Hidden Hunger
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Transcript of Hidden Hunger
Hidden HungerA Global Crisis
Danone PresentationDr Geoff Douglas KStJ MSc MA FRCP MFOM
Johannesburg - February 2016
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 disease takes hold.
World Hunger Series 2007 - Hunger and HealthWorld Food Programme
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
Nutrients
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
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
UK Wartime Rationing
UK Wartime Rationing 1940-1954
Very little meat, fat, eggs or sugar 2 ounces (50g) of butter per week One egg per fortnight
The ‘National Loaf’ – wholegrain Home-grown vegetables - 'Dig For Victory' An apple a day keeps the doctor away
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 Infant mortality rates declined Average age at which people died from natural causes
increased
California 1950
Nature’s Farming
Always grows mixed crops Never attempts to farm without livestock At great pains to preserve the soil and prevent
erosion The vegetable and animal wastes are converted
into humus The processes of growth and decay are in balance Large reserves of fertility are maintained Rainfall is stored Plants and animals protect themselves against
disease
Sir Albert Howard (1873 – 1947)
1905–1924 Imperial Economic Botanist to the Government of India
1940 ‘An Agricultural Testament’ How have our man-made systems of
agriculture fared in comparison with Nature’s?
Have we adopted Nature’s principles? Have we improved on them? What happens when we disregard them?
Beware Scientific Reductionism
Justus von Liebig (1803 – 1873) Myth #3 - Healthy plant growth depends
only on the correct balance of NPK (Nitrogen, Phosphorus and Potassium) – Death of Sustainable Agriculture
Myth #4 - Healthy human growth depends only on the correct balance of Protein, Carbohydrate and Fat – Death of Good Nutrition
Modern farming methods have conspired to maximise yields at the expense of nutrient content: Deep ploughing NPK fertilisers Pesticides & Fungicides Monoculture GM crops Hydroponics Early harvesting & Artificial ripening Factory farming Storage & Transport
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
Wholegrain Milled % Loss
(μg/g) (μg/g)
Vitamin A 0 0 0Vitamin B1 - Thiamine 4.7 1.3 72.3Vitamin B2 - Riboflavine 0.9 0.4 55.6Vitamin B3 - Niacin 16.2 9.8 39.5Vitamin B6 - Pyridoxine 5.4 1.9 64.8Vitamin E 0 0 0Folate 0.3 0.1 66.7Biotin 0.073 0.014 80.8
Calcium 30.8 14.5 52.9Phosphorus 3100 800 74.2Zinc 21 4.4 79.0Iron 23.3 10.8 53.6
Feeding People what Rodents Reject
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.
The result is a global pandemic ofHidden Hunger
(Type B Malnutrition) which afflicts
the hungry and the obese
Hidden Hunger In Southern Africa, today, the staples
are Refined maize meal (empty calories) Bread (mostly refined) White sugar (empty calories)
Soft drinks Sweets Most processed foods
Traditional margarine (trans fats) Cooking oil (trans fats)
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)
In the Third World, fortification of depleted staple foods has become commonplace: Myth #5 - we can get essential
micronutrients from chemicals added to our food, but: They are often toxic They are often poorly absorbed (low bioavailability) They use different metabolic pathways They rarely act in the body in the way intended (low
bioefficacy) With the exceptions of iodine and folic acid,
this hope has not been realised
The South African Experience The National Food Consumption Survey (1999) showed
that South Africans were deficient in iron, zinc, vitamin A and most of the B vitamins
After 5 years of mandatory wheat and maize flour fortification, the National Food Consumption Survey (2005) - Published 2008 – showed: The prevalence of poor vitamin A status in children
had increased The prevalence of poor iron status in children had
increased Almost one third of women and children were
anaemic A high prevalence of poor zinc status among children
Why Fortification in SA has Failed
The iron salts used have a bioavailability of less than 2%
Iron and zinc salts compete for absorption sites Phytic acid in grain blocks the absorption of iron,
zinc, calcium and magnesium Iron salts oxidise 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 for the most vulnerable
What About Sprinkles?
Nepal Study (2009) – 8500 children – no control group. After 6 months of intervention: Nutritional status had deteriorated Prevalence of anaemia (c.43%) remained unchanged
Pakistan Study (2013) – 2746 children – Cluster RCT. After 12 months of intervention: Haemoglobin improved marginally, but all remained
anaemic Serum zinc and retinol showed little change The improved growth in one group was paltry Side effects were serious (diarrhoea and respiratory) and
militated against any benefit
So What is Going Wrong?
Myth #6 - It is generally believed that all vitamins and minerals come from food
Myth #7 - And many health professionals believe that different forms of vitamins and minerals are the same
But, both beliefs are wrong!
Abundant 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.
Recent work shows that USP vitamins and inorganic minerals are sub-optimal delivery systems for the micronutrients we need.
Dr Paul Clayton Isolating nutrients and trying to get benefits equal to
those of whole foods reveals an ignorance of how nutrition works in the body. Relying on the use of isolated nutrients to maintain health is not only a waste of money, but potentially dangerous.
Prof T Colin CampbellThe China Study - 2005
Nutrient Form Food
The ideal, but our food is depleted of nutrients Food Form
Food State or Re-Natured are vitamins and minerals in a form as close as possible to food
Amino Acid Chelates are minerals in a form that the body accepts as food
High bioefficacy and non-toxic Isolates
Vitamins and minerals that are synthesised in the laboratory
Bioefficacy is low The vitamins are notoriously unstable
Vitamin C In the 1930s, Szent-Györgyi was awarded the
Nobel Prize for the discovery of Vitamin C 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
Calcium
Elephants - their skeletons are maintained with the Calcium they get each day from leaves and grass
Pettifor showed that 30mg of Calcium in Calcium-rich yeast is better absorbed than 300mg of Calcium Carbonate
The former went to bone; the latter to kidney
Apparently, we are not designed to eat chalk!
Forms of Selenium
Form I C50
Selenium Rich Yeast 3.0 μM
Selenomethionine 52.8 μM
Blank Yeast > 100 μM (Not an Antioxidant)
Sodium Selenite > 1000 μM (Not an Antioxidant) Inhibition Of LDL+VLDL Oxidation
By Different Forms of Selenium
Selenium is an important antioxidant. Where there is deficiency, it has become commonplace to fortify bread or salt with sodium selenate or selenite
Comparing the Bioefficacy of Combined Vitamin & Mineral Supplements
HETN supports e’Pap in Africa Suited to Africa’s taste and tradition Whole grain Pre-cooked Based on maize, and fortified with soya and a
cocktail of 28 nutrients The formulation uses state of the art, first world
fortification chemistry to ensure bioavailability and bioefficacy
There is now a wealth of data confirming that e’Pap can achieve nutrient-repleteness
Hidden Hunger The science of nutrition is less than 150
years old, and the ‘best evidence’ keeps shifting.
In the early 1960s, the dietary advice was Myth #8 - High protein (animal best) Low carbohydrate (unspecified) Low fat (Myth #9 - Traditional margarine
healthier than butter) No supplements (expensive urine)
Hidden Hunger Today, the medical advice is
Myth #10 – 5-a-Day fruit and veg Moderate unrefined carbohydrate Moderate protein (vegetable is OK) Low fat (but omegas essential)
Myth #11 - Modern margarine healthier than butter
Traditional margarine (trans fats) extremely bad
No supplements
The Elephant in the RoomSugar – A Natural Food – Myth #12 Every human cell can use glucose, but only the
liver can metabolise fructose Fructose increases:
Blood fat levels: Triglycerides Total blood cholesterol LDL (bad) cholesterol
The prevalence of: Type 2 diabetes High blood pressure Abnormal blood clotting Heart disease
Sheffield 1887
Sheffield 2007
Scary Global Statistics
Obesity prevalence has doubled worldwide in the past 25 years
In 2005, 1.6 billion adults were overweight and 400 million of them were obese
By 2015, WHO predicts there will be 2.3 billion overweight adults and 700 million of them will be obese
Shocking UK Statistics
Nutrient deficiencies afflict every group of the UK 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
We are witnessing a global explosion in the prevalence of chronic degenerative disease (CDD): Metabolic Syndrome
Obesity & Diabetes Hypertension & Heart disease
Mental Illness & Dementia Impaired immunity
Cancer TB Asthma Arthritis
Myth #13 - We are living longer Few of us are living more healthily
The Pharmaceutical ModelIs it still relevant?
100 years of research has generated a wide range of potent & specific drugs
Antimicrobials Pathogens allow differential metabolic
targeting – ‘weak link’ Wide therapeutic index - curative But resistance is now widespread
The Pharmaceutical ModelIs it still relevant?
The CDDs still have no cures … They are increasing in frequency Their age of onset is falling
Almost all drugs for CDDs are designed to suppress symptoms, and do not treat the underlying disease
Narrow therapeutic index - palliative Iatrogenic illness is now a major cause of
morbidity and mortality
Beware Dualism
Drugs v. Nutrition Only drugs can claim to cure, mitigate or
treat a disease Food and food supplements cannot
claim thisThey may make health claims but
only if substantiated by RCTs
FDA & EU Food Supplements Directive
A Call to Action Remunerate producers on the nutritional
content of the food they produce Eat fresh, local and seasonal Stop refining grain Reduce sugar, fat and salt consumption Tax sugar Ban trans fats Traffic light label all processed foods Stop believing in part solutions – we need
nutrient-replete human beings – nothing less
A Call to Action Stop believing that we can correct micronutrient
deficiencies by adding these to food in the form of chemical isolates
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, unless we believe that fat kids are healthy kids
In the face of repeated failure, we should be conducting robust research
But we need to question the validity of the RCT in nutrition research
Thank You for Your Interest
Health Empowerment Through NutritionA UK Registered Charity concerned with
The alleviation of Hidden Hungerwww.hetn.org