Stress and Wellness Journal due in 24 hours Due in 24 hours Stress and Wellness Chapter 6 of the course textbook addresses the issues of adult person -

Stress and Wellness Journal due in 24 hours
Due in 24 hours
Stress and Wellness
Chapter 6 of the course textbook addresses the issues of adult personality development. For this journal, reflect on how stress impacts overall wellness, how stress can be managed, and how you have managed it in your own life.
In this journal entry, address the following:

Comment on how this weeks learning and materials compliment, oppose, and/or affect change in your positions and attitudes on the relevant subject matter.
Identify what you consider to be the most significant sources of stress in adult life and the most relevant and effective stress management tools and methods; include comments on factors such as nutrition, exercise, cognitive appraisal, heredity, work, family, etc.
From this reflection, formulate and describe examples of stress management strategies you might share with an adult client to manage sources of stress and enhance wellness.
Share one example of an area in which you would like to make a change to better manage your own stress and enhance your wellness.

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Stress and Wellness Journal due in 24 hours Due in 24 hours Stress and Wellness Chapter 6 of the course textbook addresses the issues of adult person

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Required Text
You can find more helpful items for Constellation at the following site: https://content.rockies.edu/support/tutorials/
Constellation: Mossler, R. A., & Ziegler, M. (2016). Understanding Development: A Lifespan Perspective. San Diego, CA: Bridgepoint Education, Inc
Required References
American Psychological Association. (2011). Practice guidelines for LGB clients: Guidelines for psychological practice with lesbian, gay, and bisexual clients. Retrieved from http://www.apa.org/pi/lgbt/resources/guidelines.aspx(Links to an external site.) (Skim and familiarize yourself with the 21 Guidelines for LGBT Clients.)
Colorado Community Media. (2007). Bully prevention part of District 28 teachings. Retrieved from http://coloradocommunitymedia.com/stories/Bully-prevention-part-of-District-38-teachings,51506(Links to an external site.)
Finkelstein, S. (2006). 20/20: Exploring sexual orientation: Gay or straight, Part 1 [Video file]. New York, NY: CBS Corporation. Retrieved from60 Minutes 8/27/06 – Gay or Straight – Part 1 of 3(Links to an external site.)
Finkelstein, S. (2006). 20/20: Exploring sexual orientation: Gay or straight, Part 2 [Video file]. New York, NY: CBS Corporation. Retrieved from60 Minutes 8/27/06 – Gay or Straight – Part 2 of 3(Links to an external site.)
National Geographic. (2011a, Apr 29). Inside the living body, video 1 of 9 [Video file]. Retrieved fromNational Geographic – Inside the Living Body 1 9(Links to an external site.)
National Geographic. (2011b, Apr 29). Inside the living body, video 2 of 9 [Video file]. Retrieved fromNational Geographic – Inside the Living Body 2 9(Links to an external site.)
National Geographic. (2011c, Apr 29). Inside the living body, video 3 of 9 [Video file]. Retrieved fromNational Geographic – Inside the Living Body 3 9(Links to an external site.)
National Geographic. (2011d, Apr 29). Inside the living body, video 4 of 9 [Video file]. Retrieved fromNational Geographic – Inside the Living Body 4 9(Links to an external site.)
National Geographic. (2011e, Apr 29). Inside the living body, video 5 of 9 [Video file]. Retrieved fromNational Geographic – Inside the Living Body 5 9(Links to an external site.)
National Geographic. (2011f, Apr 29). Inside the living body, video 6 of 9 [Video file]. Retrieved fromNational Geographic – Inside the Living Body 6 9(Links to an external site.)
National Geographic. (2011g, Apr 29). Inside the living body, video 7 of 9 [Video file]. Retrieved fromNational Geographic – Inside the Living Body 7 9(Links to an external site.)
National Geographic. (2011h, Apr 29). Inside the living body, video 8 of 9 [Video file]. Retrieved fromNational Geographic – Inside the Living Body 8 9(Links to an external site.)
National Geographic. (2011i, Apr 29). Inside the living body, video 9 of 9 [Video file]. Retrieved fromNational Geographic – Inside the Living Body 9 9(Links to an external site.)
Perry, B. D. (2009). Examining child maltreatment through a neurodevelopmental lens: Clinical applications of the neurosequential mode of therapeutics. Journal of Loss and Trauma, 14(4), 240-255. doi: 10.1080/15325020903004350 (PsychINFO: 2009-10040-002). Full text article available at http://childtrauma.org/wp-content/uploads/2013/09/TraumaLoss_BDP_Final_7_09.pdf(Links to an external site.)
Smith-Osborne, A. (2007). Life span and resiliency theory: A critical review. Advances in Social Work, 8(1), 152-168. Retrieved from http://journals.iupui.edu/index.php/advancesinsocialwork/article/view/138/139(Links to an external site.)
Recommended References
American Psychological Association. (2011). Practice guidelines for LGB clients: Guidelines for psychological practice with lesbian, gay, and bisexual clients. Retrieved from http://www.apa.org/pi/lgbt/resources/guidelines.aspx(Links to an external site.) (Skim and familiarize yourself with the 21 Guidelines for LGBT Clients.)
Arnett, J.J. (2000). Emerging adulthood: A theory of development from the late teens through the twenties. American Psychologist, 55(5), 469-480. doi: 10.1037//0003-066X.55.5.469
AssistGuide Information Services. (n.d.). Types of grief and loss. Retrieved from, http://www.agis.com/Eldercare-Basics/Support-Services/End-of-Life/Grief-and-Loss/Types-of-Grief-and-Loss/default.aspx(Links to an external site.)
Blogspot. (2011). The grief cycle and loss of control. Retrieved from http://drawingablake.blogspot.com/2011/12/grief-cycle-and-loss-of-control.html(Links to an external site.).
Center for Disease Control and Prevention. (2015). Mortality tables. Retrieved from http://www.cdc.gov/nchs/nvss/mortality_tables.htm(Links to an external site.)
Changing Minds. (n.d.). Kubler-Ross grief cycle. Retrieved from http://changingminds.org/disciplines/change_management/kubler_ross/kubler_ross.htm(Links to an external site.)
Center on the Developing Child at Harvard University. (2013, Oct 31). InBrief: The science of neglect [Video file]. Retrieved fromInBrief: The Science of Neglect(Links to an external site.)
Finkelstein, S. (2006). 20/20: Exploring sexual orientation: Gay or straight, Part 3 [Video file]. New York, NY: CBS Corporation. Retrieved from60 Minutes 8/27/06 – Gay or Straight – Part 3 of 3(Links to an external site.)
Gersick, C. J. G., & Kram, K. E. (2002). High-achieving women at midlife: An exploratory study. Journal of Management Inquiry, 11(2), 104-127.
Holland, J. L. (1958). A personality inventory employing occupational titles. Journal of Applied Psychology, 42, 336-342.
Infed. (n.d). Lifespan development and lifelong learning. Retrieved from http://www.infed.org/biblio/lifecourse_development.htm(Links to an external site.)
Mayo Clinic. (n.d.). Complicated grief. Retrieved from http://www.mayoclinic.org/diseases-conditions/complicated-grief/basics/definition/con-20032765(Links to an external site.)
Mercer, J. (2011). Attachment theory and its vicissitudes: Toward an updated theory. Theory Psychology, 21(25), 25-45. doi: 10.1177/0959354309356136 (Available through SAGE Journals).
Meridian Education Corporation. (2006). Taking a stand: The bullying prevention series. [Pdf file]. Retrieved from http://fod.infobase.com/HTTP/29900/29938%20Bullies%202006%20TG.pdf(Links to an external site.)
Moules, N. J., Simonson, K., Fleiszer, A. R., Prins, M., & Glasgow, B. (2007). The soul of sorrow work. Journal of Family Nursing, 13(1), 117-141.
National Institute of Health (NIS). (n.d.). NIH senior health. Retrieved from https://www.nia.nih.gov/health/topics(Links to an external site.)
Ornstein, S., Cron, W. L., & Slocum, J. W. (1989). Life stage versus career stage: A comparative test of the theories of Levinson and Super. Journal of Organizational Behavior (1986-1998), 10(2), 117.
Shenk, J. W. (2009, June). What makes us happy? The Atlantic. Retrieved from http://www.theatlantic.com/magazine/archive/2009/06/what-makes-us-happy/7439/(Links to an external site.)
Siegel, D. J. (2004). Attachment and self-understanding: Parenting with the brain in mind. Journal of Prenatal & Perinatal Psychology and Health, 18(4), 273-285.
University of the Rockies. (2006). Cognitive buffers against stress [Video file]. Intelecom Online Resources Network.
University of the Rockies. (2006). Developmental tasks of the elder years [Video file]. Intelecom Online Resources Network.
University of the Rockies. (2006). Myths and realities of the aging adult [Video file]. Intelecom Online Resources Network.
University of the Rockies. (2006). Observational learning: The research of Albert Bandura. [Video file]. Intelecom Online Resources Network.
University of the Rockies. (2006). Social support and emotional correlates with health [Video file]. Intelecom Online Resources Network.
University of the Rockies. (2006). Use of reinforcements and punishment in shaping a childs behavior. [Video file]. Intelecom Online Resources Network.

181

6Health and Wellness

iStock/Thinkstock

Learning Objectives

After completing this chapter, you should be able to:

Analyze personal and circumstantial variables related to nutrition and activity that impact health and illness.

Compare and contrast the most prevalent eating disorders.

Outline common diseases of childhood and their potential consequences.

Identify global health concerns and efforts that prevent childhood mortality.

Examine common illnesses and diseases of adulthood.

Evaluate research in the field of psychoneuroimmunology and analyze factors that have a psychological
effect on health.

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182

Prologue

Chapter Outline

Prologue

6.1 Nutrition and Activity: Lifestyles and Circumstances
Nutrition and Weight
Overweight and Obesity
Malnutrition
Activity

6.2 Eating Disorders
Anorexia Nervosa
Bulimia Nervosa
Binge Eating Disorder

6.3 Illness in Childhood
Asthma
Diabetes

6.4 Maximizing Childhood Health Outcomes
Childhood Mortality and Prevention Efforts
Immunizations

6.5 Illness and Disease in Adulthood
Sexually Transmitted Infections and Diseases
Smoking and Use of Other Tobacco
Cancer
Diseases of the Cardiovascular System
Chronic Obstructive Pulmonary Disease
Degenerative Diseases of the Brain

6.6 Stress

Summary & Resources

Prologue
Jeanne Louise Calment, who died in 1997 at age 122 1/2, is the oldest person on record. So as
far as we know, then, the human lifespan is somewhere beyond 120 years. What is less clear
are the factors that contributed to Calments extraordinary longevity. Did she have a special
genetic makeup? A special way of living? Whereas the upper limit of the lifespan is exclusive
to primary aging, life expectancy, or how long a person is expected to live, is associated with
secondary aging. Scientists estimate the life expectancy at birth, which yields a different age
than a cohort of adults who are just turning 65. That is, if you have already lived to 65, on
average, you will live longer than a cohort that is starting at age zero. The estimated life expec-
tancy of a country is the average age at birth that a resident in the country can expect to live
(see Figure 6.1). It includes infants who die at childbirth, teens who die in accidents, adults
who die from various causes, and the very elderly who live over 100 years. We can compare
the life expectancy of one population with another population in order to discover factors
that contribute to both longevity and mortality.

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183

Country

Y
e
a
rs

U.
S.

In
do

ne
sia

Ch
in
a

Br
az

M
on

ac
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Au
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Fi
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an

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Ha

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M
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Ru
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Ja
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79.7

57.8

84.7
81.8 81.4

80.8

63.5

50.9

75.6

70.5

73.5

89.5

75.4

72.5

Prologue

What types of variables impact life expectancy? In low-income countries, lack of medical care
affects overall life expectancy, as does AIDS, famine, poor sanitation practices, and childhood
diseases. However, new research methods have allowed us to document more unusual trends
as well. In Syria, war is the leading cause of premature death; India and China account for
half the worlds suicides, which are also disproportionately high in Eastern Europe; in Latin
America and the Caribbean, interpersonal violence is a top-5 cause of death in more than half
the countries in the region. In contrast, it is a leading cause of death in only one other coun-
try in the world, South Africa (Global Burden of Disease [GBD] 2013 Mortality and Causes of
Death Collaborators, 2015).

Researchers study the different factors that contribute to variability in life expectancy within
high-income countries as well. In the United States, life expectancy varies by region. The
southern states dominate the shortest-living states, whereas the longest-living states are less
concentrated in one area. There are additional differences according to ethnicity and occu-
pation as well (Lewis & Burd-Sharps, 2015). Inevitably, differences exist due to secondary
aging factors. Among all people, but especially for adults, there is unequivocal evidence that
being a nonsmoker, maintaining a healthy weight, eating five or more servings of fruits and
vegetables a day, and engaging in regular physical activity contributes to longevity. However,
few people engage in all of these lifestyle choices (Moore & Thompson, 2015). So while there
is much that we already know, dissecting the many correlates of life longevity and mortality
is no easy task.

Figure 6.1: Life expectancy by country

Life expectancy varies greatly among regions of the world.

Source: Central Intelligence Agency. (n.d.). Country comparison: Life expectancy at birth. The World Factbook. Retrieved from
https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html

Country

Y
e
a
rs

U.
S.

In
do

ne
sia

Ch
in
a

Br
az

M
on

ac
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Au
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Fi
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Af
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M
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Ru
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Ja
pa

Ca
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79.7

57.8

84.7
81.8 81.4

80.8

63.5

50.9

75.6

70.5

73.5

89.5

75.4

72.5

mos82599_06_c06_181-218.indd 183 2/11/16 8:26 AM

https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html

184

Section 6.1 Nutrition and Activity: Lifestyles and Circumstances

6.1 Nutrition and Activity: Lifestyles and Circumstances
In wealthy countries, nutrition and exercise are leading factors that contribute to quality of
life and longevity. Diminishing numbers of people get enough exercise to burn off the increas-
ing portions of food that we consume. In the United States, for instance, about two thirds
of adults and one third of children are overweight, which leads to a host of possible health
complications. But there are also significant numbers of adolescents and some adults that
engage in dieting practices to lose weight even though they are of normal weight. Worldwide,
on the other hand, 11.3% of the population is undernourished, including 13.5% of people in
developing countries (e.g., Bhurtun & Jeewon, 2013; Fayet, Petocz, & Samman, 2012; Gusella,
Goodwin, & van Roosmalen, 2008). These outcomes related to nutrition and activity result
from a blend of individual, family, community, social, and political variablesmain features
of the ecological perspective. This section will explore these issues within the context of the
developing person throughout the lifespan.

Nutrition and Weight
In Chapter 4, we considered the role of nutrition in early infant care and some of the issues
parents assess when feeding an infant formula or breast milk. As most children begin to
exclusively eat solid foods in their second year, many parents in the United States go to great
lengths to ensure that their children are eating enough. If provided with good choices, tod-
dlers and preschoolers are actually quite good at controlling their nutritional intake. Many
adults worry about how much children are eating, but they should focus instead on what they
are eating. Anxious parents may stuff their children full of pizza, hamburgers, fried chicken
nuggets, and macaroni and cheese several times a weekor even dailybecause of worry
about their children starving. However, if offered a number of nutritious choices at meal-
time, children will learn to self-regulate. Alternatively, when the culture encourages young
children to eat more than they naturally want to consume, overeating behaviors are rewarded
and it can set a precedent for a lifelong weight problem.

It may seem self-evident, but research confirms that children generally follow the nutritional
habits of their parents. It is the reason that comparatively more Japanese children eat fish
and American children eat hamburgers. In an extensive survey of adolescent dietary habits, it
was found that teenagers who ate more fruits and vegetables had parents who also ate more
fruits and vegetables. Parents who drank more soda predicted teenagers who drank more
soda and ate more fast food, and so on. Parents can have either a positive or a negative effect
on their childrens eating behavior (Diamant, Babey, Jones, & Brown, 2009). Moreover, signifi-
cant numbers of parents do not realize when their children become overweight, which can
undermine the promotion of healthy nutritional habits (Lundahl, Kidwell, & Nelson, 2014).

Nutrition during adolescence sometimes becomes complicated. Teenagers must balance the
nutritional requirements of a period of rapid growth with the temptations and availability of
high-fat, low-nutrient foods. In early adulthood, the efficiency with which we burn energy is
slowed, and we burn fewer calories. Due to career or educational pursuits, we often become
less active during early adulthood, which compounds natural muscle loss that begins to
appear around 30. Therefore, if adults continue to eat at the same rate as they did when
they were youngereven if they engage in similar physical activitiesthey are likely to gain
weight.

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185

Section 6.1 Nutrition and Activity: Lifestyles and Circumstances

As we move into middle and late adulthood, physical changes result from both primary aging
and secondary lifestyle choices. Men tend to put on weight around the midsection, whereas
women tend to accumulate fat in the hips. On average, weight does not decline until people
reach their mid-70s. Men and women who gain apple shaped belly fat are more at risk for
health problems than people who gain pear shaped weight around their hips (Schenck-
Gustafsson, 2009). Waist to hip ratio, one of the biomarkers for longevity, can tell you if you
have an excess of belly fat. To calculate a healthy hip to waist ratio, divide the measurement of
your waist by the measurement of your hips. Men should strive for a proportion of 0.90 or
lower to minimize health risks based solely on waist to hip ratio; for women, 0.80 or lower is
optimal. There are, however, moderate variations according to race, ethnicity, age, and body
type (e.g., Price, Uauy, Breeze, Bulpitt, & Fletcher, 2006; WHO, 2011).

Good nutrition plays a major role in maintaining
optimal health. For example, healthy eating can
reduce the risk for many chronic diseases. Dietary
guidelines for Americans (USDA, 2010) include bal-
ancing the number of calories consumed with the
number of calories burned off. Consuming more
calories than the body needs leads to excess weight.
Beyond this basic premise, there are many ways to
compose a healthy diet. Most beneficial diets rec-
ommend increasing nutrient-dense foods like veg-
etables, fruits, whole grains, beans, seafood, poultry,
eggs, and low-fat or non-fat milk products. Numer-
ous studies recommend following what is known as
the Mediterranean diet to reduce risk factors for
chronic diseases. This diet emphasizes fruits and
vegetables, nuts, whole grains, olive oil, fish, and, for
some people, moderate consumption of wine (Ham-
mar & stgren, 2013). While consuming healthier
food is beneficial, so is limiting foods that are high
in salt, contain saturated or trans fats, cholesterol,
and added sugars (USDA, 2010). Advances in food
labeling have made it possible to be a smart shop-
per and make more nutritious choices.

Overweight and Obesity
In addition to calculating the waist to hip ratio, for consistency in research and for medi-
cal purposes, we use body mass index (BMI) to standardize the terms overweight (BMI of
2529.9) and obesity (BMI of 30 or more). Because of a continuing trend towards a heavier
population, researchers have also begun to use the terms grade 2 obesity for a BMI of at least
35 and grade 3 obesity for a BMI of 40 or more. About half of overweight people in the United
States at any particular age also reach the threshold for obesity; rates are generally higher
than average among minority women and children from lower-income families (Ogden, Car-
roll, Kit, & Flegal, 2014). Although overall trends are quite concerning, the obesity rate among
children 2 to 5 years has been one particular bright spot. Since peaking at 14% in 2003, less
than 10 years later it has dropped to near 8%. Figure 6.2 illustrates the childhood and adult-
hood obesity rates since 2003.

iStock/Thinkstock

The Mediterranean diet encourages
consuming vegetables, fruits, whole
grains, nuts, olive oil, fish, and the
moderate consumption of wine.

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186

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b) Prevalence of adult obesity

Age range

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Ages 25

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Ages 1219

Age range

All (ages 20)

Ages 2039

Ages 4059

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Section 6.1 Nutrition and Activity: Lifestyles and Circumstances

Figure 6.2: Rates of obesity in the United States

The prevalence of childhood obesity has decreased since 2003, but the prevalence of adult obesity
has increased. Approximately 39.5% of adults aged 40 to 59 are obese.

Source: Adapted from Ogden, C. L., Carroll, M. D., Kit, B. K., and Flegal, K. M. (2014, February 26). Prevalence of childhood and adult
obesity in the United States, 20112012. Journal of the American Medical Association. Retrieved from http://jama.jamanetwork
.com/article.aspx?articleid=1832542

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b) Prevalence of adult obesity

Age range

All (ages 219)

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Ages 1219

Age range

All (ages 20)

Ages 2039

Ages 4059

Ages 60

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http://jama.jamanetwork.com/article.aspx?articleid=1832542

187

Section 6.1 Nutrition and Activity: Lifestyles and Circumstances

Worldwide obesity rates have followed the trend of the United States. The World Health
Organization estimates that 39% of all adults are overweight and that 13% are obese (WHO,
2015c), which is more than double the rates of 30 years ago. Poor adult nutrition in low-
income countries contributes to inadequate prenatal, infant, and childhood nutrition, includ-
ing increased exposure to nutrient-poor foods that are high in fats and sugar. These patterns
have contributed to sharp increases in childhood obesity while the concurrent problem of
undernutrition in many of the same countries remains unresolved.

There is strong evidence that the road toward becoming overweight often starts with hab-
its set during childhood. Multiple longitudinal studies have found about three quarters of
overweight children are obese as adults (e.g., Guo, Wei, Chumlea, & Roche, 2002; Riedel et
al., 2014; Thompson & Bentley, 2013). As a consequence, obesity at every age is correlated
with multiple health problems later, including a host of cardiovascular diseases and pulmo-
nary, endocrine, and even orthopedic problems, as extra weight puts added strain on bones
and systems related to movement (Inge et al., 2013; Reilly & Kelly, 2011). It is conservatively
estimated that obesity results in an additional $19,000 in lifetime medical costs (Finkelstein,
Graham, & Malhotra, 2014).

Behaviorally, being overweight is associated with delayed motor development beginning
in infancy and has a negative effect on coordination in middle childhood (Joshi et al., 2015;
Slining, Adair, Goldman, Borja, & Bentley, 2010). This finding is not surprising because extra
weight limits mobility for anybody. Remember also that motor development, discussed in
Chapter 5, is intimately connected to brain development during infancy, exacerbating long-
term consequences of being overweight.

Causes and Prevention
Biology and genetics influence body type and how people react to certain foods (e.g., craving
a particular kind of taste). But with few exceptions, obesity occurs because of an imbalance
between caloric intake and energy usage. In rare cases, a genetic component is identified.
Prader-Willi syndrome, for instance, is a specific genetic disorder. It is characterized by feed-
ing difficulties during infancy that soon change to a preoccupation with food and overeating.
This syndrome is rare, occurring in only 1 out of every 25,000 births (Chen, Visootsak, Dills,
& Braham, 2007). On the other hand, the rise in obesity from less than 11% of adults in 1960
to 35% today cannot be attributed to genetics because human genetics do not change in such
a relatively short period.

Experts say the trend toward more weight is because we eat too much fast food, have super-
sized portions at home and in restaurants, do not exercise enough, pick meals that offer few
nutrients, sit too much, and pick easier physical options (e.g., taking an elevator or driving
instead of taking the stairs and walking). Young adults generally eat more than their grand-
parents did and get less physical exercise (CDC, 2015a). The obesity problem in lower income
areas is often attributed to the relatively inexpensive nature of fast food. However, there are
reasons to question this conclusion. First of all, freshly prepared food is far less expensive
than fast food. Secondly, the vast majority of obese adults are in the middle and upper income
brackets (Ogden, Lamb, Carroll, & Flegal, 2010).

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Section 6.1 Nutrition and Activity: Lifestyles and Circumstances

A larger issue occurs when there is decreased availability of fresh food. Poorer urban areas
are often called food deserts because they lack traditional supermarkets where fresh food
is available year round. In this way, SES predicts food choices, but does not cause poor food
choices. Overall, there is an inverse relationship between income level and obesity in women
that does not exist in men. In fact, among low-income black and Hispanic men, the relation-
ship is reversed. That is, while obesity prevalence is greater among low-income minority
women, it is also higher among high-income minority men. Rates of overweight and obesity
have increased at all levels of income and education, suggesting a global trend rather than one
exclusive to sex or SES.

So it appears that lifestyles at every income and educational level have changed in ways that
promote obesity. It has become the norm to purchase less nutritional food in lieu of some-
thing fresh and home-cooked. Snacks are often thought of as high-fat, low-nutrition products
that come in a bag at the corner store, rather than easily prepared carrots, celery, and fruit.
Once taste buds get accustomed to certain foods, neural processing in the brain may actually
change so that the brain and body craves those foods (Page et al., 2011). In this way, the enjoy-
ment of food becomes part of a natural conditioning process.

Malnutrition
Though rates of overweight and obesity continue to rise in some areas of the world, getting
sufficient nutrition is a daily struggle in others. One out of eight people in the world, or nearly
800 million, suffer from chronic under-nourishment (FAO, IFAD, & WFP, 2015). When nutri-
tion intake is deficient either because of not enough food or not enough specific nutrients, it
is called malnutrition. Without proper nutrients beginning in childhood, malnutrition leads
to negative physical, cognitive, and social consequences (Anjos et al., 2013). About 3 million
of the deaths among children younger than 5 years of age are associated with preventable
malnutrition, representing 45% of all deaths in that age range. As Figure 6.3 shows, an addi-
tional 159 million children suffer from stunting, a slow cumulative marker for malnutrition
that is associated with poor motor skills and arrested mental development (Black et al., 2013;
McDonald et al., 2013). Children who survive nutritional diseases suffer lasting damage to the
body and brain (Mller & Krawinkel, 2005). The effects of malnutrition on brain development
are cumulative, affecting later attention and learning ability, overall intelligence, and motor
coordination.

Activity
As mentioned in the nearby paragraphs, some speculate that the relatively low cost of fast
food may influence rates of obesity. Consider this argument in more depth by calculating the
weekly cost of dinner for four at two different fast food restaurants (four dinners at one loca-
tion and three at the other). Then, calculate the cost of home-cooked meals for the same seven
days. For recipe ideas, download Leanne Browns Good and Cheap cookbook for free (http://
www.leannebrown.com/). Compare cumulative time involved (including transportation) and
the costs and benefits of the consumed nutrition.

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50

200

150

100

1990 1995 2000 2005 2010 2014

161
142

126
114 104

b) Underweight

N
u
m

b
e
r

o
f
ch

ild
re

n
a

ffe
ct

e
d

(m
ill

io
n
s)

P
re

va
le

n
ce

(
%

)

Number of affected
(millions of children ages < 5) Prevalence (% of children aged < 5) Section 6.1 Nutrition and Activity: Lifestyles and Circumstances Figure 6.3: Global child malnutrition trends, 19902014 Approximately 800 million people in the world suffer from chronic under-nourishment, leading to 159 million children who suffer from stunting, and 3 million childhood under-5 deaths. Though still high, since the adoption of the Millennium Development Goals, these kinds of consequences have declined considerably. Though percentages vary by region, interventions that have specifically targeted areas where malnutrition is widespread have reduced the overall proportion of underweight children from 28% to 17%. Source: UNICEF. (2015, September 22). Child nutrition interactive dashboard: 2015 edition. Retrieved from http://www.data .unicef.org/resources/child-nutrition-interactive-dashboard-2015-edition.html 250 50 45 40 35 30 20 25 15 10 5 200 150 100 50 1990 1995 2000 2005 2010 2014 0 255 224 198 182 169 159 a) Stunting N u m b e r o f ch ild re n a ffe ct e d (m ill io n s) P re va le n ce ( % ) 250 50 45 40 35 30 20 25 15 10 5 200 150 100 50 1990 1995 2000 2005 2010 2014 0 1

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