Why Nutrition Matters

in the 21st Century

Speaker: Dr. Ibrahim Yousuf

Learning Objectives

• Discuss nutritional challenges

• Describe the importance of nutrition
for children
• Describe the consequences of
inappropriate nutrition
• Describe the role of the multidisciplinary
team
Nutritional challenges
• Obesity, diet-related chronic diseases and under
nutrition are reported to collectively affect about one in
three people around the globe.

• These forms of malnutrition have significant health and

economic costs for both developing and developed
countries.
• Tackling malnutrition is a global public health priority.

• Malnutrition and obesity are linked to both the quantity

and quality of food and given the fundamental and
increasing role of food and beverage companies on food
availably globally, their impact on the nutritional status of
consumers worldwide is growing.
 MALPRACTICES

• Prolonged use of the bottle to feed infants is now known to

contribute to health issues in children, which can extend
into adult life.

• Inappropriate introduction and use of a bottle/beaker cup is

linked with poor oral health, iron deficiency anemia,
delayed speech development and puts children at risk from
obesity.
• There is also consensus that prolonged bottle use and
lidded cups delay speech development, with an open cup
being the most appropriate choice to encourage skill
development.
Best practice in infancy: moving onto cups

‘Over the last decade there have been a number

of studies showing that a prolonged use of
bottles and excessive intake of liquids,
including milk is emerging as a risk factor for
overweight and obesity’
Suitable cups for use with infants. A free-flow
lid is also shown
 The Importance of
Nutrition For Children

•Food and nutrition is crucial to physical ,

mental and social development.

•A poor diet is one of

the main causes of ill health and premature
death.
Global Consequence
of Inappropriate Nutrition

• 50% of pediatric mortality directly or indirectly

associated with malnutrition.
• 30% of child mortality could be prevented with
simple nutrition intervention.
• 1.3 to 1.45 million infant deaths could be
prevented.
• Consequences of early malnutrition on adult
health.
Bryce J, et al. Lancet 2005;365:1147-1152.
Global Health Opportunities - 2006 Update on Priorities and US Investments.
http://www.reliefweb.int/rw/lib.nsf/db900SID/DPAS-6MMMFH?OpenDocument.
Black RE, et al. Lancet 2008;371:243-260.
World Deaths in 2000 Attributable
to Selected Leading Risk Factors

Source: WHR; 2002.

Worldwide Prevalence of
Stunting
Malnutrition is almost never an isolated event in
the life of an affected child.  A more complete
model would be:
Maternal and Child
Malnutrition

Black RE, et al. Lancet 2008;371:243-260. Chandra S, et al. Prog Food Nutr Sci 1986;10:1-65.
Grantham-McGregor S.J Nutr 1995;125 (suppl8): S2233-S2238.v
Impact of In-Utero Malnutrition
on Organ Development

• Pancreas: diabetic pattern

• Kidneys: hypertension
• Liver: increased lipids, glucose
• Adipose:
• Expansion, inflammation
• Multiple hormone insensitivity
• Endothelial dysfunction
Petrik J. Endocrinology 1999;140:4861-4873.
Langley-Evans SC, et al. Life Sci 1999;64:965-974.
Gluckman PD. Endocrinology 2001;142:1689-1691.
 Myths

• The mother should not breastfeed if suffering from an

infection.
• Infants need water also apart from breast milk.
• A woman who becomes pregnant must stop breastfeeding.
• Child is offered parhaizi food during illness and recovery
from illness.
 At the beginning of this new millennium, a new
challenge has emerged—a marked increase in obesity
prevalence with a parallel increase in obesity-
associated chronic diseases and their clinical onset at
ever younger ages.

Childhood Obesity: A New Pandemic of the New Millennium

Sue Y.S. Kimm, Eva Obarzanek
Pediatrics Nov 2002, 110 (5) 1003-1007; DOI: 10.1542/peds.110.5.1003
 Obesity
• Having a very high amount of body
fat in relation to lean body mass
BMI :Wt (kg) /Ht (cm)
• In pediatrics:
• Overweight:
• BMI >85th percentile
• Obese:
• BMI >95th percentile
The Obesity Epidemic in
Children

Ogden CL, et al. JAMAA 2006;295:1549-55.

The Obesity Pandemic

• 10% of young people

between 5 and 17
years are overweight
(155 million children)

• Over 1.7 billion people

worldwide are
overweight, 310 million
are obese
COMPLICATIONS OF CHILDHOOD OBESITY
Multidisciplinary Task
Conclusions

• Appropriate nutrition is critical.

• Inappropriate nutrition during critical periods
can lead to chronic diseases in adulthood.
• Appropriate nutrition requires a
multidisciplinary team.
• The Pediatrician must lead team.
THANK YOU