title: A Death in the Family (comics)

text: After the first three issues of "A Death in the Family" sold out, DC compiled the storyline into a trade paperback in time for the 1988 Christmas shopping season. The collection, "Batman: A Death in the Family", shipped on December 5, 1988, less than a week after "Batman" #429. A 2009 hardcover reprint included Wolfman, Pérez, and Aparo's 1989 sequel storyline, "", which introduced Todd's successor Tim Drake. A hardcover deluxe edition was published in April 2021.


title: A Death in the Family (comics)

text: For many years, the version of "Batman" #428 in which Todd lives remained unpublished, though the pages remained housed in DC's archives in Burbank, California. "Batman Annual" #25, published in March 2006, used one of the alternate pages Aparo had prepared; some panels were released by Les Daniels in his book "" (1999) and by "Polygon" journalist Susana Polo in 2020. In March 2020, the "DC Daily" web show unveiled all of the pages to the public for the first time, and the artwork was published in the 2021 deluxe edition.


title: A Death in the Family (comics)

text: While eavesdropping on a child pornography ring and awaiting police backup in Gotham City, Jason Todd (Robin) ignores Batman's orders and attacks the criminals. Batman chastises Todd and asks if he considers crimefighting a game; Todd replies that life is a game. At Wayne Manor, Batman decides Todd is emotionally unstable and relieves him of his duties as Robin; an enraged Todd storms off. Meanwhile, the Joker, Batman's archenemy, escapes from Arkham Asylum. Batman discovers that he has obtained a nuclear weapon and plans to sell it to terrorists, and tracks him to war-torn Lebanon.


title: A Death in the Family (comics)

text: Walking through his old neighborhood, Todd meets a friend of his late parents, who gives him his father's old documents. Todd discovers that his mother's name on his birth certificate is blotted out, and that her first initial is "S", not "C" as in Catherine Todd, the woman he knew as his mother. Todd concludes that Catherine was his stepmother and decides to search for his biological mother. He uses the Batcomputer to track three possible individuals to the Middle East and Africa. Todd travels to Lebanon, where he and Batman reunite. The two foil an attempt by terrorists to destroy Tel Aviv using the nuclear missile purchased from the Joker. Batman agrees to help Todd find his mother, and Todd interrogates his first suspect, Mossad agent Sharmin Rosen. His next suspect, Batman's old acquaintance Lady Shiva, says she is not Todd's mother after she is administered a truth serum by the duo.


title: A Death in the Family (comics)

text: Batman and Todd travel to Ethiopia and confirm that Todd's mother is Sheila Haywood, an aid worker; Todd has an emotional reunion with her. However, the Joker discovers that Haywood had performed illegal surgeries on teenagers in Gotham and has been blacklisted as a medical practitioner. The Joker uses this information to blackmail her into giving him the medical supplies her agency has stockpiled in a warehouse. He sells them on the black market and stocks the warehouse with Joker venom, which will kill thousands of people. Haywood has also been embezzling from the aid agency and, as part of a cover-up, hands Todd, in his Robin costume, over to the Joker. The Joker beats Todd with a crowbar and restrains him and Haywood in the warehouse with a time bomb. Todd throws himself on the bomb to shield Haywood as the warehouse explodes. Batman arrives too late to save them, and Todd and Haywood die from their injuries.


title: A Death in the Family (comics)

text: Traumatized, Batman takes Todd and Haywood's remains to Gotham and holds a burial with Alfred Pennyworth, Commissioner James Gordon, and Barbara Gordon. Batman blames himself for Todd's death and resolves to carry on alone, rejecting Pennyworth's suggestion to involve Dick Grayson, the first Robin. The Joker meets with Ayatollah Khomeini, who offers him a role in the Iranian government. The Joker leaves a warehouse containing the corpses of his henchmen and the address of the UN Headquarters for Batman. As Batman waits outside the UN building, Superman appears and tries to convince Batman to leave. The Joker is Iran's representative to the UN and will be giving a speech on the floor of the General Assembly, and any confrontation between Batman and him could start a diplomatic incident.


title: A Death in the Family (comics)

text: During his speech, the Joker attempts to poison the entire chamber with Joker venom, but Superman intercepts the gas. Batman pursues the Joker onto a helicopter sent by his sponsors. During the resulting struggle, one of the Joker's henchmen opens fire with a machine gun and shoots the pilot, crashing the helicopter into the sea. Superman saves Batman, but the Joker's body is not found. Batman laments that everything between him and the Joker ends unresolved.


title: A Death in the Family (comics)

text: The first three chapters of "A Death in the Family" sold out quickly, and according to Starlin, the storyline was DC's bestselling comic of 1988. The storyline drew coverage in news outlets including "USA Today", Reuters, and the "Deseret News". Many reports did not mention that Todd was not the original Robin. As an editor at Marvel Comics, O'Neil had received angry mail from fans when characters such as Phoenix and Elektra were killed, so he was prepared for reader backlash to Todd's death. However, "A Death in the Family" created much more controversy, as Robin was one of DC's most iconic characters and the Marvel deaths had occurred during a period of recession in comics.


title: A Death in the Family (comics)

text: O'Neil spent the days following "Batman" #428's publication "doing nothing but talking on the radio. I thought it would get us some ink here and there and maybe a couple of radio interviews. I had no idea—nor did anyone else—it would have the effect it did." After three days, Peggy May, DC's publicity manager, ordered O'Neil to stop talking to the media. She also barred anyone from discussing the story on television. Though initially confused, O'Neil came to appreciate May's order because he did not want the public to see him as "the guy who killed Robin". Assistant editor Dan Raspler was chastised by DC's then-executive vice president Paul Levitz for referring to "A Death in the Family" as a "stunt" in an interview.


title: A Death in the Family (comics)

text: Todd's death divided fans at the time. Many readers celebrated, some hoping it meant that Grayson could become Robin again. Others lamented how bloodthirsty comic book readers were. O'Neil and the "Batman" team received hate mail and angry phone calls; according to O'Neil, the calls ranged from You bastard,' to tearful grandmothers saying, 'My grandchild loved Robin and I don't know what to tell him. Frank Miller was critical, calling the story "the most cynical thing [DC] has ever done ... fans can call in to put the axe to a little boy's head. To me the whole killing of Robin thing was probably the ugliest thing I've seen in comics". NPR cultural critic Glen Weldon found the criticism to be ironic, as it was Miller who came up with the idea of the Joker killing Todd in "The Dark Knight Returns".


title: A Death in the Family (comics)

text: Critics have agreed with the decision to kill Todd in retrospect. Sims wrote that killing Todd was "unquestionably the right decision" and made for a far better story. He opined that allowing the Joker to defeat Batman enhanced both characters: the Joker became "a deadly threat... whose actions have lasting consequences", while Batman had "a motivating loss at a time when new readers were coming in". Hilary Goldstein of "IGN" and Jamie Hailstone of "Den of Geek" praised the story's handling of Todd's death for its emotion and portraying the dangers of superheroics.


title: A Death in the Family (comics)

text: Retrospective reviewers have faulted "A Death in the Family" for its plot. Hailstone described "A Death in the Family" as "the ultimate 80s epic": "brasher than "Top Gun", louder than Hulk Hogan and more implausible than "The A-Team"". Both Hailstone and Goldstein found the plot hard to believe, and Hailstone said that it veers into nonsense when the Joker is appointed as an ambassador. Charles Prefore, writing for "Screen Rant", said the story "can't decide if it wants to be fun or dark"; while Todd's torture and death at the hands of the Joker is quite somber, elements like the "globetrotting nature of the story" and the Joker becoming an ambassador for Iran are evocative of the goofy Silver Age of Comic Books. Prefore said the story's grim moments, which caused "A Death in the Family" to gain a reputation as one of the darkest Batman stories, overshadow the rest of its outlandishness.


title: A Death in the Family (comics)

text: "A Death in the Family" remains a popular story among readers, and despite their reservations over the plot, critics still deemed it worth reading. Hailstone called the story a "guilty pleasure" that, while not as groundbreaking as "Year One" or "" (1987), was entertaining nonetheless, and Prefore summarized it as "a good read if you don't mind all the strangeness". Publications ranking it among the best Batman stories include "IGN" and "Complex" in 2014, and "GamesRadar+" and "Screen Rant" in 2021. Sean T. Collins of "Rolling Stone" ranked it among the 15 Batman stories he considered "essential" to understanding the character, praising Aparo's art and how Starlin characterizes the Joker.


title: A Death in the Family (comics)

text: Despite Robin's status as one of the most famous sidekicks in comic book history, there has been little literary analysis of "A Death in the Family". According to literary critic Kwasu Tembo, it is generally only discussed "as either a case study within a broader discussion of Batman's ethics, or as a case study of DC's editorial decisions and socio-historical engagement with its readership". The story's message is that Batman cannot save everyone, and it portrays Todd as a tragic figure whose sympathetic journey ends in death. Tembo contended that the death leaves the reader to ponder Todd's nature as "Batman's greatest failure, as an orphan betrayed, and/or as a careless and overzealous lost boy who reaped what he had so impulsively and thoughtlessly sown".


title: A Death in the Family (comics)

text: Tembo theorized that Todd's death, as voted for by readers, "can be more thoroughly understood as a complex form of scapegoating", comparable to a public execution. Todd was unpopular because he struggled to live up to the standard of his predecessor Grayson, which made him a "bad" Robin. This created jealousy among readers, who concluded that Todd was unfit to be Robin. Citing René Girard's theory of mimetic desire, Tembo wrote that O'Neil's decision to let fans determine Todd's fate created a "mimetic crisis" because readers "could now not only influence [Todd's] existence in the story world, but in being given this power, compete against him". Readers instead saw themselves as more fit to be Batman's partner; by voting to kill Todd, they thought they were helping Batman. Tembo points out that the closeness of the vote indicates that fans may not have despised Todd as much as commonly believed. Fans who voted to save Todd may have voted to preserve the classic status quo, or because they found the Joker's murdering a child during an emotional period in his life unsettling.


title: A Death in the Family (comics)

text: "A Death in the Family" has been criticized as Islamophobic for its portrayal of Arab terrorists. The terrorists are portrayed as anti-American, anti-Israel fanatics who seek to violently take over the Western world. They are referred to as "bandits-in-bedsheets" and depicted as unshaved and always holding weapons, while Jamal, the terrorist leader, is overweight and perpetually sneering. In a 1991 study of Arab terrorist depictions in comic books, Jack Shaheen wrote that "A Death in the Family" conflates Arabs, Muslims and terrorists, and equates them to the Joker, an insane supervillain. Jehanzeb Dar and Shaheen cited the Joker's speech to the General Assembly as a particularly egregious example of Islamophobia in "A Death in the Family". Before he attempts to poison the chamber, the Joker gloats:


title: A Death in the Family (comics)

text: Dar described the Joker's speech as blatant Islamophobia disguised as humor. Shaheen and Dar argued "A Death in the Family" promotes the idea of "Them vs. Us", pitting the Arab and Western worlds against each other as diametrically opposed in values. The story contains errors in its depiction of the Middle East. Starlin writes Batman as speaking Farsi, the Persian language, in Beirut (where Arabic is actually the commonly spoken language), and the Joker dons a traditional Arab headdress and robes as the Iranian ambassador, although Iran is not an Arab country. Dar concluded that and [DC]'s disregard for cultural, religious, and political accuracy simply points to a crude and racist generalization: Arabs, Iranians, and Muslims are all the 'same' and 'hate' the West."


title: A Death in the Family (comics)

text: "A Death in the Family" was part of the American comic book industry's trend towards "grim and gritty" comics in the late 1980s, and is remembered as one of DC's most controversial storylines. Chris Snellgrove of "Looper" described the scenes depicting Todd's torture and death—with the Joker covered in his blood— as "one of the most disturbing moments in the publisher's long history". DC editors took the lessons they learned from the controversy and used media coverage for publicity when killing off major characters in the future, such as Superman in "The Death of Superman" (1992–1993).


title: A Death in the Family (comics)

text: Although "A Death in the Family" sold well, it harmed Starlin's standing at DC. DC's licensing department was infuriated over the death because of the amount of merchandise—such as lunchboxes and pajamas—that bore Robin's likeness. According to Starlin, "everybody got mad, and they needed somebody to blame—so I got blamed." Work quickly declined for him, and within six months he departed DC and returned to Marvel Comics, where he wrote "The Infinity Gauntlet" (1991).


title: A Death in the Family (comics)

text: "A Death in the Family" is regarded as one of the most important Batman comics for its effect on future Batman stories. The story altered the DC Universe: instead of killing anonymous bystanders, the Joker murdered a core character in the Batman fiction. Alongside "The Killing Joke" (which featured Barbara Gordon, Batgirl, being shot in the stomach and paralyzed) and the success of the 1989 "Batman" film, "A Death in the Family" pushed the Batman mythos in a darker direction. It portrayed Batman as more violent and emotional following Todd's death, and for the next decade of comic book canon, he was haunted by his failure to save him. Conway felt that the storyline allowed for "the entrance of the real 'Dark Knight', the idea of Batman as the pitiless enforcer of Gotham". When the DC Universe canon was rebooted during DC's 2011 New 52 reboot, the events of "A Death in the Family" were left intact because DC editors deemed it too important.


title: A Death in the Family (comics)

text: Todd was likely to be replaced as Robin regardless of his survival. O'Neil wanted to wait a year for a successor, but DC management demanded a new Robin immediately. O'Neil and Wolfman began developing the character of Tim Drake, who debuted in the 1989 storyline "A Lonely Place of Dying" by Wolfman, Pérez, and Aparo. O'Neil arranged for a nuanced introduction that explained why Batman would need a new sidekick after Todd's death, and Drake was designed to appeal to both Todd's fans and detractors. Drake proved popular and starred in several limited series and a 1993–2009 ongoing series, until he was replaced by Damian Wayne in 2009. Wayne shared Todd's willingness to go against Batman's wishes and use lethal force; Grant Morrison and Frazer Irving's "Batman and Robin" #13 (2010) featured a scene in which Wayne beat the Joker with a crowbar, paralleling Todd's murder.


title: A Death in the Family (comics)

text: Throughout the 1990s and early 2000s, Todd's death was one of the few comic book deaths that remained unreversed. Unlike traditional comic book deaths, Todd's was intended to stay permanent; at the time of "A Death in the Familys publication, O'Neil said that "it would be a really sleazy stunt to bring him back". A popular aphorism among comic book fans was that in comics, no characters stayed dead except Bucky Barnes, Uncle Ben, and Todd. (Marvel would revive Barnes in 2004 as the Winter Soldier.) Todd's revival was first teased in the "" (2002–2003) storyline by Jeph Loeb and Jim Lee, which features Clayface impersonating an undead Todd to taunt Batman. After writer Judd Winick read "Hush", he wondered why DC never revived Todd. Winick and artist Doug Mahnke's 2004–2006 storyline "" revived him as the murderous vigilante Red Hood; the in-universe explanation for Todd's revival was that he was restored to life after Superboy-Prime punched the wall of a pocket dimension. Todd eventually re-joined Batman's supporting cast as an "on-again, off-again ally", and starred in the series "Red Hood and the Outlaws" (2011–2021). Despite his resurrection, in 2020 journalist Susana Polo noted Todd was still most famous for dying in "A Death in the Family".


title: A Death in the Family (comics)

text: Bruce Timm and Paul Dini considered adapting "A Death in the Family" for "" (1992–1999), but decided it was too violent. Instead, they omitted the Todd character and incorporated some of his characteristics in Drake. The story was eventually adapted in the comic book sequel "" (2020), written by Dini and Alan Burnett and penciled by Ty Templeton. In the "Adventures Continue" adaptation, the Joker and Harley Quinn kidnap Todd, and the Joker beats him with a crowbar with intent to kill him. Harley objects to killing a child and finds Batman, who arrives as the warehouse is engulfed in flames due to hydrogen tanks. A wounded Todd begs for Batman to kill the Joker, but Batman instead tries to save him; Todd attempts to stop Batman but knocks over more hydrogen tanks, causing the explosion and his apparent death.


title: A Death in the Family (comics)

text: Elements from "A Death in the Family" were incorporated in the 2010 DC Universe Animated Original Movies film "", an adaptation of "Under the Hood" directed by Brandon Vietti. In the film, Ra's al Ghul (Jason Isaacs) hires the Joker (John DiMaggio) to distract Batman (Bruce Greenwood) and Todd (Jensen Ackles) while he destroys Europe's financial districts. They follow the Joker to Bosnia, where he kills Todd in similar fashion to "A Death in the Family". An interactive film adaptation, "", was released in 2020. The film is a sequel to "Under the Red Hood", Vietti again directing and the cast, with the exception of Vincent Martella replacing Ackles, reprising their roles. Similar to the voting system from the comic, the film allows viewers to determine if Todd lives or dies, leading to different scenarios that see him become Red Hood, Hush, or Red Robin.


title: A Death in the Family (comics)

text: "A Death in the Family" is referenced in the DC Extended Universe (DCEU), a shared universe of superhero films based on DC characters. "" (2016) features a damaged Robin suit on display in the Batcave, while "Suicide Squad" (2016) reveals that Harley Quinn (Margot Robbie) helped the Joker (Jared Leto) murder him. "Zack Snyder's Justice League" (the 2021 director's cut of "Justice League" (2017)) features a scene in which the Joker mocks Batman (Ben Affleck) for Robin's death. Though Warner Bros. and "Suicide Squad" director David Ayer stated that the dead Robin was Todd, "Batman v Superman" director Zack Snyder later said he had intended it to be Grayson, unlike "A Death in the Family". Snyder had planned to explore Robin's death in detail in his "Justice League" sequels before their cancellation. Before the release of "Zack Snyder's Justice League", Snyder proposed a comic book prequel to "Batman v Superman" that depicted Robin's death, but DC turned it down.


title: A Death in the Family (comics)

text: In "Emperor Joker", a 2010 episode of "" (2008–2011), a fourth wall-breaking Bat-Mite (Paul Reubens) references "A Death in the Family" and the 900 number, and Batman is briefly seen cradling a dead Robin. Todd's portrayal in the video game "" (2015) was inspired by "A Death in the Family". The DC Universe and HBO Max streaming television series "Titans" (2018–present) features Todd as a central character portrayed by Curran Walters. After the second season episode "Deathstroke" (2019) ended on a cliffhanger with Deathstroke (Esai Morales) attempting to kill Todd, DC Universe held a poll in which fans could vote to determine Todd's fate. The poll was only intended as a reference to "A Death in the Family" and had no effect on the series, but elements from "A Death in the Family" were incorporated in the third season of "Titans", which premiered in 2021.


title: Human nutrition

text: Human nutrition deals with the provision of essential nutrients in food that are necessary to support human life and good health. Poor nutrition is a chronic problem often linked to poverty, food security, or a poor understanding of nutritional requirements. Malnutrition and its consequences are large contributors to deaths, physical deformities, and disabilities worldwide. Good nutrition is necessary for children to grow physically and mentally, and for normal human biological development.


title: Human nutrition

text: The human body contains chemical compounds such as water, carbohydrates, amino acids (found in proteins), fatty acids (found in lipids), and nucleic acids (DNA and RNA). These compounds are composed of elements such as carbon, hydrogen, oxygen, nitrogen, and phosphorus. Any study done to determine nutritional status must take into account the state of the body before and after experiments, as well as the chemical composition of the whole diet and of all the materials excreted and eliminated from the body (including urine and feces).


title: Human nutrition

text: The seven major classes of nutrients are carbohydrates, fats, fiber, minerals, proteins, vitamins, and water. Nutrients can be grouped as either macronutrients or micronutrients (needed in small quantities). Carbohydrates, fats, and proteins are macronutrients, and provide energy. Water and fiber are macronutrients but do not provide energy. The micronutrients are minerals and vitamins.


title: Human nutrition

text: The macronutrients (excluding fiber and water) provide structural material (amino acids from which proteins are built, and lipids from which cell membranes and some signaling molecules are built), and energy. Some of the structural material can also be used to generate energy internally, and in either case it is measured in Joules or kilocalories (often called "Calories" and written with a capital 'C' to distinguish them from little 'c' calories). Carbohydrates and proteins provide 17 kJ approximately (4 kcal) of energy per gram, while fats provide 37 kJ (9 kcal) per gram, though the net energy from either depends on such factors as absorption and digestive effort, which vary substantially from instance to instance.


title: Human nutrition

text: Vitamins, minerals, fiber, and water do not provide energy, but are required for other reasons. A third class of dietary material, fiber (i.e., nondigestible material such as cellulose), seems also to be required, for both mechanical and biochemical reasons, though the exact reasons remain unclear. For all age groups, males on average need to consume higher amounts of macronutrients than females. In general, intakes increase with age until the second or third decade of life.


title: Human nutrition

text: Some nutrients can be stored – the fat-soluble vitamins – while others are required more or less continuously. Poor health can be caused by a lack of required nutrients, or for some vitamins and minerals, too much of a required nutrient. "Essential" nutrients cannot be synthesized by the body, and must be obtained from food.


title: Human nutrition

text: Molecules of carbohydrates and fats consist of carbon, hydrogen, and oxygen atoms. Carbohydrates range from simple monosaccharides (glucose, fructose, galactose) to complex polysaccharides (starch). Fats are triglycerides, made of assorted fatty acid monomers bound to a glycerol backbone. Some fatty acids, but not all, are essential in the diet: they cannot be synthesized in the body. Protein molecules contain nitrogen atoms in addition to carbon, oxygen, and hydrogen. The fundamental components of protein are nitrogen-containing amino acids, some of which are essential in the sense that humans cannot make them internally. Some of the amino acids are convertible (with the expenditure of energy) to glucose and can be used for energy production just as ordinary glucose, in a process known as gluconeogenesis. By breaking down existing protein, some glucose can be produced internally; the remaining amino acids are discarded, primarily as urea in urine. This occurs naturally when atrophy takes place, or during periods of starvation.


title: Human nutrition

text: The list of nutrients that people are known to require is, in the words of Marion Nestle, "almost certainly incomplete".


title: Human nutrition

text: Carbohydrates may be classified as monosaccharides, disaccharides or polysaccharides depending on the number of monomer (sugar) units they contain. They are a diverse group of substances, with a range of chemical, physical and physiological properties. They make up a large part of foods such as rice, noodles, bread, and other grain-based products, but they are not an essential nutrient, meaning a human does not need to eat carbohydrates. The brain is the largest consumer of sugars in the human body, and uses particularly large amounts of glucose, accounting for 20% of total body glucose consumption. The brain uses mostly glucose for energy; if glucose is insufficient however, it switches to using fats.


title: Human nutrition

text: Monosaccharides contain one sugar unit, disaccharides two, and polysaccharides three or more. Monosaccharides include glucose, fructose and galactose. Disaccharides include sucrose, lactose, and maltose; purified sucrose, for instance, is used as table sugar. Polysaccharides, which include starch and glycogen, are often referred to as 'complex' carbohydrates because they are typically long multiple-branched chains of sugar units.


title: Human nutrition

text: Traditionally, simple carbohydrates were believed to be absorbed quickly, and therefore raise blood-glucose levels more rapidly than complex carbohydrates. This is inaccurate. Some simple carbohydrates (e.g., fructose) follow different metabolic pathways (e.g., fructolysis) that result in only a partial catabolism to glucose, while, in essence, many complex carbohydrates may be digested at the same rate as simple carbohydrates. The World Health Organization recommends that added sugars should represent no more than 10% of total energy intake.


title: Human nutrition

text: The most common plant carbohydrate nutrient starch varies in its absorption. Starches have been classified as rapidly digestible starch, slowly digestible starch and resistant starch. Starches in plants are resistant to digestion (resistant starch), but cooking the starch in the presence of water can break down the starch granule and releases the glucose chains, making them more easily digestible by human digestive enzymes. Historically, food was less processed and starches were contained within the food matrix, making them less digestible. Modern food processing has shifted carbohydrate consumption from less digestible and resistant starch to much more rapidly digestible starch. For instance, the resistant starch content of a traditional African diet was 38 grams/day. The resistant starch consumption from countries with high starch intakes has been estimated to be 30-40 grams/day. In contrast, the average consumption of resistant starch in the United States was estimated to be 4.9 grams/day (range 2.8-7.9 grams of resistant starch/day).


title: Human nutrition

text: A molecule of dietary fat typically consists of several fatty acids (containing long chains of carbon and hydrogen atoms), bonded to a glycerol. They are typically found as triglycerides (three fatty acids attached to one glycerol backbone). Fats may be classified as saturated or unsaturated depending on the chemical structure of the fatty acids involved. Saturated fats have all of the carbon atoms in their fatty acid chains bonded to hydrogen atoms, whereas unsaturated fats have some of these carbon atoms double-bonded, so their molecules have relatively fewer hydrogen atoms than a saturated fatty acid of the same length. Unsaturated fats may be further classified as monounsaturated (one double-bond) or polyunsaturated (many double-bonds). Furthermore, depending on the location of the double-bond in the fatty acid chain, unsaturated fatty acids are classified as omega-3 or omega-6 fatty acids. Trans fats are a type of unsaturated fat with "trans"-isomer bonds; these are rare in nature and in foods from natural sources; they are typically created in an industrial process called (partial) hydrogenation. There are nine kilocalories in each gram of fat. Fatty acids such as conjugated linoleic acid, catalpic acid, eleostearic acid and punicic acid, in addition to providing energy, represent potent immune modulatory molecules.


title: Human nutrition

text: Saturated fats (typically from animal sources) have been a staple in many world cultures for millennia. Unsaturated fats (e. g., vegetable oil) are considered healthier, while trans fats are to be avoided. Saturated and some trans fats are typically solid at room temperature (such as butter or lard), while unsaturated fats are typically liquids (such as olive oil or flaxseed oil). Trans fats are very rare in nature, and have been shown to be highly detrimental to human health, but have properties useful in the food processing industry, such as rancidity resistance.


title: Human nutrition

text: Most fatty acids are non-essential, meaning the body can produce them as needed, generally from other fatty acids and always by expending energy to do so. However, in humans, at least two fatty acids are essential and must be included in the diet. An appropriate balance of essential fatty acids—omega-3 and omega-6 fatty acids—seems also important for health, although definitive experimental demonstration has been elusive. Both of these "omega" long-chain polyunsaturated fatty acids are substrates for a class of eicosanoids known as prostaglandins, which have roles throughout the human body.


title: Human nutrition

text: The omega-3 eicosapentaenoic acid (EPA), which can be made in the human body from the omega-3 essential fatty acid alpha-linolenic acid (ALA), or taken in through marine food sources, serves as a building block for series 3 prostaglandins (e.g., weakly inflammatory PGE3). The omega-6 dihomo-gamma-linolenic acid (DGLA) serves as a building block for series 1 prostaglandins (e.g. anti-inflammatory PGE1), whereas arachidonic acid (AA) serves as a building block for series 2 prostaglandins (e.g. pro-inflammatory PGE 2). Both DGLA and AA can be made from the omega-6 linoleic acid (LA) in the human body, or can be taken in directly through food. An appropriately balanced intake of omega-3 and omega-6 partly determines the relative production of different prostaglandins. In industrialized societies, people typically consume large amounts of processed vegetable oils, which have reduced amounts of the essential fatty acids along with too much of omega-6 fatty acids relative to omega-3 fatty acids.


title: Human nutrition

text: The conversion rate of omega-6 DGLA to AA largely determines the production of the prostaglandins PGE1 and PGE2. Omega-3 EPA prevents AA from being released from membranes, thereby skewing prostaglandin balance away from pro-inflammatory PGE2 (made from AA) toward anti-inflammatory PGE1 (made from DGLA). The conversion (desaturation) of DGLA to AA is controlled by the enzyme delta-5-desaturase, which in turn is controlled by hormones such as insulin (up-regulation) and glucagon (down-regulation).


title: Human nutrition

text: Dietary fiber is a carbohydrate, specifically a polysaccharide, which is incompletely absorbed in humans and in some animals. Like all carbohydrates, when it is metabolized, it can produce four Calories (kilocalories) of energy per gram, but in most circumstances, it accounts for less than that because of its limited absorption and digestibility.


title: Human nutrition

text: Whole grains, beans, and other legumes, fruits (especially plums, prunes, and figs), and vegetables are good sources of dietary fiber. Fiber has three primary mechanisms, which in general determine their health impact: bulking, viscosity and fermentation. Fiber provides bulk to the intestinal contents, and insoluble fiber facilitates peristalsis – the rhythmic muscular contractions of the intestines which move contents along the digestive tract. Some soluble and insoluble fibers produce a solution of high viscosity; this is essentially a gel, which slows the movement of food through the intestines. Fermentable fibers are used as food by the microbiome, mildly increasing bulk, and producing short-chain fatty acids and other metabolites, including vitamins, hormones, and glucose. One of these metabolites, butyrate, is important as an energy source for colon cells, and may improve metabolic syndrome.


title: Human nutrition

text: In 2016, the U.S. FDA approved a qualified health claim stating that resistant starch might reduce the risk of type 2 diabetes, but with qualifying language for product labels that only limited scientific evidence exists to support this claim. The FDA requires specific labeling language, such as the guideline concerning resistant starch: "High-amylose maize resistant starch may reduce the risk of type 2 diabetes. FDA has concluded that there is limited scientific evidence for this claim."


title: Human nutrition

text: Proteins are the basis of many animal body structures (e.g. muscles, skin, and hair) and form the enzymes that control chemical reactions throughout the body. Each protein molecule is composed of amino acids which contain nitrogen and sometimes sulphur (these components are responsible for the distinctive smell of burning protein, such as the keratin in hair). The body requires amino acids to produce new proteins (protein retention) and to replace damaged proteins (maintenance). Amino acids are soluble in the digestive juices within the small intestine, where they are absorbed into the blood. Once absorbed, they cannot be stored in the body, so they are either metabolized as required or excreted in the urine. Proteins consist of amino acids in different proportions. The most important aspect and defining characteristic of protein from a nutritional standpoint is its amino acid composition.


title: Human nutrition

text: For all animals, some amino acids are "essential" (an animal cannot produce them internally so they must be eaten) and some are "non-essential" (the animal can produce them from other nitrogen-containing compounds). About twenty amino acids are found in the human body, and about ten of these are essential. The synthesis of some amino acids can be limited under special pathophysiological conditions, such as prematurity in the infant or individuals in severe catabolic distress, and those are called conditionally essential.


title: Human nutrition

text: A diet that contains adequate amounts of amino acids (especially those that are essential) is particularly important in some situations: during early development and maturation, pregnancy, lactation, or injury (a burn, for instance). A complete protein source contains all the essential amino acids; an incomplete protein source lacks one or more of the essential amino acids. It is possible with protein combinations of two incomplete protein sources (e.g., rice and beans) to make a complete protein source, and characteristic combinations are the basis of distinct cultural cooking traditions. However, complementary sources of protein do not need to be eaten at the same meal to be used together by the body. Excess amino acids from protein can be converted into glucose and used for fuel through a process called gluconeogenesis.


title: Human nutrition

text: There is an ongoing debate about the differences in nutritional quality and adequacy of protein from vegan, vegetarian and animal sources, though many studies and institutions have found that a well-planned vegan or vegetarian diet contains enough high-quality protein to support the protein requirements of both sedentary and active people at all stages of life.


title: Human nutrition

text: Water is excreted from the body in multiple forms; including urine and feces, sweating, and by water vapour in the exhaled breath. Therefore, it is necessary to adequately rehydrate to replace lost fluids.


title: Human nutrition

text: Early recommendations for the quantity of water required for maintenance of good health suggested that six to eight glasses of water daily is the minimum to maintain proper hydration. However, the notion that a person should consume eight glasses of water per day cannot be traced to a credible scientific source. The original water intake recommendation in 1945 by the Food and Nutrition Board of the National Research Council read: "An ordinary standard for diverse persons is 1 milliliter for each calorie of food. Most of this quantity is contained in prepared foods." More recent comparisons of well-known recommendations on fluid intake have revealed large discrepancies in the volumes of water we need to consume for good health. Therefore, to help standardize guidelines, recommendations for water consumption are included in two recent European Food Safety Authority (EFSA) documents (2010): (i) Food-based dietary guidelines and (ii) Dietary reference values for water or adequate daily intakes (ADI). These specifications were provided by calculating adequate intakes from measured intakes in populations of individuals with "desirable osmolarity values of urine and desirable water volumes per energy unit consumed."


title: Human nutrition

text: For healthful hydration, the current EFSA guidelines recommend total water intakes of 2.0 L/day for adult females and 2.5 L/day for adult males. These reference values include water from drinking water, other beverages, and from food. About 80% of our daily water requirement comes from the beverages we drink, with the remaining 20% coming from food. Water content varies depending on the type of food consumed, with fruit and vegetables containing more than cereals, for example. These values are estimated using country-specific food balance sheets published by the Food and Agriculture Organisation of the United Nations.


title: Human nutrition

text: The EFSA panel also determined intakes for different populations. Recommended intake volumes in the elderly are the same as for adults as despite lower energy consumption, the water requirement of this group is increased due to a reduction in renal concentrating capacity. Pregnant and breastfeeding women require additional fluids to stay hydrated. The EFSA panel proposes that pregnant women should consume the same volume of water as non-pregnant women, plus an increase in proportion to the higher energy requirement, equal to 300 mL/day. To compensate for additional fluid output, breastfeeding women require an additional 700 mL/day above the recommended intake values for non-lactating women. Dehydration and over-hydration – too little and too much water, respectively – can have harmful consequences. Drinking too much water is one of the possible causes of hyponatremia, i.e., low serum sodium.


title: Human nutrition

text: Dietary minerals are inorganic chemical elements required by living organisms, other than the four elements carbon, hydrogen, nitrogen, and oxygen that are present in nearly all organic molecules. Some have roles as cofactors, while others are electrolytes. The term "mineral" is archaic, since the intent is to describe simply the less common elements in the diet. Some are heavier than the four just mentioned – including several metals, which often occur as ions in the body. Some dietitians recommend that these be supplied from foods in which they occur naturally, or at least as complex compounds, or sometimes even from natural inorganic sources (such as calcium carbonate from ground oyster shells). Some are absorbed much more readily in the ionic forms found in such sources. On the other hand, minerals are often artificially added to the diet as supplements; the most well-known is likely iodine in iodized salt which prevents goiter.


title: Human nutrition

text: Elements with recommended dietary allowance (RDA) greater than 150 mg/day are, in alphabetical order:


title: Human nutrition

text: Many elements are required in smaller amounts (microgram quantities), usually because they play a catalytic role in enzymes. Some trace mineral elements (RDA < 200 mg/day) are, in alphabetical order:


title: Human nutrition

text: Ultratrace minerals are an as yet unproven aspect of human nutrition, and may be required at amounts measured in very low ranges of μg/day. Many ultratrace elements have been suggested as essential, but such claims have usually not been confirmed. Definitive evidence for efficacy comes from the characterization of a biomolecule containing the element with an identifiable and testable function. These include:


title: Human nutrition

text: Except for vitamin D, vitamins are essential nutrients, necessary in the diet for good health. Vitamin D can be synthesized in the skin in the presence of UVB radiation. (Many animal species can synthesize vitamin C, but humans cannot.) Certain vitamin-like compounds that are recommended in the diet, such as carnitine, are thought useful for survival and health, but these are not "essential" dietary nutrients because the human body has some capacity to produce them from other compounds. Moreover, thousands of different phytochemicals have recently been discovered in food (particularly in fresh vegetables), which may have desirable properties including antioxidant activity (see below); experimental demonstration has been suggestive but inconclusive. Other essential nutrients not classed as vitamins include essential amino acids (see above), essential fatty acids (see above), and the minerals discussed in the preceding section.


title: Human nutrition

text: Vitamin deficiencies may result in disease conditions: goiter, scurvy, osteoporosis, impaired immune system, disorders of cell metabolism, certain forms of cancer, symptoms of premature aging, and poor psychological health (including eating disorders), among many others.


title: Human nutrition

text: Excess levels of some vitamins are also dangerous to health. The Food and Nutrition Board of the Institute of Medicine has established Tolerable Upper Intake Levels (ULs) for seven vitamins.


title: Human nutrition

text: In developed countries, the diseases of malnutrition are most often associated with nutritional imbalances or excessive consumption; there are more people in the world who are malnourished due to excessive consumption. According to the United Nations World Health Organization, the greatest challenge in developing nations today is not starvation, but insufficient nutrition – the lack of nutrients necessary for the growth and maintenance of vital functions. The causes of malnutrition are directly linked to inadequate macronutrient consumption and disease, and are indirectly linked to factors like "household food security, maternal and child care, health services, and the environment."


title: Human nutrition

text: The U.S. Food and Nutrition Board sets Estimated Average Requirements (EARs) and Recommended Dietary Allowances (RDAs) for vitamins and minerals. EARs and RDAs are part of Dietary Reference Intakes. The DRI documents describe nutrient deficiency signs and symptoms.


title: Human nutrition

text: The U.S. Food and Nutrition Board sets Tolerable Upper Intake Levels (known as ULs) for vitamins and minerals when evidence is sufficient. ULs are set a safe fraction below amounts shown to cause health problems. ULs are part of Dietary Reference Intakes. The European Food Safety Authority also reviews the same safety questions and set its own ULs.


title: Human nutrition

text: When too much of one or more nutrients is present in the diet to the exclusion of the proper amount of other nutrients, the diet is said to be unbalanced. High calorie food ingredients such as vegetable oils, sugar and alcohol are referred to as "empty calories" because they displace from the diet foods that also contain protein, vitamins, minerals and fiber.


title: Human nutrition

text: Pure ethanol provides 7 calories per gram. For distilled spirits, a standard serving in the United States is 1.5 fluid ounces, which at 40% ethanol (80 proof), would be 14 grams and 98 calories. Wine and beer contain a similar range of ethanol for servings of 5 ounces and 12 ounces, respectively, but these beverages also contain non-ethanol calories. A 5-ounce serving of wine contains 100 to 130 calories. A 12-ounce serving of beer contains 95 to 200 calories. According to the U.S. Department of Agriculture, based on NHANES 2013-2014 surveys, women ages 20 and up consume on average 6.8 grams/day and men consume on average 15.5 grams/day. Ignoring the non-alcohol contribution of those beverages, the average ethanol calorie contributions are 48 and 108 cal/day. Alcoholic beverages are considered empty calorie foods because other than calories, these contribute no essential nutrients.


title: Human nutrition

text: Phytochemicals such as polyphenols are compounds produced naturally in plants (phyto means "plant" in Greek). In general, the term identifies compounds that are prevalent in plant foods, but are not proven to be essential for human nutrition, as of 2018. There is no conclusive evidence in humans that polyphenols or other non-nutrient compounds from plants confer health benefits, mainly because these compounds have poor bioavailability, i.e., following ingestion, they are digested into smaller metabolites with unknown functions, then are rapidly eliminated from the body.


title: Human nutrition

text: While initial studies sought to reveal if dietary supplements might promote health, one meta-analysis concluded that supplementation with antioxidant vitamins A and E and beta-carotene did not convey any benefits, and may increase risk of death. Vitamin C and selenium supplements did not impact mortality rate. Health effect of non-nutrient phytochemicals such as polyphenols were not assessed in this review.


title: Human nutrition

text: The intestines contain a large population of gut flora. In humans, the four dominant phyla are Bacillota, Bacteroidota, Actinomycetota, and Pseudomonadota. They are essential to digestion and are also affected by food that is consumed. Bacteria are essential for metabolizing food substrates and thereby increasing energy output, and produce a great variety of metabolites, including vitamins and short-chain fatty acids that contribute to the metabolism in a wide variety of ways. These metabolites are responsible for stimulating cell growth, repressing the growth of harmful bacteria, priming the immune system to respond only to pathogens, helping to maintain a healthy gut barrier, control gene expression by epigenetic regulation and defending against some infectious diseases.


title: Human nutrition

text: The challenges facing global nutrition are disease, child malnutrition, obesity, and vitamin deficiency.


title: Human nutrition

text: The most common non-infectious diseases worldwide, that contribute most to the global mortality rate, are cardiovascular diseases, various cancers, diabetes, and chronic respiratory problems, all of which are linked to poor nutrition. Nutrition and diet are closely associated with the leading causes of death, including cardiovascular disease and cancer. Obesity and high sodium intake can contribute to ischemic heart disease, while consumption of fruits and vegetables can decrease the risk of developing cancer.


title: Human nutrition

text: Food-borne and infectious diseases can result in malnutrition, and malnutrition exacerbates infectious disease. Poor nutrition leaves children and adults more susceptible to contracting life-threatening diseases such as diarrheal infections and respiratory infections. According to the WHO, in 2011, 6.9 million children died of infectious diseases like pneumonia, diarrhea, malaria, and neonatal conditions, of which at least one third were associated with undernutrition.


title: Human nutrition

text: According to UNICEF, in 2011, 101 million children across the globe were underweight and one in four children, 165 million, were stunted in growth. Simultaneously, there are 43 million children under five who are overweight or obese. Nearly 20 million children under five suffer from severe acute malnutrition, a life-threatening condition requiring urgent treatment. According to estimations at UNICEF, hunger will be responsible for 5.6 million deaths of children under the age of five this year. These all represent significant public health emergencies. This is because proper maternal and child nutrition has immense consequences for survival, acute and chronic disease incidence, normal growth, and economic productivity of individuals.


title: Human nutrition

text: Childhood malnutrition is common and contributes to the global burden of disease. Childhood is a particularly important time to achieve good nutrition status, because poor nutrition has the capability to lock a child in a vicious cycle of disease susceptibility and recurring sickness, which threatens cognitive and social development. Undernutrition and bias in access to food and health services leaves children less likely to attend or perform well in school.


title: Human nutrition

text: UNICEF defines undernutrition "as the outcome of insufficient food intake (hunger) and repeated infectious diseases. Under nutrition includes being underweight for one's age, too short for one's age (stunted), dangerously thin (wasted), and deficient in vitamins and minerals (micronutrient malnutrient). Under nutrition causes 53% of deaths of children under five across the world. It has been estimated that undernutrition is the underlying cause for 35% of child deaths. The Maternal and Child Nutrition Study Group estimate that under nutrition, "including fetal growth restriction, stunting, wasting, deficiencies of vitamin A and zinc along with suboptimum breastfeeding—is a cause of 3.1 million child deaths and infant mortality, or 45% of all child deaths in 2011".


title: Human nutrition

text: When humans are undernourished, they no longer maintain normal bodily functions, such as growth, resistance to infection, or have satisfactory performance in school or work. Major causes of under nutrition in young children include lack of proper breast feeding for infants and illnesses such as diarrhea, pneumonia, malaria, and HIV/AIDS. According to UNICEF 146 million children across the globe, that one out of four under the age of five, are underweight. The number of underweight children has decreased since 1990, from 33 percent to 28 percent between 1990 and 2004. Underweight and stunted children are more susceptible to infection, more likely to fall behind in school, more likely to become overweight and develop non-infectious diseases, and ultimately earn less than their non-stunted coworkers. Therefore, undernutrition can accumulate deficiencies in health which results in less productive individuals and societies


title: Human nutrition

text: Many children are born with the inherent disadvantage of low birth weight, often caused by intrauterine growth restriction and poor maternal nutrition, which results in worse growth, development, and health throughout the course of their lifetime. Children born at low birthweight (less than 5.5 pounds or 2.5 kg), are less likely to be healthy and are more susceptible to disease and early death. Those born at low birthweight also are likely to have a depressed immune system, which can increase their chances of heart disease and diabetes later on in life. Because 96% of low birthweight occurs in the developing world, low birthweight is associated with being born to a mother in poverty with poor nutritional status that has had to perform demanding labor.


title: Human nutrition

text: Stunting and other forms of undernutrition reduces a child's chance of survival and hinders their optimal growth and health. Stunting has demonstrated association with poor brain development, which reduces cognitive ability, academic performance, and eventually earning potential. Important determinants of stunting include the quality and frequency of infant and child feeding, infectious disease susceptibility, and the mother's nutrition and health status. Undernourished mothers are more likely to birth stunted children, perpetuating a cycle of undernutrition and poverty. Stunted children are more likely to develop obesity and chronic diseases upon reaching adulthood. Therefore, malnutrition resulting in stunting can further worsen the obesity epidemic, especially in low and middle income countries. This creates even new economic and social challenges for vulnerable impoverished groups.


title: Human nutrition

text: Data on global and regional food supply shows that consumption rose from 2011 to 2012 in all regions. Diets became more diverse, with a decrease in consumption of cereals and roots and an increase in fruits, vegetables, and meat products. However, this increase masks the discrepancies between nations, where Africa, in particular, saw a decrease in food consumption over the same years. This information is derived from food balance sheets that reflect national food supplies, however, this does not necessarily reflect the distribution of micro and macronutrients. Often inequality in food access leaves distribution which uneven, resulting in undernourishment for some and obesity for others.


title: Human nutrition

text: Undernourishment, or hunger, according to the FAO, is dietary intake below the minimum daily energy requirement. The amount of undernourishment is calculated utilizing the average amount of food available for consumption, the size of the population, the relative disparities in access to the food, and the minimum calories required for each individual. According to FAO, 868 million people (12% of the global population) were undernourished in 2012. This has decreased across the world since 1990, in all regions except for Africa, where undernourishment has steadily increased. However, the rates of decrease are not sufficient to meet the first Millennium Development Goal of halving hunger between 1990 and 2015. The global financial, economic, and food price crisis in 2008 drove many people to hunger, especially women and children. The spike in food prices prevented many people from escaping poverty, because the poor spend a larger proportion of their income on food and farmers are net consumers of food. High food prices cause consumers to have less purchasing power and to substitute more-nutritious foods with low-cost alternatives.


title: Human nutrition

text: Malnutrition in industrialized nations is primarily due to excess calories and non-nutritious carbohydrates, which has contributed to the obesity epidemic affecting both developed and some developing nations. In 2008, 35% of adults above the age of 20 years were overweight (BMI ≥ 25 kg/m), a prevalence that has doubled worldwide between 1980 and 2008. Also 10% of men and 14% of women were obese, with a BMI greater than 30. Rates of overweight and obesity vary across the globe, with the highest prevalence in the Americas, followed by European nations, where over 50% of the population is overweight or obese.


title: Human nutrition

text: Obesity is more prevalent amongst high income and higher middle income groups than lower divisions of income. Women are more likely than men to be obese, where the rate of obesity in women doubled from 8% to 14% between 1980 and 2008. Being overweight as a child has become an increasingly important indicator for later development of obesity and non-infectious diseases such as heart disease. In several western European nations, the prevalence of overweight and obese children rose by 10% from 1980 to 1990, a rate that has begun to accelerate recently.


title: Human nutrition

text: Vitamins and minerals are essential to the proper functioning and maintenance of the human body. There are 20 trace elements and minerals that are essential in small quantities to body function and overall human health.


title: Human nutrition

text: Iron deficiency is the most common inadequate nutrient worldwide, affecting approximately 2 billion people. Globally, anemia affects 1.6 billion people, and represents a public health emergency in mothers and children under five. The World Health Organization estimates that there exists 469 million women of reproductive age and approximately 600 million preschool and school-age children worldwide who are anemic. Anemia, especially iron-deficient anemia, is a critical problem for cognitive developments in children, and its presence leads to maternal deaths and poor brain and motor development in children. The development of anemia affects mothers and children more because infants and children have higher iron requirements for growth. Health consequences for iron deficiency in young children include increased perinatal mortality, delayed mental and physical development, negative behavioral consequences, reduced auditory and visual function, and impaired physical performance. The harm caused by iron deficiency during child development cannot be reversed and result in reduced academic performance, poor physical work capacity, and decreased productivity in adulthood. Mothers are also very susceptible to iron-deficient anemia because women lose iron during menstruation, and rarely supplement it in their diet. Maternal iron deficiency anemia increases the chances of maternal mortality, contributing to at least 18% of maternal deaths in low and middle income countries.


title: Human nutrition

text: Vitamin A plays an essential role in developing the immune system in children, therefore, it is considered an essential micronutrient that can greatly affect health. However, because of the expense of testing for deficiencies, many developing nations have not been able to fully detect and address vitamin A deficiency, leaving vitamin A deficiency considered a silent hunger. According to estimates, subclinical vitamin A deficiency, characterized by low retinol levels, affects 190 million pre-school children and 19 million mothers worldwide.


title: Human nutrition

text: The WHO estimates that 5.2 million of these children under five are affected by night blindness, which is considered clinical vitamin A deficiency. Severe vitamin A deficiency (VAD) for developing children can result in visual impairments, anemia and weakened immunity, and increase their risk of morbidity and mortality from infectious disease. This also presents a problem for women, with WHO estimating that 9.8 million women are affected by night blindness. Clinical vitamin A deficiency is particularly common among pregnant women, with prevalence rates as high as 9.8% in South-East Asia.


title: Human nutrition

text: Estimates say that 28.5% of the global population is iodine deficient, representing 1.88 billion individuals. Although salt iodization programs have reduced the prevalence of iodine deficiency, this is still a public health concern in 32 nations. Moderate deficiencies are common in Europe and Africa, and over consumption is common in the Americas. Iodine-deficient diets can interfere with adequate thyroid hormone production, which is responsible for normal growth in the brain and nervous system. This ultimately leads to poor school performance and impaired intellectual capabilities.


title: Human nutrition

text: Improvement of breast feeding practices, like early initiation and exclusive breast feeding for the first two years of life, could save the lives of 1.5 million children annually. Nutrition interventions targeted at infants aged 0–5 months first encourages early initiation of breastfeeding. Though the relationship between early initiation of breast feeding and improved health outcomes has not been formally established, a recent study in Ghana suggests a causal relationship between early initiation and reduced infection-caused neo-natal deaths. Also, experts promote exclusive breastfeeding, rather than using formula, which has shown to promote optimal growth, development, and health of infants. Exclusive breastfeeding often indicates nutritional status because infants that consume breast milk are more likely to receive all adequate nourishment and nutrients that will aid their developing body and immune system. This leaves children less likely to contract diarrheal diseases and respiratory infections.


title: Human nutrition

text: Besides the quality and frequency of breastfeeding, the nutritional status of mothers affects infant health. When mothers do not receive proper nutrition, it threatens the wellness and potential of their children. Well-nourished women are less likely to experience risks of birth and are more likely to deliver children who will develop well physically and mentally. Maternal undernutrition increases the chances of low-birth weight, which can increase the risk of infections and asphyxia in fetuses, increasing the probability of neonatal deaths. Growth failure during intrauterine conditions, associated with improper mother nutrition, can contribute to lifelong health complications. Approximately 13 million children are born with intrauterine growth restriction annually.


title: Human nutrition

text: The lifetime prevalence of anorexia nervosa in women is 0.9%, with 19 years as the average age of onset. Although relatively uncommon, eating disorders can negatively affect menstruation, fertility, and maternal and fetal well-being. Among infertile women with amenorrhea or oligomenorrhea due to eating disorders, 58% had menstrual irregularities, according to preliminary research in 1990.


title: Human nutrition

text: The findings of the 2003 National Assessment of Adult Literacy (NAAL), conducted by the US Department of Education, provide a basis upon which to frame the nutrition literacy problem in the U.S. NAAL introduced the first-ever measure of "the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions" – an objective of Healthy People 2010 and of which nutrition literacy might be considered an important subset. On a scale of below basic, basic, intermediate and proficient, NAAL found 13 percent of adult Americans have proficient health literacy, 44% have intermediate literacy, 29 percent have basic literacy and 14 percent have below basic health literacy. The study found that health literacy increases with education and people living below the level of poverty have lower health literacy than those above it.


title: Human nutrition

text: Another study examining the health and nutrition literacy status of residents of the lower Mississippi Delta found that 52 percent of participants had a high likelihood of limited literacy skills. While a precise comparison between the NAAL and Delta studies is difficult, primarily because of methodological differences, Zoellner et al. suggest that health literacy rates in the Mississippi Delta region are different from the U.S. general population and that they help establish the scope of the problem of health literacy among adults in the Delta region. For example, only 12 percent of study participants identified the My Pyramid graphic two years after it had been launched by the USDA. The study also found significant relationships between nutrition literacy and income level and nutrition literacy and educational attainment further delineating priorities for the region.


title: Human nutrition

text: These statistics point to the complexities surrounding the lack of health/nutrition literacy and reveal the degree to which they are embedded in the social structure and interconnected with other problems. Among these problems are the lack of information about food choices, a lack of understanding of nutritional information and its application to individual circumstances, limited or difficult access to healthful foods, and a range of cultural influences and socioeconomic constraints such as low levels of education and high levels of poverty that decrease opportunities for healthful eating and living.


title: Human nutrition

text: The links between low health literacy and poor health outcomes has been widely documented and there is evidence that some interventions to improve health literacy have produced successful results in the primary care setting. More must be done to further our understanding of nutrition literacy specific interventions in non-primary care settings in order to achieve better health outcomes.


title: Human nutrition

text: According to UNICEF, South Asia has the highest levels of underweight children under five, followed by sub-Saharan Africans nations, with Industrialized countries and Latin nations having the lowest rates.


title: Human nutrition

text: In the US, dietitians are registered (RD) or licensed (LD) with the Commission for Dietetic Registration and the American Dietetic Association, and are only able to use the title "dietitian", as described by the business and professions codes of each respective state, when they have met specific educational and experiential prerequisites and passed a national registration or licensure examination, respectively. Anyone may call themselves a nutritionist, including unqualified dietitians, as this term is unregulated. Some states, such as the State of Florida, have begun to include the title "nutritionist" in state licensure requirements. Most governments provide guidance on nutrition, and some also impose mandatory disclosure/labeling requirements for processed food manufacturers and restaurants to assist consumers in complying with such guidance.


title: Human nutrition

text: In the US, nutritional standards and recommendations are established jointly by the US Department of Agriculture and US Department of Health and Human Services. Dietary and physical activity guidelines from the USDA are presented in the concept of a plate of food which in 2011 superseded the MyPyramid food pyramid that had replaced the Four Food Groups. The Senate committee currently responsible for oversight of the USDA is the "Agriculture, Nutrition and Forestry Committee". Committee hearings are often televised on C-SPAN. The U.S. Department of Health and Human Services provides a sample week-long menu which fulfills the nutritional recommendations of the government. Canada's Food Guide is another governmental recommendation.


title: Human nutrition

text: According to UNICEF, the Commonwealth of Independent States has the lowest rates of stunting and wasting, at 14 percent and 3 percent. The nations of Estonia, Finland, Iceland, Lithuania and Sweden have the lowest prevalence of low birthweight children in the world- at 4%. Proper prenatal nutrition is responsible for this small prevalence of low birthweight infants. However, low birthweight rates are increasing, due to the use of fertility drugs, resulting in multiple births, women bearing children at an older age, and the advancement of technology allowing more pre-term infants to survive. Industrialized nations more often face malnutrition in the form of over-nutrition from excess calories and non-nutritious carbohydrates, which has contributed greatly to the public health epidemic of obesity. Disparities, according to gender, geographic location and socio-economic position, both within and between countries, represent the biggest threat to child nutrition in industrialized countries. These disparities are a direct product of social inequalities and social inequalities are rising throughout the industrialized world, particularly in Europe.


title: Human nutrition

text: South Asia has the highest percentage and number of underweight children under five in the world, at approximately 78 million children. Patterns of stunting and wasting are similar, where 44% have not reached optimal height and 15% are wasted, rates much higher than any other regions. This region of the world has extremely high rates of underweight children. According to a 2006 UNICEF study, 46% of its child population under five is underweight. The same study indicates India, Bangladesh, and Pakistan combined account for half the globe's underweight child population. South Asian nations have made progress towards the MDGs, considering the rate has decreased from 53% since 1990, however, a 1.7% decrease of underweight prevalence per year will not be sufficient to meet the 2015 goal. Some nations, such as Afghanistan, Bangladesh, and Sri Lanka, on the other hand, have made significant improvements, all decreasing their prevalence by half in ten years. While India and Pakistan have made modest improvements, Nepal has made no significant improvement in underweight child prevalence. Other forms of undernutrition have continued to persist with high resistance to improvement, such as the prevalence of stunting and wasting, which has not changed significantly in the past 10 years. Causes of this poor nutrition include energy-insufficient diets, poor sanitation conditions, and the gender disparities in educational and social status. Girls and women face discrimination especially in nutrition status, where South Asia is the only region in the world where girls are more likely to be underweight than boys. In South Asia, 60% of children in the lowest quintile are underweight, compared to only 26% in the highest quintile, and the rate of reduction of underweight is slower amongst the poorest.


title: Human nutrition

text: The Eastern and Southern African nations have shown no improvement since 1990 in the rate of underweight children under five. They have also made no progress in halving hunger by 2015, the most prevalent Millennium Development Goal. This is due primarily to the prevalence of famine, declined agricultural productivity, food emergencies, drought, conflict, and increased poverty. This, along with HIV/AIDS, has inhibited the nutrition development of nations such as Lesotho, Malawi, Mozambique, Swaziland, Zambia and Zimbabwe. Botswana has made remarkable achievements in reducing underweight prevalence, dropping 4% in 4 years, despite its place as the second leader in HIV prevalence amongst adults in the globe. South Africa, the wealthiest nation in this region, has the second-lowest proportion of underweight children at 12%, but has been steadily increasing in underweight prevalence since 1995. Almost half of Ethiopian children are underweight, and along with Nigeria, they account for almost one-third of the underweight under five in all of Sub-Saharan Africa.


title: Human nutrition

text: West and Central Africa has the highest rate of children under five underweight in the world. Of the countries in this region, the Congo has the lowest rate at 14%, while the nations of Democratic Republic of the Congo, Ghana, Guinea, Mali, Nigeria, Senegal and Togo are improving slowly. In Gambia, rates decreased from 26% to 17% in four years, and their coverage of vitamin A supplementation reaches 91% of vulnerable populations. This region has the next highest proportion of wasted children, with 10% of the population under five not at optimal weight. Little improvement has been made between the years of 1990 and 2004 in reducing the rates of underweight children under five, whose rate stayed approximately the same. Sierra Leone has the highest child under five mortality rate in the world, due predominantly to its extreme infant mortality rate, at 238 deaths per 1000 live births. Other contributing factors include the high rate of low birthweight children (23%) and low levels of exclusive breast feeding (4%). Anemia is prevalent in these nations, with unacceptable rates of iron deficient anemia. The nutritional status of children is further indicated by its high (10%) rate of child wasting. Wasting is a significant problem in Sahelian countries – Burkina Faso, Chad, Mali, Mauritania and Niger – where rates fall between 11% and 19% of under fives, affecting more than 1 million children.


title: Human nutrition

text: In Mali, the International Crops Research Institute for the Semi-Arid Tropics (ICRISAT) and the Aga Khan Foundation trained women's groups to make "equinut", a healthy and nutritional version of the traditional recipe "di-dèguè" (comprising peanut paste, honey and millet or rice flour). The aim was to boost nutrition and livelihoods by producing a product that women could make and sell, and which would be accepted by the local community because of its local heritage.


title: Human nutrition

text: Six countries in the Middle East and North Africa region are on target to meet goals for reducing underweight children by 2015, and 12 countries have prevalence rates below 10%. However, the nutrition of children in the region as a whole has degraded for the past ten years due to the increasing portion of underweight children in three populous nations – Iraq, Sudan, and Yemen. Forty six percent of all children in Yemen are underweight, a percentage that has worsened by 4% since 1990. In Yemen, 53% of children under five are stunted and 32% are born at low birth weight. Sudan has an underweight prevalence of 41%, and the highest proportion of wasted children in the region at 16%. One percent of households in Sudan consume iodized salt. Iraq has also seen an increase in child underweight since 1990. Djibouti, Jordan, the Occupied Palestinian Territory (OPT), Oman, the Syrian Arab Republic and Tunisia are all projected to meet minimum nutrition goals, with OPT, Syrian AR, and Tunisia the fastest improving regions. This region demonstrates that undernutrition does not always improve with economic prosperity, where the United Arab Emirates, for example, despite being a wealthy nation, has similar child death rates due to malnutrition to those seen in Yemen.


title: Human nutrition

text: The East Asia and Pacific region has reached its goals on nutrition, in part due to the improvements contributed by China, the region's most populous country. China has reduced its underweight prevalence from 19 percent to 8 percent between 1990 and 2002. China played the largest role in the world in decreasing the rate of children under five underweight between 1990 and 2004, halving the prevalence. This reduction of underweight prevalence has aided in the lowering of the under 5 mortality rate from 49 to 31 of 1000. They also have a low birthweight rate at 4%, a rate comparable to industrialized countries, and over 90% of households receive adequate iodized salts. However, large disparities exist between children in rural and urban areas, where 5 provinces in China leave 1.5 million children iodine deficient and susceptible to diseases. Singapore, Vietnam, Malaysia, and Indonesia are all projected to reach nutrition MDGs. Singapore has the lowest under five mortality rate of any nation, besides Iceland, in the world, at 3%. Cambodia has the highest rate of child mortality in the region (141 per 1,000 live births), while still its proportion of underweight children increased by 5 percent to 45% in 2000. Further nutrient indicators show that only 12 per cent of Cambodian babies are exclusively breastfed and only 14 per cent of households consume iodized salt.


title: Human nutrition

text: This region has undergone the fastest progress in decreasing poor nutrition status of children in the world. The Latin American region has reduced underweight children prevalence by 3.8% every year between 1990 and 2004, with a current rate of 7% underweight. They also have the lowest rate of child mortality in the developing world, with only 31 per 1000 deaths, and the highest iodine consumption. Cuba has seen improvement from 9 to 4 percent underweight under 5 between 1996 and 2004. The prevalence has also decreased in the Dominican Republic, Jamaica, Peru, and Chile. Chile has a rate of underweight under 5, at merely 1%. The most populous nations, Brazil and Mexico, mostly have relatively low rates of underweight under 5, with only 6% and 8%. Guatemala has the highest percentage of underweight and stunted children in the region, with rates above 45%. There are disparities amongst different populations in this region. For example, children in rural areas have twice the prevalence of underweight at 13%, compared to urban areas at 5%.


title: Human nutrition

text: Occurring throughout the world, lack of proper nutrition is both a consequence and cause of poverty. Impoverished individuals are less likely to have access to nutritious food and to escape from poverty than those who have healthy diets. Disparities in socioeconomic status, both between and within nations, provide the largest threat to child nutrition in industrialized nations, where social inequality is on the rise. According to UNICEF, children living in the poorest households are twice as likely to be underweight as those in the richest. Those in the lowest wealth quintile and whose mothers have the least education demonstrate the highest rates of child mortality and stunting. Throughout the developing world, socioeconomic inequality in childhood malnutrition is more severe than in upper income brackets, regardless of the general rate of malnutrition.


title: Human nutrition

text: According to UNICEF, children in rural locations are more than twice as likely to be underweight as compared to children under five in urban areas. In Latin American/Caribbean nations, "Children living in rural areas in Bolivia, Honduras, Mexico and Nicaragua are more than twice as likely to be underweight as children living in urban areas. That likelihood doubles to four times in Peru." Concurrently, the greatest increase in childhood obesity has been seen in the lower middle income bracket.


title: Human nutrition

text: In the United States, the incidence of low birthweight is on the rise among all populations, but particularly among minorities.


title: Human nutrition

text: According to UNICEF, boys and girls have almost identical rates as underweight children under age 5 across the world, except in South Asia.


title: Human nutrition

text: Nutrition directly influences progress towards meeting the Millennium Goals of eradicating hunger and poverty through health and education. Therefore, nutrition interventions take a multi-faceted approach to improve the nutrition status of various populations. Policy and programming must target both individual behavioral changes and policy approaches to public health. While most nutrition interventions focus on delivery through the health-sector, non-health sector interventions targeting agriculture, water and sanitation, and education are important as well. Global nutrition micro-nutrient deficiencies often receive large-scale solution approaches by deploying large governmental and non-governmental organizations. For example, in 1990, iodine deficiency was particularly prevalent, with one in five households, or 1.7 billion people, not consuming adequate iodine, leaving them at risk to develop associated diseases. Therefore, a global campaign to iodize salt to eliminate iodine deficiency successfully boosted the rate to 69% of households in the world consuming adequate amounts of iodine.


title: Human nutrition

text: Emergencies and crises often exacerbate undernutrition, due to the aftermath of crises that include food insecurity, poor health resources, unhealthy environments, and poor healthcare practices. Therefore, the repercussions of natural disasters and other emergencies can exponentially increase the rates of macro and micronutrient deficiencies in populations. Disaster relief interventions often take a multi-faceted public health approach. UNICEF's programming targeting nutrition services amongst disaster settings include nutrition assessments, measles immunization, vitamin A supplementation, provision of fortified foods and micronutrient supplements, support for breastfeeding and complementary feeding for infants and young children, and therapeutic and supplementary feeding. For example, during Nigeria's food crisis of 2005, 300,000 children received therapeutic nutrition feeding programs through the collaboration of UNICEF, the Niger government, the World Food Programme, and 24 NGOs utilizing community and facility based feeding schemes.


title: Human nutrition

text: Interventions aimed at pregnant women, infants, and children take a behavioral and program-based approach. Behavioral intervention objectives include promoting proper breast-feeding, the immediate initiation of breastfeeding, and its continuation through 2 years and beyond. UNICEF recognizes that to promote these behaviors, healthful environments must be established conducive to promoting these behaviors, like healthy hospital environments, skilled health workers, support in the public and workplace, and removing negative influences. Finally, other interventions include provisions of adequate micro and macro nutrients such as iron, anemia, and vitamin A supplements and vitamin-fortified foods and ready-to-use products. Programs addressing micro-nutrient deficiencies, such as those aimed at anemia, have attempted to provide iron supplementation to pregnant and lactating women. However, because supplementation often occurs too late, these programs have had little effect. Interventions such as women's nutrition, early and exclusive breastfeeding, appropriate complementary food and micronutrient supplementation have proven to reduce stunting and other manifestations of undernutrition. A Cochrane review of community-based maternal health packages showed that this community-based approach improved the initiation of breastfeeding within one hour of birth. Some programs have had adverse effects. One example is the "Formula for Oil" relief program in Iraq, which resulted in the replacement of breastfeeding for formula, which has negatively affected infant nutrition.


title: Human nutrition

text: In April 2010, the World Bank and the IMF released a policy briefing entitled "Scaling up Nutrition (SUN): A Framework for action" that represented a partnered effort to address the Lancet's Series on under nutrition, and the goals it set out for improving under nutrition. They emphasized the 1000 days after birth as the prime window for effective nutrition intervention, encouraging programming that was cost-effective and showed significant cognitive improvement in populations, as well as enhanced productivity and economic growth. This document was labeled the SUN framework, and was launched by the UN General Assembly in 2010 as a road map encouraging the coherence of stakeholders like governments, academia, UN system organizations and foundations in working towards reducing under nutrition. The SUN framework has initiated a transformation in global nutrition- calling for country-based nutrition programs, increasing evidence based and cost–effective interventions, and "integrating nutrition within national strategies for gender equality, agriculture, food security, social protection, education, water supply, sanitation, and health care". Government often plays a role in implementing nutrition programs through policy. For instance, several East Asian nations have enacted legislation to increase iodization of salt to increase household consumption. Political commitment in the form of evidence-based effective national policies and programs, trained skilled community nutrition workers, and effective communication and advocacy can all work to decrease malnutrition. Market and industrial production can play a role as well. For example, in the Philippines, improved production and market availability of iodized salt increased household consumption. While most nutrition interventions are delivered directly through governments and health services, other sectors, such as agriculture, water and sanitation, and education, are vital for nutrition promotion as well.


title: Human nutrition

text: Canada's Food Guide is an example of a government-run nutrition program. Produced by Health Canada, the guide advises food quantities, provides education on balanced nutrition, and promotes physical activity in accordance with government-mandated nutrient needs. Like other nutrition programs around the world, Canada's Food Guide divides nutrition into four main food groups: vegetables and fruit, grain products, milk and alternatives, and meat and alternatives. Unlike its American counterpart, the Canadian guide references and provides alternative to meat and dairy, which can be attributed to the growing vegan and vegetarian movements.


title: Human nutrition

text: In the US, nutritional standards and recommendations are established jointly by the US Department of Agriculture and US Department of Health and Human Services (HHS) and these recommendations are published as the Dietary Guidelines for Americans. Dietary and physical activity guidelines from the USDA are presented in the concept of MyPlate, which superseded the food pyramid, which replaced the Four Food Groups. The Senate committee currently responsible for oversight of the USDA is the "Agriculture, Nutrition and Forestry Committee". Committee hearings are often televised on C-SPAN. The U.S. HHS provides a sample week-long menu that fulfills the nutritional recommendations of the government.


title: Human nutrition

text: Governmental organisations have been working on nutrition literacy interventions in non-primary health care settings to address the nutrition information problem in the U.S. Some programs include:


title: Human nutrition

text: The Family Nutrition Program (FNP) is a free nutrition education program serving low-income adults around the U.S. This program is funded by the Food Nutrition Service's (FNS) branch of the United States Department of Agriculture (USDA) usually through a local state academic institution that runs the program. The FNP has developed a series of tools to help families participating in the Food Stamp Program stretch their food dollar and form healthful eating habits including nutrition education.


title: Human nutrition

text: Expanded Food and Nutrition Education Program (ENFEP) is a unique program that currently operates in all 50 states and in American Samoa, Guam, Micronesia, Northern Marianas, Puerto Rico, and the Virgin Islands. It is designed to assist limited-resource audiences in acquiring the knowledge, skills, attitudes, and changed behavior necessary for nutritionally sound diets, and to contribute to their personal development and the improvement of the total family diet and nutritional well-being.


title: Human nutrition

text: An example of a state initiative to promote nutrition literacy is Smart Bodies, a public-private partnership between the state's largest university system and largest health insurer, Louisiana State Agricultural Center and Blue Cross and Blue Shield of Louisiana Foundation. Launched in 2005, this program promotes lifelong healthful eating patterns and physically active lifestyles for children and their families. It is an interactive educational program designed to help prevent childhood obesity through classroom activities that teach children healthful eating habits and physical exercise.


title: Human nutrition

text: Nutrition is taught in schools in many countries. In England and Wales, the Personal and Social Education and Food Technology curricula include nutrition, stressing the importance of a balanced diet and teaching how to read nutrition labels on packaging. In many schools, a Nutrition class will fall within the Family and Consumer Science (FCS) or Health departments. In some American schools, students are required to take a certain number of FCS or Health related classes. Nutrition is offered at many schools, and, if it is not a class of its own, nutrition is included in other FCS or Health classes such as: Life Skills, Independent Living, Single Survival, Freshmen Connection, Health etc. In many Nutrition classes, students learn about the food groups, the food pyramid, Daily Recommended Allowances, calories, vitamins, minerals, malnutrition, physical activity, healthful food choices, portion sizes, and how to live a healthy life.


title: Human nutrition

text: A 1985 US National Research Council report entitled "Nutrition Education in US Medical Schools" concluded that nutrition education in medical schools was inadequate. Only 20% of the schools surveyed taught nutrition as a separate, required course. A 2006 survey found that this number had risen to 30%. Membership by physicians in leading professional nutrition societies such as the American Society for Nutrition has generally declined from the 1990s.


title: Human nutrition

text: In the US, Registered dietitian nutritionists (RDs or RDNs) are health professionals qualified to provide safe, evidence-based dietary advice which includes a review of what is eaten, a thorough review of nutritional health, and a personalized nutritional treatment plan through dieting. They also provide preventive and therapeutic programs at work places, schools and similar institutions. Certified Clinical Nutritionists or CCNs, are trained health professionals who also offer dietary advice on the role of nutrition in chronic disease, including possible prevention or remediation by addressing nutritional deficiencies before resorting to drugs. Government regulation especially in terms of licensing, is currently less universal for the CCN than that of RD or RDN. Another advanced Nutrition Professional is a Certified Nutrition Specialist or CNS. These Board Certified Nutritionists typically specialize in obesity and chronic disease. In order to become board certified, potential CNS candidate must pass an examination, much like Registered Dieticians. This exam covers specific domains within the health sphere including; Clinical Intervention and Human Health. The National Board of Physician Nutrition Specialists offers board certification for physicians practicing nutrition medicine.


title: Human nutrition

text: The protein requirement for each individual differs, as do opinions about whether and to what extent physically active people require more protein. The 2005 Recommended Dietary Allowances (RDA), aimed at the general healthy adult population, provide for an intake of 0.8 grams of protein per kilogram of body weight. A review panel stating that "no additional dietary protein is suggested for healthy adults undertaking resistance or endurance exercise."


title: Human nutrition

text: The main fuel used by the body during exercise is carbohydrates, which is stored in muscle as glycogen – a form of sugar. During exercise, muscle glycogen reserves can be used up, especially when activities last longer than 90 min.


title: Human nutrition

text: Adequate nutrition is essential for the growth of children from infancy right through until adolescence. Some nutrients are specifically required for growth on top of nutrients required for normal body maintenance, in particular calcium and iron.


title: Human nutrition

text: Malnutrition in general is higher among the elderly, but has different aspects in developed and undeveloped countries.


title: Human nutrition

text: Early human nutrition was largely determined by the availability and palatability of foods. Humans evolved as omnivorous hunter-gatherers, though the diet of humans has varied significantly depending on location and climate. The diet in the tropics tended to depend more heavily on plant foods, while the diet at higher latitudes tended more towards animal products. Analyses of postcranial and cranial remains of humans and animals from the Neolithic, along with detailed bone-modification studies, have shown that cannibalism also occurred among prehistoric humans.


title: Human nutrition

text: Agriculture developed at different times in different places, starting about 11,500 years ago, providing some cultures with a more abundant supply of grains (such as wheat, rice and maize) and potatoes; and originating staples such as bread, pasta dough, and tortillas. The domestication of animals provided some cultures with milk and dairy products.


title: Human nutrition

text: In 2020, archeological research discovered a frescoed thermopolium (a fast-food counter) in an exceptional state of preservation from 79 in Pompeii, including 2,000-year-old foods available in some of the deep terra cotta jars.


title: Human nutrition

text: During classical antiquity, diets consisted of simple fresh or preserved whole foods that were either locally grown or transported from neighboring areas during times of crisis.


title: Human nutrition

text: Since the Industrial Revolution in the 18th and 19th century, the food processing industry has invented many technologies that both help keep foods fresh longer and alter the fresh state of food as they appear in nature. Cooling and freezing are primary technologies used to maintain freshness, whereas many more technologies have been invented to allow foods to last longer without becoming spoiled. These latter technologies include pasteurisation, autoclavation, drying, salting, and separation of various components, all of which appearing to alter the original nutritional contents of food. Pasteurisation and autoclavation (heating techniques) have no doubt improved the safety of many common foods, preventing epidemics of bacterial infection.


title: Human nutrition

text: Modern separation techniques such as milling, centrifugation, and pressing have enabled concentration of particular components of food, yielding flour, oils, juices, and so on, and even separate fatty acids, amino acids, vitamins, and minerals. Inevitably, such large-scale concentration changes the nutritional content of food, saving certain nutrients while removing others. Heating techniques may also reduce the content of many heat-labile nutrients such as certain vitamins and phytochemicals, and possibly other yet-to-be-discovered substances.


title: Human nutrition

text: Because of reduced nutritional value, processed foods are often enriched or fortified with some of the most critical nutrients (usually certain vitamins) that were lost during processing. Nonetheless, processed foods tend to have an inferior nutritional profile compared to whole, fresh foods, regarding content of both sugar and high GI starches, potassium/sodium, vitamins, fiber, and of intact, unoxidized (essential) fatty acids. In addition, processed foods often contain potentially harmful substances such as oxidized fats and trans fatty acids.


title: Human nutrition

text: A dramatic example of the effect of food processing on a population's health is the history of epidemics of beri-beri in people subsisting on polished rice. Removing the outer layer of rice by polishing it removes with it the essential vitamin thiamine, causing beri-beri. Another example is the development of scurvy among infants in the late 19th century in the United States. It turned out that the vast majority of those affected were being fed milk that had been heat-treated (as suggested by Pasteur) to control bacterial disease. Pasteurisation was effective against bacteria, but it destroyed the vitamin C.


title: Human nutrition

text: Around 3000 BC the Vedic texts made mention of scientific research on nutrition. The first recorded dietary advice, carved into a Babylonian stone tablet in about 2500 BC, cautioned those with pain inside to avoid eating onions for three days. Scurvy, later found to be a vitamin C deficiency, was first described in 1500 BC in the Ebers Papyrus.


title: Human nutrition

text: According to Walter Gratzer, the study of nutrition probably began during the 6th century BC. In China, the concept of "qi" developed, a spirit or "wind" similar to what Western Europeans later called "pneuma". Food was classified into "hot" (for example, meats, blood, ginger, and hot spices) and "cold" (green vegetables) in China, India, Malaya, and Persia. "Humours" developed perhaps first in China alongside "qi". Ho the Physician concluded that diseases are caused by deficiencies of elements (Wu Xing: fire, water, earth, wood, and metal), and he classified diseases as well as prescribed diets. About the same time in Italy, Alcmaeon of Croton (a Greek) wrote of the importance of equilibrium between what goes in and what goes out, and warned that imbalance would result in disease marked by obesity or emaciation.


title: Human nutrition

text: Around 475 BC, Anaxagoras wrote that food is absorbed by the human body and, therefore, contains "homeomerics" (generative components), suggesting the existence of nutrients. Around 400 BC, Hippocrates, who recognized and was concerned with obesity, which may have been common in southern Europe at the time, said, "Let food be your medicine and medicine be your food." The works that are still attributed to him, "Corpus Hippocraticum", called for moderation and emphasized exercise.


title: Human nutrition

text: Salt, pepper and other spices were prescribed for various ailments in various preparations for example mixed with vinegar. In the 2nd century BC, Cato the Elder believed that cabbage (or the urine of cabbage-eaters) could cure digestive diseases, ulcers, warts, and intoxication. Living about the turn of the millennium, Aulus Celsus, an ancient Roman doctor, believed in "strong" and "weak" foods (bread for example was strong, as were older animals and vegetables).


title: Human nutrition

text: The Book of Daniel, dated to the second century BC, contains a description of a comparison in health of captured people following Jewish dietary laws versus the diet of the soldiers of the king of Babylon. (The story may be legendary rather than historical.)


title: Human nutrition

text: Galen was physician to gladiators in Pergamon, and in Rome, physician to Marcus Aurelius and the three emperors who succeeded him.