a type of malnutrition.]

Protein-energy malnutrition (PEM) is the most lethal form of malnutrition/hunger. It is basically a lack of calories and protein. Food is converted into energy by humans, and the energy contained in food is measured by calories. Protein is necessary for key body functions including provision of essential amino acids and development and maintenance of muscles.

Take a two-question hunger quiz on this section

Number of hungry people in the world

925 million hungry people in 2010

No one really knows how many people are malnourished. The statistic most frequently cited is that of the United Nations Food and Agriculture Organization, which measures 'undernutrition'. The most recent estimate, released in October 2010 by FAO, says that 925 million people are undernourished. As the figure below shows, the number of hungry people has increased since 1995-97, though the number is down from last year. The increase has been due to three factors: 1) neglect of agriculture relevant to very poor people by governments and international agencies; 2) the current worldwide economic crisis, and 3) the significant increase of food prices in the last several years which has been devastating to those with only a few dollars a day to spend. 925 million people is 13.6 percent of the estimated world population of 6.8 billion. Nearly all of the undernourished are in developing countries.

Number of hungry people, 1969-2010

Source: FAO

In round numbers there are 7 billion people in the world. Thus, with an estimated 925 million hungry people in the world, 13.1 percent, or almost 1 in 7 people are hungry.

The FAO estimate is based on statistical aggregates. It looks at a country's income level and income distribution and uses this information to estimate how many people receive such a low level of income that they are malnourished. It is not an estimate based on seeing to what extent actual people are malnourished and projecting from there (as would be done by survey sampling).3

Undernutrition is a relatively new concept, but is increasingly used. It should be taken as basically equivalent to malnutrition. (It should be said as an aside, that the idea of undernourishment, its relationship to malnutrition, and the reasons for its emergence as a concept is not clear to Hunger Notes.)

Children are the most visible victims of undernutrition. Children who are poorly nourished suffer up to 160 days of illness each year. Poor nutrition plays a role in at least half of the 10.9 million child deaths each year--five million deaths. Undernutrition magnifies the effect of every disease, including measles and malaria. The estimated proportions of deaths in which undernutrition is an underlying cause are roughly similar for diarrhea (61%), malaria (57%), pneumonia (52%), and measles (45%) (Black 2003, Bryce 2005). Malnutrition can also be caused by diseases, such as the diseases that cause diarrhea, by reducing the body's ability to convert food into usable nutrients.

According to the most recent estimate that Hunger Notes could find, malnutrition, as measured by stunting, affects 32.5 percent of children in developing countries--one of three (de Onis 2000). Geographically, more than 70 percent of malnourished children live in Asia, 26 percent in Africa and 4 percent in Latin America and the Caribbean. In many cases, their plight began even before birth with a malnourished mother. Under-nutrition among pregnant women in developing countries leads to 1 out of 6 infants born with low birth weight. This is not only a risk factor for neonatal deaths, but also causes learning disabilities, mental, retardation, poor health, blindness and premature death.

Take a three-question hunger quiz on this section

Does the world produce enough food to feed everyone?

The world produces enough food to feed everyone. World agriculture produces 17 percent more calories per person today than it did 30 years ago, despite a 70 percent population increase. This is enough to provide everyone in the world with at least 2,720 kilocalories (kcal) per person per day (FAO 2002, p.9). The principal problem is that many people in the world do not have sufficient land to grow, or income to purchase, enough food.

What are the causes of hunger?

What are the causes of hunger is a fundamental question, with varied answers.

Poverty is the principal cause of hunger. The causes of poverty include poor people's lack of resources, an extremely unequal income distribution in the world and within specific countries, conflict, and hunger itself. As of 2008 (2005 statistics), the World Bank has estimated that there were an estimated 1,345 million poor people in developing countries who live on $1.25 a day or less.3 This compares to the later FAO estimate of 1.02 billion undernourished people. Extreme poverty remains an alarming problem in the world’s developing regions, despite some progress that reduced "dollar--now $1.25-- a day" poverty from (an estimated) 1900 million people in 1981, a reduction of 29 percent over the period. Progress in poverty reduction has been concentrated in Asia, and especially, East Asia, with the major improvement occurring in China. In Sub-Saharan Africa, the number of people in extreme poverty has increased. The statement that 'poverty is the principal cause of hunger' is, though correct, unsatisfying. Why then are (so many) people poor? The next section summarizes Hunger Notes answer.

Harmful economic systems are the principal cause of poverty and hunger. Hunger Notes believes that the principal underlying cause of poverty and hunger is the ordinary operation of the economic and political systems in the world. Essentially control over resources and income is based on military, political and economic power that typically ends up in the hands of a minority, who live well, while those at the bottom barely survive, if they do. We have described the operation of this system in more detail in our special section on Harmful economic systems.

Conflict as a cause of hunger and poverty. At the end of 2005, the global number of refugees was at its lowest level in almost a quarter of a century. Despite some large-scale repatriation movements, the last three years have witnessed a significant increase in refugee numbers, due primarily to the violence taking place in Iraq and Somalia. By the end of 2008, the total number of refugees under UNHCR’s mandate exceeded 10 million. The number of conflict-induced internally displaced persons (IDPs) reached some 26 million worldwide at the end of the year . Providing exact figures on the number of stateless people is extremely difficult But, important, (relatively) visible though it is, and anguishing for those involved conflict is less important as poverty (and its causes) as a cause of hunger. (Using the statistics above 1.02 billion people suffer from chronic hunger while 36 million people are displaced [UNHCR 2008])

Hunger is also a cause of poverty, and thus of hunger. By causing poor health, low levels of energy, and even mental impairment, hunger can lead to even greater poverty by reducing people's ability to work and learn, thus leading to even greater hunger.

Climate change Climate change is increasingly viewed as a current and future cause of hunger and poverty. Increasing drought, flooding, and changing climatic patterns requiring a shift in crops and farming practices that may not be easily accomplished are three key issues. See the Hunger Notes special report: Hunger, the environment, and climate change for further information, especially articles in the section: Climate change, global warming and the effect on poor people such as Global warming causes 300,000 deaths a year, study says and Could food shortages bring down civilization?

Progress in reducing the number of hungry people

The target set at the 1996 World Food Summit was to halve the number of undernourished people by 2015 from their number in 1990-92. (FAO uses three year averages in its calculation of undernourished people.) The (estimated) number of undernourished people in developing countries was 824 million in 1990-92. In 2009, the number had climbed to 1.02 billion people. The WFS goal is a global goal adopted by the nations of the world; the present outcome indicates how marginal the efforts were in face of the real need.

So, overall, the world is not making progress toward the world food summit goal, although there has been progress in Asia, and in Latin America and the Caribbean.

Micronutrients

Quite a few trace elements or micronutrients--vitamins and minerals--are important for health. 1 out of 3 people in developing countries are affected by vitamin and mineral deficiencies, according to the World Health Organization. Three, perhaps the most important in terms of health consequences for poor people in developing countries, are:

Vitamin A Vitamin A deficiency can cause night blindness and reduces the body's resistance to disease. In children Vitamin A deficiency can also cause growth retardation. Between 100 and 140 million children are vitamin A deficient. An estimated 250,000 to 500 000 vitamin A-deficient children become blind every year, half of them dying within 12 months of losing their sight. (World Health Organization)

Iron Iron deficiency is a principal cause of anemia. Two billion people—over 30 percent of the world’s population—are anemic, mainly due to iron deficiency, and, in developing countries, frequently exacerbated by malaria and worm infections. For children, health consequences include premature birth, low birth weight, infections, and elevated risk of death. Later, physical and cognitive development are impaired, resulting in lowered school performance. For pregnant women, anemia contributes to 20 percent of all maternal deaths (World Health Organization).

Iodine Iodine deficiency disorders (IDD) jeopardize children’s mental health– often their very lives. Serious iodine deficiency during pregnancy may result in stillbirths, abortions and congenital abnormalities such as cretinism, a grave, irreversible form of mental retardation that affects people living in iodine-deficient areas of Africa and Asia. IDD also causes mental impairment that lowers intellectual prowess at home, at school, and at work. IDD affects over 740 million people, 13 percent of the world’s population. Fifty million people have some degree of mental impairment caused by IDD (World Health Organization).

(Updated June 22, 2011)

Footnotes

1. The relation between hunger, malnutrition, and other terms such as undernutrition is not 'perfectly clear,' so we have attempted to spell them out briefly in "World Hunger Facts."

2. For example, the Oxford English Dictionary (1971 edition) has 'insufficient nutrition' as the only meaning for malnutrition.

3. It has been argued that the FAO approach is not sufficient to give accurate estimates of malnutrition (Poverty and Undernutrition p. 298 by Peter Svedberg. For other discussions of measuring hunger see Califero 2011, Headey 2011 and Masset, in press.

4. The table used to calculate this number.
Region % in $1.25 a day poverty Population (millions) Pop. in $1 a day poverty (millions)
East Asia and Pacific 16.8 1,884 316
Latin America and the Caribbean 8.2 550 45
South Asia 40.4 1,476 596
Sub-Saharan Africa 50.9 763 388
Total Developing countries 28,8 4673 1345
Europe and Central Asia 0.04 473 17
Middle East and North Africa 0.04 305 11
Total 5451 1372

Source: See World Bank PovcalNet "Replicate the World Bank's Regional Aggregation" at http://iresearch.worldbank.org/PovcalNet/povDuplic.html (accessed May 7, 2010). Also see World Bank "PovcalNet" at http://web.worldbank.org/WBSITE/EXTERNAL/EXTDEC/EXTRESEARCH/EXTPROGRAMS/EXTPOVRES/EXTPOVCALNET/0,,contentMDK:21867101~pagePK:64168427~piPK:64168435~theSitePK:5280443,00.html

Bibliography

Black RE, Morris SS, Bryce J. "Where and why are 10 million children dying every year?" Lancet. 2003 Jun 28;361(9376):2226-34.

Black, Robert E, Lindsay H Allen, Zulfiqar A Bhutta, Laura E Caulfield, Mercedes de Onis, Majid Ezzati, Colin Mathers, Juan Rivera, for the Maternal and Child Undernutrition Study Group Maternal and child undernutrition: global and regional exposures and health consequences. (Article access may require registration) The Lancet Vol. 371, Issue 9608, 19 January 2008, 243-260.

Jennifer Bryce, Cynthia Boschi-Pinto, Kenji Shibuya, Robert E. Black, and the WHO Child Health Epidemiology Reference Group. 2005. "WHO estimates of the causes of death in children." Lancet ; 365: 1147–52.

Cafiero, Carlo and Pietro Gennari. 2011. The FAO indicator of the prevalence of undernourishment FAO

Caulfield LE, de Onis M, Blössner M, Black RE. Undernutrition as an underlying cause of child deaths associated with diarrhea, pneumonia, malaria, and measles. American Journal of Clinical Nutrition 2004; 80: 193–98.

Shaohua Chen and Martin Ravallion. June 2004. "How have the world’s poorest fared since the early 1980s?" World Bank Policy Research Working Paper 3341 Washington: World Bank.

de Onis, Mercedes, Edward A. Frongillo and Monika Blossner. 2000. "Is malnutrition declining? An analysis of changes in levels of child malnutrition since 1980." Bulletin of the World Health Organization 2000, : 1222–1233.

Food and Agriculture Organization, International Fund for Agricultural Development, World Food Program. 2002 "Reducing Poverty and Hunger, the Critical Role of Financing for Food, Agriculture, and Rural Development."

Food and Agriculture Organization. 2006. State of World Food Insecurity 2006

Food and Agriculture Organization. 2010. The state of Food Insecurity in the World 2010

Headey, Derek. 2011. “Was the Global Food Crisis Really a Crisis? Simulations versus Self-Reporting”, IFPRI Discussion Paper 01087.

International Food Policy Research Institute. 2010. 2010 Global Hunger Index

Masset, Edoardo. 2011 In Press. A review of hunger indices and methods to monitor country commitment to fighting hunger Food Policy.

Oxford University Press. 1971. Oxford English Dictionary. Definition for malnutrition.

Pelletier DL, Frongillo EA Jr, Schroeder D, Habicht JP. The effects of malnutrition on child mortality in developing countries. Bulletin of the World Health Organization 1995; 73: 443–48.

Svedberg, Peter. 2000. Poverty and Undernutrition Oxford University Press: New York p. 298.

United Nations High Commissioner on Refugees. 2007. Statistical Yearbook 2006 "Main Findings"

UNHCR 2008 Global Report 2008 "The Year in Review" http://www.unhcr.org/4a2d0b1d2.pdf

World Bank. Understanding Poverty website

World Health Organization Comparative Quantification of Health Risks: Childhood and Maternal Undernutition

Starvation is a severe reduction in vitamin, nutrient and energy intake. It is the most extreme form of malnutrition. In humans, prolonged starvation can cause permanent organ damage[1] and eventually, death. The term inanition refers to the symptoms and effects of starvation.

According to the World Health Organization, hunger is the single gravest threat to the world's public health.[2] The WHO also states that malnutrition is by far the biggest contributor to child mortality, present in half of all cases.[2] Six million children die of hunger every year.[3]Figures on actual starvation are difficult to come by, but according to the FAO, the less severe condition of undernourishment currently affects about 925 million people, or about 14 % of the world population.[4]

The bloated stomach, as seen in the picture to the right, represents a form of malnutrition called kwashiorkor which is caused by protein deficiency combined with inadequate caloric consumption.[5] Children are more vulnerable to kwashiorkor whose advanced symptoms include weight loss and muscle wasting.[6] It is quite common to depict a thin child with a bloated stomach as starving, but in reality, such child is malnourished.
Contents
[hide]

1 Common causes
2 Signs and symptoms
3 Biochemistry
4 Efforts
4.1 Treatment
4.2 Prevention
4.3 Example of successful response in Malawi
4.4 Organizations
5 Starvation statistics
6 As capital punishment
7 See also
8 References
8.1 External links

[edit] Common causes

The basic cause of starvation is an imbalance between energy intake and energy expenditure. In other words, the body expends more energy than it takes in as food. This imbalance can arise from one or more medical conditions and/or circumstantial situations, which can include:

Medical reasons

Anorexia nervosa
Bulimia nervosa
Coeliac Disease
Coma
Major depressive disorder
Diabetes mellitus
Digestive disease
Constant vomiting

Circumstantial causes

Famine – for any reason, including overpopulation and war.
Fasting – done without proper medical supervision and lasting more than a month.
Poverty

[edit] Signs and symptoms

Individuals experiencing starvation lose substantial fat (adipose) and muscle mass as the body breaks down these tissues for energy. Catabolysis is the process of a body breaking down its own muscles and other tissues in order to keep vital systems such as the nervous system and heart muscle (myocardium) functioning. Vitamin deficiency is a common result of starvation, often leading to anemia, beriberi, pellagra, and scurvy. These diseases collectively can also cause diarrhea, skin rashes, edema, and heart failure. Individuals are often irritable and lethargic as a result.

Early symptoms include impulsivity, irritability, hyperactivity and possibly submissiveness.[7] Atrophy (wasting away) of the stomach weakens the perception of hunger, since the perception is controlled by the percentage of the stomach that is empty. Victims of starvation are often too weak to sense thirst, and therefore become dehydrated.

All movements become painful due to muscle atrophy and dry, cracked skin that is caused by severe dehydration. With a weakened body, diseases are commonplace. Fungi, for example, often grow under the esophagus, making swallowing unbearably painful.

The energy deficiency inherent in starvation causes fatigue and renders the victim more apathetic over time. As the starving person becomes too weak to move or even eat, their interaction with the surrounding world diminishes.

There is also an inability to fight diseases, and in females, irregular menstruation can occur.
[edit] Biochemistry

When food intake ceases, the body enters the starvation response. Initially, the body's glycogen stores are used up in about 24 hours.[citation needed] The level of insulin in circulation is low and the level of glucagon is very high. The main means of energy production is lipolysis. Gluconeogenesis converts glycerol into glucose and the Cori cycle converts lactate into usable glucose. Two systems of energy enter the gluconeogenesis: proteolysis provides alanine and lactate produced from pyruvate, while acetyl CoA produces dissolved nutrients (Ketone bodies), which can be detected in urine and are used by the brain as a source of energy.

In terms of insulin resistance, starvation conditions make more glucose available to the brain.
[edit] Efforts
[edit] Treatment
Wiki letter w cropped.svg This section requires expansion.

Starving patients can be treated, but this must be done cautiously to avoid refeeding syndrome.[8]
[edit] Prevention
See also: Food security

For the individual, prevention obviously consists of ensuring they eat plenty of food, varied enough to provide a nutritionally complete diet. Short of sitting in front of a potentially starving person and offering him or her food, to address societal mechanisms by which people are denied access to food is a more complicated matter.

Supporting farmers in areas of food insecurity through such measures as free or subsidized fertilizers and seeds increases food harvest and reduces food prices.[9]
[edit] Example of successful response in Malawi

In Malawi, almost 5 million of its 13 million people needed emergency food aid. Then, however, deep fertilizer subsidies and lesser ones for seed, abetted by good rains, helped farmers produce record-breaking corn harvests in 2006 and 2007, according to government crop estimates. The government reported that corn production rose from 1.2 million metric tons (mmt) in 2005, to 2.7 mmt in 2006 and 3.4 mmt in 2007. The harvest also helped the poor by lowering food prices and increasing wages for farm workers. Malawi became a major food exporter, selling more corn to the World Food Program and the United Nations than any other country in Southern Africa.

Over the 20 years prior to this change in policy (enacted by the World Bank), some richer nations that Malawi depended on for aid had periodically pressed it to cut back or eliminate fertilizer subsidies, in the name of free market policies. This is despite the fact that the United States and Europe extensively subsidized their own farmers. However, many, if not most, of its farmers are too poor to afford fertilizer at market prices. Proponents for helping the farmers includes the economist Jeffrey Sachs, who has championed the idea that wealthy countries should invest in fertilizer and seed for Africa’s farmers. He also conceived the Millennium Villages Project (MVP), which provides seeds and fertilizers, as well as training, to qualifying farmers. In one Kenyan village, application of this policy resulted in a tripling of its corn harvest, even though the village had previously experienced a cycle of hunger.
[edit] Organizations
Main article: Famine relief

Many organizations have been highly effective at reducing starvation in different regions. Aid agencies give direct assistance to individuals, while political organizations pressure political leaders to enact more macro-scale policies that will reduce famine and provide aid.
[edit] Starvation statistics
Main articles: Malnutrition and Hunger

According to estimates by the FAO there were 925 million under- or malnourished people in the world in 2010.[10] This was a decrease from an estimate of 1023 million malnourished people in 2009.[11] In 2007, 923 million people were reported as being undernourished, an increase of 80 million since 1990-92.[12] It has also been recorded that the world already produces enough food to support the world's population.

As the definitions of starving and malnourished people are different, the number of starving people is different from that of malnourished. Generally, much fewer people are starving, than are malnourished. The numbers here may provide some indication, but should not be quoted as a number of starving people.

The share of malnourished and of starving people in the world has been more or less continually decreasing for at least several centuries.[13] This is due to an increasing supply of food and to overall gains in economic efficiency. In 40 years, the share of malnourished people in the developing world has been more than halved. The share of starving people has decreased even faster. This improvement is expected to continue in the future.
Year 1970 1980 1990 2005 2007 2009
Share of undernourished people in the developing world[11][14][15] 37 % 28 % 20 % 16 % 17 % 16 %
[edit] As capital punishment
This section needs additional citations for verification. Please help improve this article by adding reliable references. Unsourced material may be challenged and removed. (December 2008)
Wikisource has original text related to this article:
The Women of the Caesars
The starving Livilla refusing food.
From a drawing by André Castagne

Historically, starvation has been used as a death sentence. From the beginning of civilization to the Middle Ages, people were immured, or walled in, and would die for want of food.

In ancient Greco-Roman societies, starvation was sometimes used to dispose of guilty upper class citizens, especially erring female members of patrician families. For instance, in the year 31, Livilla, the niece and daughter-in-law of Tiberius, was discreetly starved to death by her mother for her adulterous relationship with Sejanus and for her complicity in the murder of her own husband, Drusus the Younger.

Another daughter-in-law of Tiberius, named Agrippina the Elder (a granddaughter of Augustus and the mother of Caligula), also died of starvation, in 33 AD. (However, it is not clear whether or not her starvation was self inflicted.)

A son and daughter of Agrippina were also executed by starvation for political reasons; Drusus Caesar, her second son, was put in prison in 33 AD, and starved to death by orders of Tiberius (he managed to stay alive for nine days by chewing the stuffing of his bed); Agrippina's youngest daughter, Julia Livilla, was exiled on an island in 41 by her uncle, Emperor Claudius, and not much later, her death by starvation was arranged by the empress Messalina.

It is also possible that Vestal Virgins were starved when found guilty of breaking their vows of celibacy.

Ugolino della Gherardesca, his sons and other members of his family were immured in the Muda, a tower of Pisa, and starved to death in the thirteenth century. Dante, his contemporary, wrote about Gherardesca in his masterpiece The Divine Comedy.

In Sweden in 1317, King Birger of Sweden imprisoned his two brothers for a coup they had staged several years earlier (Nyköping Banquet). A few weeks later, they died of starvation.

In Cornwall in 1671, John Trehenban from St Columb Major was condemned to be starved to death in a cage at Castle An Dinas for the murder of two girls.

Saint Maximilian Kolbe, a martyred Polish friar, offered his life to save another inmate who had a family that had been sentenced to death in the Auschwitz concentration camp along with nine other prisoners because a prisoner had escaped. He was starved, along with another nine inmates. After two weeks of starvation, only Kolbe and three other inmates were still alive, and they were then executed with injections of phenol.
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