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International Nutrition

International Nutrition. International Nutrition. When was the problem of undernutrition first recognized as a global concern? Which 3 UN bodies deal with nutrition issues? How does the focus of each differ?. UNICEF. United Nations Children’s Emergency Fund Infant Health & Survival Program

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International Nutrition

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  1. International Nutrition

  2. International Nutrition • When was the problem of undernutrition first recognized as a global concern? • Which 3 UN bodies deal with nutrition issues? • How does the focus of each differ?

  3. UNICEF • United Nations Children’s Emergency Fund • Infant Health & Survival Program • GOBI - Growth/development, Oral rehydration, Breastfeeding promotion, Immunization • Which deficiency problem has UNICEF addressed?

  4. FAO • Food and Agriculture Organization • Collaboration of agriculture & health sectors • World leader in fight against food insecurity • Strong advocate for nutrition policy development

  5. FAO • World Food Program (WFP) • Largest humanitarian agency • Strives to eradicate hunger • Distributed 4.2 million tons of food to 96.7 million people in 82 countries • Funded by world governments, corporations, private donations

  6. WHO • World Health Organization • 1948 • Emphasizes prevention of nutrition problems • What nutrition issues has WHO programs addressed?

  7. UN Agencies • Which other UN agencies have become involved in international nutrition issues? • How has The World Bank assisted with nutrition issues of countries? • United Nations University? • SCN?

  8. Strengthen institutions Supplementary foods to vulnerable groups Targeted financial assistance Health & nutrition services Nutrition education Treatment of anemia Small scale food production Food technology Water supply & sanitation control Food commercialization International Nutrition Programs

  9. Is International Work for you? • Entrepreneurial spirit needed • “We can create the jobs” (Stacia Nordin in Aase, p. 1509) • “requires some thinking out of the box about your career” (Camella Rising in Aase, p. 1509) • “Adapting to a new culture demands flexibility, resilience, patience, openness, confidence, and the willingness to learn (Aase, p. 1510)

  10. Careers in International Nutrition • Undergraduate degree in Nutrition or Agriculture • International internship • e.g., Coady, CIDA, Healthbridge • Graduate degree • An advantage • Development • Second language helpful

  11. To Breastfeed or Not The Dilemma of HIV Positive Women

  12. HIV and Breastfeeding • Child mortality rates are increasing • 5 million children have died from AIDS • 2.7 million children are living with AIDS • 800,000 children where infected in 2001 • 90+% of HIV infected children live in sub-Saharan Africa

  13. HIV and Breastfeeding • Mother-to-child transmission of HIV • Pregnancy • Childbirth • Breastfeeding

  14. Breast Milk Without HIV • Best food for infants • Prevents ~ 6 million infant deaths • Provides optimum nutrition • Protection against common childhood diseases (diarrhea and respiratory infections) • Promotes child spacing

  15. Transmission of HIV during Breastfeeding Stats • 1985 first case • Results in ~ 200,000 – 300,000 infant HIV infections

  16. Mechanisms-Composition of breast milk • Undergoes several changes • Increased leukocyte numbers and immunoglobulin concentrations found in colostrum • Therefore it is suggested that colostrum has a greater concentration of cell-associated HIV

  17. Timing of Breast Milk Transmission • Depends on when the mother acquired the infection • Infected just before delivery or during breastfeeding =  Rate of transmission

  18. Summary of Transmission Rates

  19. The Decision • The risk of HIV transmission through breastfeeding is substantial • The risks of morbidity and mortality from diarrhea & respiratory disease in non breastfed infants is also substantial

  20. Possible Alternatives • Oral antiretroviral (ARV) therapy • Banked donor human milk • Mothers own modified milk (heat treatment inactivates virus) • Commercial infant formula

  21. Current Recommendations “When children born to women living with HIV can be ensured uninterrupted accessto nutritionally adequate substitutes that are safely prepared and fed to them, they are at less risk of illness and death if they are not breastfed. However, when these conditions are not fulfilled, in particular in an environment where infectious diseases and malnutrition are the primary causes of death during infancy, artificial feeding substantially increases children’s risk of illness and death.” WHO

  22. HIV and Breast Feeding • Ethical concerns arising from recommendation to not breastfeed if HIV-positive? • Increased diarrheal disease • ID mother as HIV positive (Stigma) • Factors policy makers must take into account when setting guidelines? • Transmission rates • Finances • Clean water supply • Social stigma / norms

  23. Required Readings • Maillet, 2008. Ethical and legal issues in nutrition, hydration and feeding. • Knowles, & Gilmore, 1994. Discontinuation of Total Parenteral Nutrition. • Duester, 1997. Building your business – Setting your fees: A cost-based approach. • Gross, & Ostrowski, 2008. Getting started in private practice.

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