Hidden Hunger affects more than two billion people. Even when a person consumes adequate calories and protein, if they lack one single micronutrient - or a combination of vitamins and minerals their immune system is compromised, and infections take hold.

Hidden Hunger

A Physician’s Perspective

World Hunger Series 2007 - Hunger and Health World Food Program

Health Empowerment Through Nutrition Sportron Annual Convention - August 2011

Nutrients There is a global nutrition crisis, with a dual problem of hunger and obesity 



Myth #1 - The escalation of food insecurity makes it imperative to maximise agricultural yields Myth #2 - The escalation of obesity makes it imperative to promote a balanced diet

The human body needs sufficient nutrients for optimum health  On a daily basis, we require 

17 minerals 14 vitamins  9 amino acids  2 fatty acids  

Over tens of thousands of years, human beings developed sustainable ways to feed themselves:    

 

Preservation of topsoil Crop rotation Natural fertilisers Locally grown, seasonal fruit and vegetables Fresh, free range meat, eggs and milk Freshly cooked, nutritious meals

1889

1

California 1950

1919

It was no different in Southern Africa, where people had less money than they have today: 







Millet, sorghum and – more recently maize, grown and milled at home Ground nuts, sweet potato, pumpkin, cabbage Gathering herbs, roots, shoots, fruits and wild spinach Moderate intake of fresh, free range meat, eggs and milk

Kalahari Bushmen

Hidden Hunger 



In contrast, the science of nutrition is less than 150 years old, and the ‘best evidence’ keeps shifting. In the early 1960s, the medical advice was   



Myth #4 - High protein (animal best) Low carbohydrate (unspecified) Low fat (Myth #5 - Traditional margarine healthier than butter) No supplements (expensive urine)

2

Hidden Hunger 

Hidden Hunger

After Burkitt’s work in Uganda, the medical advice (late 1960s) was



Myth #6 - 5 fruit and veg Moderate unrefined carbohydrate  Moderate protein  Low fat (but omegas essential) 

High unrefined carbohydrate (fibre)  Moderate protein (pulses good)  Low fat (traditional margarine still healthier than butter)  No supplements It is interesting that Ugandans were healthier (no appendicitis, diverticulitis, diabetes, gallstones, ischaemic heart disease, hypertension and certain cancers) 



Antioxidant Comparison of Plant and Animal foods Nutrient: 500 Cal Cholesterol mg Fat mg Protein mg Beta Carotene mg Dietary Fibre mg Vitamin C mg Folate mg Vitamin E mg Iron mg Magnesium mg Calcium mg

Plant Based

Animal Based

0 4000 33000 29.9 31000 293 1.17 11 20 548 545

137 36000 34000 0.017 0 4 0.004 0.5 2 51 252



 



Plant Based Foods = Equal parts of tomatoes, spinach, lima beans, potatoes and peas

Modern margarine healthier than butter Traditional margarine (trans fats) extremely bad

No supplements

Modern farming methods have conspired to maximise yields at the expense of nutrient content:       

These nutrients are universally acknowledged as vital to protect against cancers of all kinds

Today, the medical advice is

 

Deep ploughing NPK fertilisers Pesticides & Fungicides Monoculture GM crops Hydroponics Early harvesting & Artificial ripening Factory farming Storage & Transport

Animal Based Foods = Equal parts of beef, pork, chicken and whole milk

Today, our food contains a fraction of the essential micronutrients it contained 100 years ago The Food Industry has compounded this problem by:     

Refining Milling Processing Additives Extensive use of sugar, corn syrup and hydrogenated oils (trans fats)

Influence of Milling on Vitamin & Mineral Content of Maize

Vitamin Vitamin Vitamin Vitamin Vitamin Vitamin Folate Biotin

A B1 B2 B3 B6 E

Calcium Phosphorus Zinc Iron

-

Thiamine Riboflavine Niacin Pyridoxine

Wholegrain

Milled

(μg/g)

(μg/g)

% Loss

0 4.7 0.9 16.2 5.4 0 0.3 0.073

0 1.3 0.4 9.8 1.9 0 0.1 0.014

0 72.3 55.6 39.5 64.8 0 66.7 80.8

30.8 3100 21 23.3

14.5 800 4.4 10.8

52.9 74.2 79.0 53.6

3

Feeding People what Rodents Reject

Thiamine – Vitamin B1 





Sammy eats the maize germ, where the cereal fat and micronutrients are found. Human beings refine out the nutrient rich maize germ and eat the sterile remains.

Sugar – A Natural Food – Myth #7  





Positive energy balance

Every human cell can use glucose, but only the liver can metabolise fructose It turns it into fat. Fructose increases: 



1884 – Takaki rejects the germ theory for beriberi and attributes the disease to insufficient diet 1897 – Eijkman discovers that fowl fed on polished rice develop paralysis, which can be reversed by discontinuing rice polishing 1901 – Grijns correctly interprets the connection between consumption of polished rice and beriberi

Blood lipid levels – triglyceride, total and LDL cholesterol The prevalence of type 2 diabetes, hypertension, abnormal blood clotting and heart disease

Teenage males in the US consume 34 teaspoons per day - 25% of total calorie intake Chromium?

1940

50

60

70

80

DoH ’98, USDA ’02, NIH ’03, NCHS ‘04

The result is a global pandemic of Hidden Hunger (Type B Malnutrition) which afflicts the hungry and the obese

This is manifest in an explosion in the prevalence of chronic degenerative disease:    

Obesity & Diabetes Hypertension & Heart disease Mental Illness & Dementia Impaired immunity    

Cancer TB Asthma Arthritis

Myth #8 - We are living longer. Few of us are living healthier.

4

Sheffield 1887

Hardee’s ‘Monster Thickburger’

1420 calories, 107g fat: $5.49

5

2001

Sheffield 2007

 We are bombarded with nutrition

Hidden Hunger

guidelines that promote a balanced diet:   

MyPlate 5-a-Day (fruit & veg) Traffic light labelling (fat, sugar & salt)



In SA, today, the staples are Refined maize meal (empty calories)  Bread (mostly refined)  White sugar (empty calories) 

 Some believe that Organic and Free

Range are best

Soft drinks Sweets  Most processed foods 

 All these guidelines assume that our food



contains the nutrients we need for health

 But 5-a-Day won’t cut it. Nor will 10!

 

Traditional margarine (trans fats) Cooking oil

Hidden Hunger 

Iron Deficiency - Children < 5 years: Mozambique - 95% Tanzania - 65%  South Africa - 37%  Worldwide - 1.2 billion (1988) - 3.5 billion (2000)  



Zinc Deficiency 

Worldwide - 2 Billion (2001)

6

Hidden Hunger





The National Food Consumption Survey (1999) showed that South Africans were deficient in iron, zinc, vitamin A and most of the B vitamins Is it any wonder that immunity is impaired?

In the Third World, fortification of depleted staple foods has become commonplace: 



Myth #9 - We can get essential micronutrients from chemicals added to our food 

They are often toxic



They are poorly absorbed



They rarely act in the body in the way intended

With the exceptions of iodine and folic acid, this has not been achieved

Why it has Failed 



 



The electrolytic iron used has a bioavailability of less than 2% Phytates in maize block the absorption of iron, zinc, calcium and magnesium Electrolytic iron oxidizes the vitamin A The vitamins are denatured and destroyed by cooking The RDAs are based on adult, not child food portions – which reduces the intake of the most vulnerable

Abundant Scientific Evidence In 1999, Nobel Prize winner, Günter Blobel, demonstrated that for vitamins and minerals to be effectively absorbed into cells, they needed to be associated with their plant carrier proteins.

The Lancet (2008)  One third of child deaths are due to under nutrition  The international nutrition system is fragmented, dysfunctional and in desperate need of reform The China study (2005)  Isolating nutrients and trying to get benefits equal to those of whole foods reveals an ignorance of how nutrition works in the body

7

Wartime Rationing

Wartime Rationing 1940-1954 

Very little meat, fat, eggs or sugar  

  

The ‘National Loaf’ – wholegrain Home-grown vegetables - 'Dig For Victory' An apple a day keeps the doctor away  







 

 

This image cannot currently be display ed.

have different structures use different metabolic pathways function differently in the body

With supplements or fortification, the crucial consideration is bio-availability and bio-efficacy Selenium, for example, is an important antioxidant. Where there is deficiency, it has become commonplace to fortify bread or salt with sodium selenate or selenite

Vitamin C 

In the 1930s, Szent-Györgyi was awarded the Nobel Prize for the discovery of Vitamin C 





Infant mortality rates declined Average age at which people died from natural causes increased

Forms of Selenium

Myth #10 - Many health professionals believe that different forms of vitamins and minerals are the same, but isolates and food nutrients 

Children were allocated milk, cod-liver oil and orange juice Schoolchildren had a weekly dose of malt extract

Most people were better fed during wartime food rationing than before the war years 

Nutrient Form

2 ounces (50g) of butter per week One egg per fortnight

He demonstrated that the active material in paprika was ascorbic acid When, with repeated distillation, he extracted crystalline ascorbic acid, he expected a strong reaction But it did nothing - the concentrated whole foods he had used in his research were far more effective

Inhibition Of LDL+VLDL Oxidation By Different Forms of Selenium

Calcium 







Elephants - their skeletons are maintained with the Calcium they get each day from leaves and grass Pettifor showed that 30mg of Calcium in Carich yeast is better absorbed that 300mg of Calcium Carbonate The former went to bone; the latter to kidney Apparently, we are not designed to eat chalk!

8

Tuberculosis

TB – The Global Situation 





 

Tuberculosis is caused by a mycobacterium One third of the world’s population is infected Infected people don't usually get sick It is only sick people who can infect others







Of all infectious diseases, TB is the leading killer of adults - c.2 million people per year Someone in the world is newly infected with TB every second Between 2002 and 2020 over 150 million people will become ill and 36 million will die if there is not better control The evolution of drug resistant strains of TB have had an even greater impact on morbidity and mortality in the face of the global HIV pandemic

Tuberculosis - History 

  

Throughout the nineteenth and early twentieth centuries, TB was common in the cities of Europe and North America London was one of the worst affected areas TB once caused one in eight of all deaths in the UK The decline was achieved through a combination of   

Methods of Control 

3 months resting  

 

  

Deaths from Tuberculosis – New York

1854 - Sanatorium treatment began 



Better housing and nutrition Isolation of infectious patients Pasteurisation of milk

Initial confinement to bed Periods of increased activity slowly introduced

Fresh air at all times and in all weathers Enormous amounts of food

1935 1944 1952 1953

– – – –

Pasteurisation of milk introduced in UK First use of Streptomycin First use of Isoniazid BCG vaccination introduced in UK

Year

Deaths

per 100,000

1910

10029

382

1920

7084

244

1930

5043

178

1940

3569

119

1950

2287

57

9

A Lesson from History

In Summary 



This dramatic shift in TB mortality was not achieved with:  





Antibiotics Early detection through mass chest x-ray programmes Or BCG immunisation









All of which came into widespread general use after 1950

Our Poor Nutritional Status 



Nutrient deficiencies afflict every group of our population The greatest deficiencies are among those who need the most (the young, the elderly and pregnant women) Sub-optimal intake of vitamins and minerals is prevalent in every group All groups failed to meet the recommended intake of omega 3

Five-a-Day









Protection from all forms of illness 





It is fruit and vegetables that provide us with the protection we need in the form of antioxidants and other protective nutrients Antioxidants help neutralise our waste material. These free radicals or oxidants are at the root of everyday illness They are especially dangerous if left in the body over time but, when we lack antioxidants, the body has to store them

Nutritional repleteness is fundamental to good health The human body requires a daily intake of food nutrients to meet its physiological needs Sub-optimal intake of nutrients is linked to many of the prevailing degenerative diseases

We should be getting a minimum of 5 fruit and vegetables in our diet every day In the UK, people are only getting half of that (2.7 portions on average in 2008) 16-25 year olds, on average, get only a quarter of what they need (1.3 portions) Some people eat none at all

Fruit & vegetables provide 90% of our antioxidants 





This is why the 5-a-Day fruit and vegetable message is pushed so hard by the UK Government It is also why in other EU countries they recommend up to 10 portions a day These antioxidant nutrients are vital to long term good health

10

Obstacles to Change  





Everyone knows that they should eat 5-a-Day And everyone says that health is important to them But we are a nation of junk food addicts – and habits die hard The UK Government has been promoting the 5-a-Day message for the past 15 years, but the average intake across the population has not changed at all

HETN recommends Sportron Products for addressing Hidden Hunger 



You can buy products that sound similar at a lower cost, but they will not give the same beneficial results FoodState nutrients are beneficially combined into a food medium which naturally contains all the phytonutrients and other food factors necessary for absorption and use of each nutrient within the body

A Call to Action 





Stop feeding hungry children in the Third World with CSB (refined cereal) or Plumpy’Nut (high fat, high sugar) Stop using BMI as a measure of nutritional status Stop believing that we can correct micronutrient deficiencies by adding these to food in the form of chemical isolates

We ignore this at our peril 



But if we don’t have the time or the inclination to take our 5-a-Day ………what to do? We need to make up this difference in other ways

A Call to Action



    

Remunerate producers on the nutritional content of the food they produce Eat fresh, local and seasonal Stop refining grain Ban trans fats Reduce sugar, fat and salt consumption Traffic light label all processed foods

There are no Magic Bullets 

In 1940 they could not wait for the science   



Today there is no time to waste  



They were at war They had to act on the RDA information they had In the process, they improved the health of all We are at war Our front line is dying of TB and AIDS while we sit in ivory towers arguing science

The time is now

11

Thank You for Your Interest

Health Empowerment Through Nutrition is a UK Registered Charity concerned with the alleviation of Hidden Hunger www.hetn.org

12