Reflections on the 2005 World Food Prize Symposium:

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Reflections on the 2005 World Food Prize
Symposium

• Nevin S. Scrimshaw, PhD, MD, MPH
• President, International Nutrition Foundation

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THE LIFE CYCLE APPROACH TO NUTRITION AND FOOD
NEEDS

• At the moment of conception nearly everyone has
  the genotype for a long and healthy life.
• From the this time onward environmental factors
  damage this potential to produce a far different
  phenotype than at conception.
• Malnutrition and overnutrition are the most
  common and consistent factors responsible, for
  this damage.

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The Life Cycle Approach Involves Nutrition at All
Ages

• Pregnant lactating women
• Infant toddler
• School child adolescents
• Adults at all ages
• Women of child bearing age

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Pregnancy

• Folic acid deficiency in early pregnancy
  increases neural tube defects.
• Iodine deficiency impairs fetal brain
  development
• Protein-energy deficiency lowers birthweight with
  multiple consequences.
• Iron deficiency lowers infant iron stores at
  birth.
• .

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Infancy

• When breast milk is no longer sufficient,
  appropriate complementary feeding is essential or
  physical and mental stunting results.
• Iron deficiency and protein-calorie malnutrition
  are the main risks.

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Lactation/Infant Feeding

• Breast feeding provides only half the daily iron
  required in infancy the balance must come from
  the stores at birth
• These are exhausted by about 6 months, by 4
  months if mother is anemic, by 2 months for low
  birth weight infants.
• Without supplementation or iron fortified food
  permanent impairment of myelenation of cranial
  nerves and dopamine neurons inevitable when
  stores at birth are exhausted.

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Toddler/Pre-school Child

• PEM can permanently reduce physical and mental
  development.
• Vitamin D deficiency leads to rickets.
• Iron deficiency anemia causes reduced cognitive
  and motor performance.

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School child and adolescent

• PEM affects physical growth and behavior.
• Iron deficiency impairs school performance.
• Vitamin D deficiency leads to rickets.
• Low calcium intakes predispose to adult
  osteoporosis

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Adult

• Poor diet and life style lead to the early
  development of
• Diabetes type II
• Hypertension
• Heart disease
• Increased susceptibility to cancer
• Less resistance to infection

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Elderly Adult

• Partially preventable declines in
• Physical strength (sarcopenia)
• Cognitive function and dementia
• Mobility and independence
• Partially preventable increases in
• Malignancies
• Infections
• Dependency

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Still neglectedWomen of Child-bearing Age

• Women must enter pregnancy with adequate folic
  acid status to avoid fetal neural tube defects
• Iron supplementation during pregnancy is too
  late!
• Good weight gain is essential to normal infant
  birth weight.

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Examples of Destructive Non Nutritional Factors

• Use of Tobacco
• Use of Narcotics
• Alcohol Medication Abuse
• Trauma
• Heavy metal poisoning lead, arsenic fluoride
• Radiation

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New insights into global hunger

• Agronomic Characteristics and Nutritional Value
• Overt Hunger and Hidden Hunger
• Nutritional Deficiency and Nutritional Excesses
• The triple burden of Nutritional Disease
• (Due to Fetal Origins of Adult Disease)

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Challenges to Agriculturists

• Plant breeding
• Improve protein quality
• Improve beta carotene content
• Improve availability of non-heme iron
• Animal husbandry
• Lower proportion of total fat
• More healthful fatty acid composition

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Challenges to the Nutritionists

• By developing international consensus
• priorities to avoid waste of financial and
  human resources due to conflicting or poor
  nutritional advice to agriculturists.
• Be advocates for maximizing the qualitative as
  well as quantitative contributions of agriculture
  to feeding the human population.

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Dont depend on any one solution!

• Protein quality can be assured from genetically
  improved cereals such as QPM or by legumes or oil
  seed protein to complement a cereal staple or by
  adding animal protein to the diet.
• Vitamin A activity can come from the beta
  carotene of yellow vegetables and be enhanced by
  genetic engineering as well as animals.
• B vitamins and minerals can be provided cheaply
  and effectively by universal multiple
  fortification of the cereal staple so that
  breeding for them may not be worthwhile.

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Conclusions

• Target the process, not just the
  problem Mainstreaming in development, PRSPs
• Challenge the invisibility of
  malnutrition forgotten emergencies, hidden
  hunger,
• Address all aspects (lifecycle) of malnutrition
  Wasting, stunting, micronutrients, obesity
• Protect investments against shocks Multiple
  inputs, links with all MDGs
• Legislated empowerment (rights)
• Meeting demand requires funds for nutrition

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Thank you

• Thank you