1. Understanding Nutrition and the Consequences of Undernutrition Brian R. Barthel, Ph.D.

9. Nutrients and Their Functions

12. Obesity in America

13. Leading Causes of Death in the United States

14. Leading Causes of Death - Peru TABLE 1. Leading causes of mortality, Peru, 2004. Causes of mortality (PAHO List 6/67) per 100,000 population 1 Acute respiratory infections 68.0 2 Ischemic heart diseases 25.7 3 Cerebrovascular diseases 24.3 4 Septicemia, except for neonatal 21.5 5 Cirrhosis and certain other chronic liver diseases 21.4 6 Hypertensive diseases 16.9 7 Malignant stomach tumors 15.6 8 Respiratory disorders originating in the perinatal period 14.7 9 Tuberculosis 13.2 10 Diabetes mellitus 12.3 Source: Adapted from Peru, Ministerio de Salud, mortality database .

15. Causes of Death Southern Highlands, Peru Leading causes of death, Southern Highlands, Peru, 2000. Causes of mortality (List 6/67 PAHO) per 100,000 population 1 Acute respiratory infections 147.9 2 Cirrhosis and certain other chronic liver diseases 51.0 3 Cardiac insufficiency 46.5 4 Nutritional deficiencies and anemia 44.8 5 Appendicitis, hernia of the abdominal cavity, and intestinal obstruction 44.2 6 Cerebrovascular diseases 41.3 7 Respiratory disorders originating during the perinatal period 31.3 8 Septicemia, except for neonatal 26.2 9 Land transportation accidents 25.9 10 Malignant stomach tumors 25.0 Source: Adapted from Peru, Ministerio de Salud, mortality database.

16. Nutritional Profile of Peru Nationwide, 24 percent of children under five are chronically undernourished, and the prevalence has not changed over the last decade. In remote rural areas, rates can reach up to 70 percent (ENDES 2004). Almost 50 percent of children less than five suffer from anaemia, and the figures are much higher in the highlands (60-70 percent).

18. Climate and Natural Disaster Issues A lack of access to food commodities, poor consumption patterns, inadequate child care and nutrition practices and poor educational levels among mothers, are the main causes of chronic undernutrition in Peru. Food insecurity in Peru tends to be periodically aggravated by recurrent emergencies which mainly affect the southern highland area. 2007 was a particularly difficult year in terms of natural disasters: floods, frost, hail storms and heavy snowfalls affected approximately 700.000 people in 13 Peru regions. And along with all the other disasters a 7.9 earthquake!

19. The Malnutrition Downward Spiral

24. Comparison of Kwashiorkor and Marasmus A classic sign of Kwashiorkor is edema. Marasmus results in an emaciated appearance.

25. Signs of Protein Energy Malnutrition in Peruvian Children

29. Animation: Vitamin A and Epithelial Tissue | Vitamin A and Epithelial Tissue

34. Rickets Before Treatment After Treatment Wind Swept Rickets

35. Rickets Before and After Treatment

36. Childhood Rickets – Vitamin D Deficiency

44. Iodine Deficiency Goiter is an early sign of iodine deficiency Cretinism can result from an iodine deficiency during the early stages of fetal development

47. Thank You! Eat Healthy!