Food Availability and Diet Quality

Poor access to and an inadequate intake of a good quality diet is the major cause of undernutrition in

POVERTY

Immediate determinants

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Political and economic structure / , ^ Basic x , determinants

Sociocultural 1 environment

Potential resources: environment, technology, people

Figure 1 Determinants of undernutrition (Reproduced with permission from Smith LC and Haddad L (2000) Overcoming Child Malnutrition in Developing Countries: Past Achievements and Future Choices, Food, Agriculture, and the Environment Discussion Paper No. 30. Washington, DC: International Food Policy Research Institute.)

developing countries. Children are particularly at risk of becoming undernourished due to their high energy and nutrient requirements. Diet diversity, including the intrahousehold distribution of animal source foods, feeding patterns, and child growth are all related to household socioeconomic status.

Low energy intake is associated with growth retardation and often related to a poor quality diet.

Higher

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Figure 2 Nutrition throughout the life cycle. (Reproduced with permission from ACC/SCN (2000) Fourth Report on the World Nutrition Situation. Geneva: ACC/SCN (in collaboration with the International Food Policy Research Institute).)

Moreover, children can become anorectic when fed monotonous diets, and this can be compounded when superimposed on frequent and repeated bouts of infections. A high-carbohydrate, low-fat diet with a low energy density also precipitates undernutrition in children. Protein deficiency per se is not the major cause of growth retardation, but little is known about the specific effects of essential fatty acid deficiencies on growth. Micronutrient deficiencies, particularly zinc deficiency, cause growth retardation. Zinc supplementation can increase body weight and length/ height, but the effect is modest compared with the growth deficit usually observed in growth-faltered children. Children in poor communities are likely to have multiple micronutrient deficiencies, and the combined effect of these coupled with inadequate fat and energy intake will affect growth patterns.

Low income is associated with a low intake of the more expensive animal source foods (meat, fish, dairy, and eggs). The mainly vegetarian diets eaten by children in poor families are frequently associated with growth retardation. Children in developed countries who for cultural reasons eat a diet that lacks any animal products have growth patterns similar to those observed in developing countries.

Women of reproductive age and adolescent girls are also susceptible to micronutrient deficiencies, especially iron, due to their increased physiological requirements for nutrients that can rarely be met from a diet low in animal source foods. In addition, food availability for women is often compounded by sociocultural practices that discriminate against women, and this can start in early childhood and continue throughout the life span.

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