It is a popular misconception that hunger and malnutrition are prevalent only in third-world countries. One only has to turn on his television set and watch a "Feed The Children" infomercial to be reminded of the problem. While malnutrition levels seem to be increasing at an alarming rate in underdeveloped countries, such as Ethiopia and Sudan, there still exist nutrition problems in the United States-particularly in areas where impoverished adults and children live. Even though the United States is considered to be one of the wealthiest countries in the world and has put in place many food and outreach programs targeting low-income families, a large number of people-from fetuses in the womb to the elderly-are still suffering from some level of malnutrition. In fact, according to the Food Research and Action Center (FRAC), food hardship affected 51 percent of low-income parents in 2002. Lack of food resources can often result in the following in mild to severe malnutrition on both a short-term and long-term basis:
- Physical impairments
- Psychological problems
- Developmental disabilities
- Behavioral concerns
- Social limitations
As defined by the World Health Organization (WHO), malnutrition is "the cellular imbalance between the supply of nutrients and energy and the body's demand for them to ensure growth, maintenance, and specific functions". Cook & Frank (2004) coined a related term called "food insecurity," which is defined as "the inability, because of financial constraints, to consistently obtain food of sufficient quantity or quality for an active and healthy life." Regardless of the terminology, many people attribute malnutrition to meaning "undernutrition" or lacking adequate calories and protein for growth. It is easy to assume a person's bone-thin appearance is the symptom of malnutrition or starvation, just as it is comfortable to automatically believe that a well-proportioned person who looks "good" continually engages in good nutrition. WHO, however, broadens the malnutrition label to account for both "overnutrition" (consumption of excess calories) and also "secondary malnutrition," which results when people "are unable to utilize fully the food they eat". Extremely overweight or "fat" people can also exhibit signs of poor nutrition, dispelling one of the stereotypical beliefs that individuals are obese because they just simply consume too many calories and do not exercise: Quantity is focused on more than quality.
Malnutrition is especially prevalent among those living in poverty due to: lack of financial resources to buy/replenish nutritious foods, inadequate medical care, social isolation, poor hygiene, lack of transportation, and limited access to outreach community programs or healthcare facilities. For these people, the choices directly impacting their ability to survive significantly outweigh those made in a grocery store or concerning a food label. For example, one recent report noted that 30 percent of emergency food clients had to choose between paying for food or buying medicine or medical care. In this case, the entire issue of whether or not to buy food that is nourishing or unwholesome becomes secondary (or non-existent!): Cost is often the primary concern. As economics continually fluctuate so do people's ability to increase their food quality and intake, or balance their children's diets. This, in turn, throws their health off-balance, ultimately affecting them on a long-term or permanent basis.
Undernourishment has had, perhaps, the most serious and harmful impact on impoverished children, not only affecting their present health status but hindering their physical, mental, and social development into and throughout adulthood. The importance of adequate nutrition really begins before the child is conceived when the mother is preparing her body for pregnancy. Maternal malnutrition can be "exerted at many stages of development, from prior to conception until after birth". For example, talk to most ob/gyn doctors and hear recommendations about how women should stop taking their birth control pill and/or begin supplementing with a prenatal vitamin a few months before trying to conceive. The effects of malnutrition can be mild to severe, increasing babies' chances of disease, malformation, and other complications. Many doctors and health organizations, for instance, suggest that women consume 400 micrograms of folic acid per day in the months leading up to conception and also during the first few weeks of pregnancy to dramatically decrease the chance their babies will develop spina bifida and other birth defects. Iodine is another example of how lack of a nutrient can have adverse effects on a baby, and deficiency of this trace element has been linked to a child's developmental delay and mental retardation. Additionally, if in the last trimester of pregnancy the mother's diet is lacking protein and calories, her baby's brain development might be affected. Mothers who live in poverty and cannot afford the proper prenatal medical care are more likely to become malnourished and are thereby more prone to having children born with physical and mental handicaps.