© T. M. Whitmore TODAY Irish famine example The Nutrition Transition.

© T. M. Whitmore

TODAY

• Irish famine example

•The Nutrition Transition

© T. M. Whitmore

Questions?•Synergy between nutrition and

disease continued

•Especially vulnerable populations

•Four faces of hunger

•Global Hunger

© T. M. Whitmore

Irish “hunger” of 1846-51 an example of Underlying Processes

& background • Surplus production and appropriation &

resource competition

• The potato

• Population growth

• Crop failures and subsistence crisis throughout the nineteenth century

• Racist views toward the Irish (probably delayed help)

© T. M. Whitmore

Irish “hunger” an example of Immediate/Proximate Causes &

Processes • Environmental Fluctuation – infection of

potato crop with Phytophthora infestons a fungal infection (late potato blight) spread by the wind

• Socio-Economic policies that deprived millions of entitlements to food

• A process – not a single event

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Irish “hunger” Process• Blight 1845 => 40% loss and famine in

1846• 1846 => near 100% loss + severe winter

=> severe famine & disease in 1847• 1847 - 1850 potato crop not blighted but

output low due to small planting (people expected blight)

• Entitlements Crops failed => loss of production

entitlement~ 500,000 people were evicted (could not

pay rent) => lost production entitlementFood prices soared => income

entitlement problems even for urban poor

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Irish “hunger” Responses• Slow British govt. responses (the Irish

exaggerate)

• First relief = imported maize from north America – not well tolerated

• Eventually British govt. relief schemesWorkhouses (housing workers on public

works such as roads, canals, etc.) became centers of contagion

• Duke of Norfolk suggested that the Irish should substitute curry powder for the potato and nourish themselves on curry powder mixed with water.

© T. M. Whitmore

Irish “hunger” Responses II• Corn laws repealed 1846

Little heal since the Irish had no cash regardless of grain prices

• Late in 1846 a Whig administration dedicated to a laissez-faire policyExtension of poor laws (that denied aid

to most)• Wheat, oats, barley, butter, eggs, beef and

pork were exported from the large estates Ireland in large quantities - as many as eight ships left Ireland daily carrying foodstuffs

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Irish “hunger” commentary• A “blame the victim” mentality: the Irish

were at fault for over-dependence on potatoes and high fertility (too many kids)

• The British also saw it as a “natural disaster”Charles Trevelyn (oversaw relief for Whig

govt.) “…the problem of Ireland being altogether beyond the power of man, the cure has been applied by all-wise Providence…”

• All the while – food was exported from the large estates Ireland in large quantities - as many as eight ships left Ireland daily carrying wheat, oats, barley, butter, eggs, beef and pork

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Irish “hunger” Consequences • Starvation and disease became epidemic

More died of disease than of starvation. Most were weakened from long starvation

when they finally succumbed to typhus, cholera, dysentery, and scurvy.

At least 1 million perished• 1 – 2 + million emigrated during the hunger

(mostly to US and England)• Population of Ireland

1850 = 6.5 m (down from 8.5m 5 yrs earlier)

1900 4.5 m => longer-term emigration, much to US

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Related historic processes of change• Interconnected “Transitions”

Demographic Transition (DT) Stages of change in mortality and fertility

=> population growth over time Regional differences-geography

Epidemiologic Transition (ET) Shift in the patterns of causes of death

over time Regional differences-geography

Nutrition Transition Shifts in dietary and physical activity-

inactivity patterns Regional differences-geography

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The Nutrition Transition’s “Stage 1: “Collecting Food”

• Hunter gatherersHigh in carbohydrates and fiber and low

in fat, especially saturated fatActivity patterns are very high with little

obesityStages 1-2 of DT First phase in ET

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The Nutrition Transition’s “Stage 2: “Famine”

• Early agriculture and contemporary least developed areas generallyDiet becomes much less varied and

subject to larger variations and periods of acute scarcity of food

Little change in activity levels Stages 1-2 of DT First-Second phases in ET

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The Nutrition Transition’s “Stage 3: “Receding Famine”

• Scientific agriculture, early industrialization, and contemporary developing areasConsumption of fruits, vegetables, and

animal protein increases, and starchy staples become less important in the diet

Activity patterns start to shift and inactivity and leisure becomes a part of the lives of more people

Stages 2-3 in DT Second/Third Phases of ET

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The Nutrition Transition’s “Stage 4: “Nutrition-related Non-

communicable Disease (NR-NCD)”

• Associated with “modern” industrial lifestylesA diet high in total fat, cholesterol,

sugar, and other refined carbohydrates and low in polyunsaturated fatty acids and fiber

Often accompanied by an increasingly sedentary life

Stage 4 in DT Third Phase of ET

© T. M. Whitmore

The Nutrition Transition’s “Stage 5: “Behavioral Change”

• “Post-modern” industrial lifestylesA new dietary pattern => changes in

diet associated with the desire to prevent or delay degenerative diseases and prolong health

May be associated with increased “recreational” or health related exercise

Stage 4 in DT Third Phase of ET

Demographic Transition Model

Nutrition Patterns 1 & 2 Nutrition Patterns 3, 4, & 5

Nutrition Patterns 1 & 2 Nutrition Patterns 3, 4, & 5

New York Times

New York Times

Stages of Health, Nutritional, and Demographic ChangeStages of Health, Nutritional, and Demographic Change

Focus on famine alleviation/prevention

Focus on family planning,infectious disease control

Chronic diseases predominate

Reduced fertility, aging

Focus on medical intervention, policy initiatives, behavioral change

Focus on healthy aging spatial redistribution

Demographic Transition Epidemiologic Transition Nutrition Transition

Receding pestilence, poorenvironmental conditions

Reduced mortality,changing age structure

High prevalence infectious disease

Diet-related noncommmucable

diseases predominate

Receding famine

High prevalence undernutrition

High fertility/mortality

Source: Popkin, Barry M. ( 2002) Public Health Nutrition 5:93-103.

Stages of the Nutrition TransitionUrbanization, economic growth, technological changes for work, leisure,

& food processing, mass media growth

Pattern 3Receding Famine

Slow mortality decline

• increased fat, sugar, processed foods

• shift in technology ofwork and leisure

Pattern 4Degenerative Disease

accelerated life expectancy,shift to increased DR-NCD,increased disability period

• reduced fat, increased fruit, veg,CHO,fiber

• replace sedentarianism with purposeful changes

in recreation, other activity

Pattern 5Behavioral Change

extended health aging,reduced DR-NCD

MCH deficiencies, weaning disease,stunting

• starchy, low variety, low fat,high fiber

• labor-intensive work/leisure

obesity emerges,bone density problems

reduced body fatness,improved bone health

Source: Popkin, Barry M. ( 2002) Public Health Nutrition 5:93-103.

2,500

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4,500

1900 1920 1940 1960 1980 2000

Average caloric intake in USA: 1909-2004

Source: USDA/Center for Nutrition Policy and Promotion, March 3, 2006

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1900 1920 1940 1960 1980 2000

Average total fat (grams) in USA diet: 1909-2004

Source: USDA/Center for Nutrition Policy and Promotion, March 3, 2006

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700

1965 1970 1975 1980 1985 1990 1995 2000 2005 2010

Average daily caloric intake of added fats and sugars in the USA

Source: Source: USDA/Economic Research Service

New York Times

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100

150

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1965 1970 1975 1980 1985 1990 1995 2000 2005 2010

Avearge daily caloric intake of sugar and corn sweetners in the USA

Source: Source: USDA/Economic Research Service

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140

160

1965 1970 1975 1980 1985 1990 1995 2000 2005 2010

Average per capita daily calories (net) from fruits and vegetables in US

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1965 1970 1975 1980 1985 1990 1995 2000 2005 2010

Average daily calorie intake of red meat and chicken in USA

Source: Source: USDA/Economic Research Service