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    Functional consequences of malnutrition for human populations: a comment.

    Scrimshaw NS

    Journal of Interdisciplinary History. 1983 Autumn; 14(2):409-11.

    When food intake falls chronically below the amounts required for physiological energy balance, tissue wasting is inevitable, and eventually death must ensue. Most malnutrition and hunger remains hidden, as populations remain unaware of their inadequate food energy. The World Health Organization (WHO), and Food and Agriculture Organization (FAO), have estimated that most populations are consuming an average of 10 to 20% fewer calories than their bodily requirements; for many individuals, the intake is far less than this average. Yet these populations are not wasting away or dying of starvation. They have adapted physiologically, mainly by reducing their physical activity, and are in overall energy balance but at a social cost. Because work activities must be maintained for survival, it is discretionary activities which are sacrificed first. Yet it is these activities that are needed most for the future improvement of social infrastructure and the community, for ancillery economic activities and home improvement. For children, such adaptation means less interaction with their environment at a critical age, and as a consequence, permanent cognitive deficiencies. The FAO/WHO in 1975 pointed out that very sedentary individuals could survive at levels averaging only 50% above their basal metabolic rate, although this type of existence precludes work or discretionary activities. It has been demonstrated that 15 times the basal metabolic rate is not sufficient either for productive economic activity or for long term maintenance of health. Thus, indicators of nutritional status such as physical growth and development, physical capacity, work output, cognitive performance, morbidity and mortality from infectious diseases, and energy available for social development should be part of the judgment of the significance of food-consumption patterns in any society at any period of time.
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