Fast Food Nation Finale
•Paeratakul et al., J Am Diet Assoc 103: 1332-1338, 2003
Fast food consumption among US adults and children
•Data collected by 2 nonconsecutive 24-hour recalls of food intake
•Recalls were 3-10 days apart
Results
•Fast food use reported by 37% of adults and 42% of children
•Men consumed fast food more frequently than women
•Use of fast food lowest among adults 60 and older, and people with incomes ≤ 100% of
poverty level
Results in kids
•Fast food eaters had lower intake of breads & cereals
•Also consumed fewer vegetables EXCEPT for fried potatoes
•Also consumed less fruit and juices, milk, and legumes
Results in Adults
•Lower intakes of bread, cereals, grains, milk, and legumes
•Intake of all fruits and vegetables EXCEPT fried potatoes was lower
•Also consumed more chicken, meat mixture, grain mixtures (pizza), and carbonated
drinks
Intake on fast food day vs. non-fast food day
•Fast food day contained more Calories, fat, saturated fat, cholesterol
•Fast food day contained less fiber, vitamins A & C, beta-carotene
Diet and Health
•Nutrition is key to good health
•(But you should know that by now)
Nutrition and Immunity
•Poor nutrition predisposes one to infection
•Supplementation may not increase defenses further in healthy people
Components of Immune System
•Innate, or Passive
–Barrier functions of skin & epithelia
–Phagocytes
•Acquired
–Antigen-specific
–Can involve antibodies (produced by B lymphocytes) and T lymphocytes
T Lymphocytes
•Antigen specific
•Supply immune system with “memory”
•Also responsible for transplant rejection and tumor cell destruction
Specific Nutrients and Immunity
•Protein
•Fatty acids
•Vitamin A
•Vitamin E
•Vitamin B6
•Folate
•Vitamin C
•Iron
•Zinc
•Selenium
HIV/AIDS
•The epidemic that won’t go away
The Two Faces of HIV/AIDS
•Developed countries--a manageable chronic disease, if you have health insurance
•Rest of world--inevitably fatal
What HIV does
•Virus is taken up by CD4+ T cells
•Multiplies within cell
•Viral offspring are exported from cell to attack other CD4+ cells
•Key feature--reduction in number of CD4+ T cells
–Normal about 1000/1 µL blood
–HIV infection--< 500 (often < 100)
End Results of HIV Infection
•Reduced resistance to infection
•Kaposi’s sarcoma and other cancers
•AIDS wasting syndrome--weight loss due to
–Fever
–Diarrhea
–Unknown causes
•Death
Nutrition in HIV Patients
Highly individualized
•Increased Calories, protein
•Increased micronutrients like zinc, vitamins A, C, and E
•Food safety is ESSENTIAL
Hunger and Food Insecurity
•Still problematic after all these years
Food Insecurity
•Condition in which the availability of nutritionally adequate and safe foods or the ability
to acquire acceptable foods in socially acceptable ways is limited or uncertain
Food insecurity includes
•Availability of food
•Access to food
•Certainty of availability and access to food
•Social and cultural acceptability of food
•Nutrient quality and safety of food
Hunger
•The uneasy or painful sensation caused by a lack of food
•A potential consequence of food insecurity, but not always
Food Insufficiency
•Insufficient food to meet all of nutritional needs
•Not quite hunger
•“Too much month at the end of the money”
•Food insufficient children are more likely to be in fair or poor health
Who has food insecurity?
•Poor
•Working poor
•Isolated--rural and urban people who have no family or friends
•Elderly
•Homeless or inadequately housed
•Children
Some shameful statistics
•Food insecurity rates in US have increased in last few years to total of 11.1%
•Healthy People 2010 has set a goal of ≤6% food insecure households by the next decade
Closer to home
•Washington is #5 hungriest state
•Over 12% of households are food insecure
•40% of food insecure households in WA are hungry
•Rural food insecurity rate is 22%; urban/suburban area rate is 11.2%
Worldwide--State of Food Insecurity, from UN FAO
•842 million people undernourished in world
•In western Africa, 35% of children under 5 are stunted; 5-15% are wasted
–Obesity is a problem in cities
•HIV/AIDS is reducing agricultural capacity of many sub-Saharan African countries
Food insecurity findings
•Women in food insecure households were half as likely to consume 5 servings of fruits
and vegetables/day
•Women in food insecure households were MORE likely to be obese
–They averaged 2 BMI units higher than women in food secure households
More food insecurity findings
J Am Diet Assoc. Nov 2003
•Study of women in Canada
•35% of households were food insecure with moderate hunger; 22% had severe hunger
•38% of women had inadequate iron intakes; 31% had low magnesium intakes; 28% had
low vitamin A intake
From the same study
•97% of participants consumed foods prepared from scratch at least once
•57% consumed foods compared from scratch on all 3 days studied
•Frequency of prep from scratch and complexity of preparation were positively related to
women’s intake of all food groups and all nutrients examined
BUT
•Food preparation skills did not protect these low-income families from food insecurity
Elderly and Food Insecurity
•60% of low income elderly have two or more health problems that may need dietary
treatment
•Food insecurity may make it difficult for them to follow a medically-prescribed diet
The Safety Net
•A bit frayed here and there
Federal programs (under USDA)
•Food Stamps
•School Lunch Program
•School Breakfast Program
•Summer Feeding
•Commodity Supplemental Food
•WIC
School Lunch Program
•First signed into law in 1946
•1998-added reimbursement for snacks served in certain after school programs
School Lunch Guidelines
•Lunches must contain ≤30% of Calories from fat, <10% of Calories from saturated fat
•Must meet 1/3 of RDA for protein, vitamins A & C, iron, calcium, and Calories
School Breakfasts
•Initiated as pilot program in rural districts in 1966; expanded to rest of country in 1975
•Meals must meet ≥25% of RDA for key nutrients (see school lunches)
•Kids who get school breakfasts score higher on reading and math, consume more fruits
and milk and less saturated fat
Free/Reduced Price Meals
•Reduced-price meals: 130-185% of US poverty level
•Free meals: ≤130% of US poverty level
Food Stamps
•Cornerstone of US food assistance
•Established in mid 1960’s
•US citizens and legal immigrants are eligible
•51% of recipients are children; 10% are elderly; 13% are disabled
•Debit cards are used in place of funny money
What can you not buy with food stamps?
•Non-food items (paper products, cleaning supplies, cosmetics, toothpaste, soap)
•Alcohol or tobacco
•Hot foods
•Foods to be eaten within the store
•Vitamins or drugs
Non-Governmental Anti-Hunger Organizations
•Churches
•Food banks
•Fremont Public Association
•Second Harvest
•Share Our Strength
Hunger on a Global Scale
•“A hungry person is always a poor person”
•UN World Food Program website
•www.wfp.org
Some grim statistics
•842 million people undernourished in world
•Hunger affects 1 out of 7 people on the planet
•70% of the world’s hungry are women and children
In Africa
•In western Africa, 35% of children under 5 are stunted; 5-15% are wasted
–Obesity is a problem in cities
•HIV/AIDS is reducing agricultural capacity of many sub-Saharan African countries
•HIV/AIDS incidence is highest in food insecure areas
In Asia
•Cambodia has a hunger rate that’s among the highest in Southeast Asia
•Chronic malnutrition may affect up to 47% of the population in Laos
• 35% of India’s population is food insecure
Why overpopulation in poor countries?
•Infant mortality is high
•Children are hands to work
•“Insurance” for parents as they age
•Religious/political considerations
Political and Natural Disasters
•War
•Refugees
•Trade sanctions
•Decline of former Soviet Union
•Floods or droughts
•Hurricanes, earthquakes
Inequitable food distribution
•Women and children last
•Politically powerful vs. powerless
•Developed vs. developing countries
Cash crops
•Coffee, cotton, tea, flowers
•Opium, coca
•Farmers can get more money for these than for food crops like corn or vegetables
Common nutrition-related problems in developing countries
•Protein-energy malnutrition
•Iodine deficiency--goiter, cretinism
•Vitamin A deficiency
•Iron deficiency anemia
Some potential solutions
•Improving status of women
•Microcredit loans for agriculture or small business
•Free education, including school lunches
•Other ideas?