Drop of Life

A person can live without food for three weeks, but only three days without water.

Water is vital to the metabolic process, aiding in the digestion, absorption, and transportation of nutrients in the body. The recommended daily water intake is eight
glasses of water or about two liters. This, however, is just the minimum. Depending on the activity, location, and temperature in the area, a person may actually need more than that.

Unfortunately, water scarcity affects four in ten people and the World Health Organization predicts that the number of affected people may rise given the growing global population. While much of the earth is surrounded with water, only three percent are considered freshwater; the rest are too saline for human consumption.

Agricultural demand for water
There are varied factors for the depletion of water sources, including climate change and environmental degradation, but a major culprit was agriculture. With about 70 percent of the world’s water supply consumed by the agriculture sector, it is easy to see why. In the Asia-Pacific region alone, 81.3 percent of freshwater is utilized for agricultural purposes.

While potable drinking water is a key element in nutrition, the paradox is that huge amount of it is required by the agricultural industry to produce food items. Increased agricultural output has been at the forefront of the global fi ght against food insecurity. As the demand for food rises, so is the demand for water needed to
produce these items. While the daily water requirement for each individual is just about two to four liters, the amount of water needed to produce a person’s daily food
requirement ranges from 2,000 to 5,000 liters.

The solution to this problem is not to limit agricultural output, but rather the adoption of sustainable farming practices, as well as a change in food consumption pattern.

When it comes to food consumption pattern, there is a global shift to a meat-based diet, which means more water is needed to produce meat product. As a comparison, producing a kilo of wheat requires about 1000 liters of water. A kilo of meat, on the other hand, requires fi ve to ten times more water to produce.

The next conflict point?
In Tajikistan, people in the town of Taboshar are leaving the community due to acute water shortage, with the local water agency hardly able to meet even just 15 percent of the town’s water needs.

There are two confl icting views on whether water may be the next fl ash points for geo-political confl icts. The US Central Intelligence Agency is but one of the groups
predicting that this might very well be the case; after all, the UNESCO said that one-third of 262 international river basins are shared by two or more countries.

In the Middle East, five countries are sharing the Jordan River basin: Israel, Palestine, Jordan, Lebanon, and Syria. In 2001, tension erupted between Lebanon and Israel when the former attempted to build a pipeline on the Wassani River, which contributes 150 cubic meter of water to the Jordan River. Only the timely intervention of the international community prevented the tension from escalating.

Although there is no major war fought over the control of a water source, there have been periodic clashes, which tend to be localized. In 2000, Chinese police and farmers in Shandong province clashed over the planned diversion of irrigation water to cities and industries.

The other view is more circumspect; water is so vital that nations would benefit more from cooperation in the management of a water source, rather than fi ghting a war for its absolute control.

Prof. Asit Bikwas, a 2006 Stockholm Water Prize awardee, argued that the main issue is not really water scarcity but “bad water management.” He is not alone in this assessment. In the book “Water, a shared responsibility,” the UNESCO – World Water Assessment Programme, acknowledges that “the problem we face today is largely one of governance: equitably sharing this water while ensuring the sustainability of natural ecosystems. At this point in time, we have not yet achieved this balance.”

Addressing the threat of a global water shortage does provide a glimmer of hope, with countries willing to sit down and come up with a compromise on how to better
share a water source. However, it also highlights once more the vulnerability of the poor.

Indeed, when it comes to water allocation, the poor, as always, are left holding an empty jerry can.


Source: Health Alert Asia Pacific, Issue 13, 2008

The pangs of hidden hunger

Micronutrients defi ciency is another indicator of poor nutritional status, and is one that cuts across economic class. Iodine defi ciency, for instance, is a continuing problem even in the affl uent European continent. A 2004 estimate showed that 20 percent of the global population at risk of iodine defi ciency reside in the region.

According to Unicef, for every four persons in the planet, one is suffering from micronutrients defi ciency. The health impacts of micronutrients defi ciency are varied and can be quite staggering: blindness, mental retardation, and even death, particularly for anemic pregnant women.

Iron deficiency
The World Health Organization characterized iron deficiency as “the most common and widespread nutritional disorder in the world.” Establishing the exact magnitude of the problem is hard, but since iron defi ciency is closely tied to anemia, the global prevalence of iron deficiency anemia (IDA) is used as a proxy indicator. IDA is a key indicator of a country’s maternal and child health, and its prevalence refl ects socio-economic disparity: in developing countries, 52 percent of pregnant women are affected with IDA, while the fi gure is down to 23 percent of pregnant women in developed countries.

While the general population is at risk, a new study published at the Pediatrics Journal showed that overweight children are more than twice as likely to have iron deficiency than children with normal body weight. Iodine deficiency A 1994 study showed that there was a drop of up to 13.5 points in the intelligent quotient of populations living in areas with severe iodine defi ciency, as compared to the
population of non-iodine defi cient areas.

The land-locked region of Central Asia is particularly vulnerable to iodine defi ciency due to its mountainous terrain. UNICEF nutrition specialist Arnold Timmer
attributes the depletion of iodine in the region’s soil to erosion and rainfall. The collapse of the Soviet Union, which used to supply the region with iodized salt, added to the problem.

A 2004 study in Uzbekistan showed that prevalence of goiter – an indicator of iodine defi ciency – was 49.6 percent for children and 41.6 percent for adults. Kazakhstan, meanwhile, had a goiter prevalence of 56.5 percent.

Vitamin A deficiency (VAD)
An estimated 21 percent of children worldwide are Vitamin A-defi cient, with the highest concentration located in Asia and Africa. On top of causing blindness, VAD also increases a child’s susceptibility to malaria and diarrhea. Food fortification and breastfeeding The international community is responding to the problem with the adoption of two key strategies: the promotion of breastfeeding and food fortification. Breast milk contains all the essential nutrients needed for a baby’s full development. However, there is still a low adoption of exclusive breastfeeding particularly in poor regions.

With regards to food fortification, it is undeniably a costeffective way of combating micronutrients defi ciency. The Central Asian region’s adoption of salt iodization program has effectively reduced, if not totally eliminated the prevalence of iodine deficiency. Food fortification is indeed effi cient, but policymakers must not make this the major cornerstone of their micronutrients program. Food manufacturers have jumped in on the fortifi cation bandwagon, with the market for fortified foods expected to grow by an average of 10.1 percent between 2005 and 2012. While some of these manufacturers are really driven by a sense of responsibility, governments must still exercise some caution.

The Philippines, for instance, has a Sangkap Pinoy program where food fortifi ed with micronutrients are given a seal. But here lies the problem: some of the products
bearing the Sangkap Pinoy seal are junk foods. Another thing to be considered is economics. Even if fortifi ed foods are readily available, do the people have the means to buy these items?

Sources:
Eliminating Iodine Deficiency in Central Eastern Europe,Commonwealth Independent States and the Baltics by Arnold Timmer. http://www.iccidd.org/media/IDD%20Newsletter/1991-2006/nov2004.htm#g

Iodine deficiency in Europe: a continuing problem. Published by the WHO and UNICEF. http://www.who.int/nutrition/publications/VMNIS_Iodine_defi ciency_in_Europe.pdf

Assessment of Iodine deficiency disorders and monitoring their elimination: A guide to program managers, third edition. Published by the WHO, UNICEF and ICCIDD. http://whqlibdoc.who.int/publications/2007/9789241595827_eng.pdf

http://www.who.int/rhl/pregnancy_childbirth/medical/anaemia/cfcom/en/

http://www.nutraingredients.com/Industry/Vitamin-enrichedfoods-growing-faster-in-SE-Asia-than-Europe8

Obesity in the Asia-Pacific Region

With much of the focus resting on under-nutrition and micronutrients defi ciency, it is easy to dismiss obesity as nothing but a disease peculiar to affl uent nations. However, experts warned that obesity is reaching an epidemic proportion, and should thus be treated as a valid health concern.

Consider these statistics: in 2005, 1.6 billion adults over the age of 15 are overweight and at least 400 million of this number is obese. By 2015, the World Health Organization calculates the number of overweight adults to increase to 2.3 billion, with 700 million of them clinically obese. Each year at least 2.6 million people die from health complications resulting from all the excessive weight.

Read more »

A wake-up call for a return to nutrition basics

More than 800 million people, or about 13 percent of the global population, are classifi ed as undernourished. The defi ciency in essential nutrients is said to be the underlying cause of an estimated 3.5 million deaths each year, mostly in young children and pregnant women. Under-nutrition among pregnant women in developing
countries is reported to lead to one out of six infants born with low birth weight.

In Malaysia, diabetes has reached very alarming proportions. In the first National
Health and Morbidity Survey (NHMS)carried out in 1986, the prevalence of diabetes was 6.3 percent. Just ten years later this figure increased to 8.3 percent. Now, based on the latest NHMS III, conducted in 2006, diabetes prevalence has increased to 14.9 percent.

Diabetes Type II is strongly linked to high sugar consumption and obesity.

Nutrition can be defi ned as the process of taking in the substances needed to nourish and support life and growth. Access to nutritious food is a key element in
achieving a well-balanced nutrition. But as the world becomes more dependent on artifi cially processed food, balanced nutrition is compromised, resulting in chronic
health problems. Worsening the problem is the addition of toxic chemicals on essential food products.

Tainted milk
The recent scandal where four children in China died following the consumption of baby formula milk contaminated with the toxic chemical known as melamine should serve as a wake-up call.

Melamine, used as an ingredient in the manufacture of some plastics and fertilizers, has found its way into food products such as infant formula and confectionaries. It
is abhorrent that melamine has been deliberately added to milk to give the false
impression of higher levels of protein than actually exists.

Authorities try to allay the fears of the public by announcing that the levels of melamine in certain foods are within “permissible levels”. This term should be questioned.

Melamine is a synthetic chemical. It does not occur naturally in food. Should permissible levels be set for substances that are not naturally occurring in food?
By law, there should be a zero tolerance for melamine, as well as other synthetic toxic chemicals in food, rather than waiting for all the evidence to come in, which might be too late – when harm has already been done.

There is the danger of the cumulative doses or ingestions that enhance the harm posed by such chemicals. Furthermore, the full effects of chemicals not meant for humans may not have been studied fully, and for over a suffi ciently long period of time. It is not ethical to conduct such tests on people. In cases such as these, the *Precautionary Principle should be applied and the consumption of this chemical should be fully avoided.

In the case of infants, breast milk is the safest and healthiest choice – fully for the fi rst six months, and thereafter as a complement to solid foods right up to at
least two years. Governments and the community as a whole would need to make a commitment to move in this direction and create a supportive environment.

Buyers beware
Overall, the Consumer Association of Penang (CAP) believes that it is timely for people to move away from eating so much artifi cially-processed foods, and instead
move towards natural healthy produce and home-cooked meals. There are countless additives included in many of the highly-processed foods in the market. Foods are altered so far from their original state. We did not require all these artificial additives at one time. If really needed, there are numerous natural substances such as natural colours or flavours that can be used for food. We do not see that it is possible for the public to take any realistic precautions themselves when it comes to
products on the shelves as it is impossible for people to know which foods contain dangerous chemicals. At the very least, food manufacturers should be required
to list the common names of all additives, such as preservatives, coloring, fl avors, flavor enhancers, antioxidants and conditioners, on the food labels and outer
packaging - as opposed to using numerical or alphabet codes or merely using phrases such as “Permitted Coloring” or “Permitted Conditioners” under the ingredients list. Information on the concentrations of these additives should also be provided.

The excuse sometimes given is that there is not enough space on the food label. We ask - should there be so many additives in a product that the information cannot even fit on a label, and should this be permitted by the authorities?

In view of the rise of critical chronic diseases such as heart disease, diabetes, obesity and high blood pressure, the information on salt, sugar, saturated fats and trans fats should be listed on current food labels. These particular components should be separated out from the general “Nutrition facts” or “Nutritional Labelling” so that the public is not lulled into a false sense of security. Rather, the attention of consumers can be immediately drawn towards taking special note of these ingredients that are linked to adverse health outcomes.

In view of our country’s alarming diabetic rates, which are only expected to worsen over the coming years, CAP believes that much more needs to be done, and with greater sense of urgency. Firm action needs to be taken against the numerous sweets and confectionaries that have fl ooded the market. These products that are being marketed to children are not conducive to health. They contain basically nothing more than sugar, coloring and other additives, which are not even labeled on the
packaging. Children received no nutritional benefit from consuming these products.
Sugary soft drinks, either carbonated or non-carbonated, used to be more of a luxury in the past and they were consumed as a treat. Nowadays, these drinks are sold in abundance everywhere. Vending machines proffering these drinks are also found at many locations, including airports, hospitals and schools. It is also becoming
increasingly common to see these drinks being offered in “jumbo” portions at various restaurants and food joints.


S.M. Mohamed Idris is the president of the Consumers’ Association of Penang (CAP). The organization may be contacted at Tel. No. 60-4-8299511, or through its website at www.en.cap.org.my. Graphics from Consumer Association of Penang.

This article appeared in the Health Alert Asia Pacific newsletter, Issue 13 2008. For copies of the newsletter, please write to hain@hain.org

Nutrition in Asia and the Pacific: An Ugly Portrait

Food and nutrition are human rights. International caucuses such as the 1989 Convention on the Rights of the Child enshrine these and thus deem governments as duty-bound in ensuring that the right to food and nutrition, as part of the overall well-being of a person, is achieved by all of its citizens.

Much as food and nutrition are regarded as basic human rights, the problem of malnutrition persists in many Asian countries. In fact, the concentration of malnutrition in Asia is greatest compared to anywhere else in the world.
The Asian Development Bank reports that one in three preschool children is stunted,
rising to one out of every two children in the countries of South Asia such as India,
Bangladesh, and Nepal.

The most painful subject with regard to under nutrition is the human cost. In 1999 alone, an estimated 2.8 million child deaths in nine low-income Asian countries, or 51 percent of child deaths were associated with malnutrition. (The countries included are Bangladesh, Cambodia, PRC, India, Lao PDR, Nepal, Pakistan, Sri Lanka, and Vietnam).

Different economic, political, and cultural characteristics in the region portray different faces of malnutrition. In many countries of the Asia-Pacifi c Region, under
nutrition is the most common. In some areas however, there are also incidences of over nutrition.

Read more »

ENCOURAGE WIDER PRACTICE OF TRADITIONAL MEDICINE

Western or modern medicine is presently the dominant healthcare system in our country. However, the emphasis on private curative health measures, sophisticated technology, expensive drugs and complicated machinery has given rise to increasingly exorbitant medical costs and also the incidence of medical errors. The critical shortage of medical professionals and support staff has further strained the delivery of medical services.

The detractors of traditional medicine systems are quick to highlight adverse incidents connected to the practice of these systems. However, the public may often not be aware, or may overlook, the magnitude of problems experienced with prescribed conventional modern drugs and treatments.

For example, in the US alone, studies carried out between 1993 and 1998 revealed that there were 12,000 deaths a year from unnecessary surgery, 7,000 deaths a year from medication errors in hospitals, 20,000 deaths a year from other errors in hospitals, 80,000 deaths a year from infections in hospitals, and 106,000 deaths a year from non-error, adverse effects of medication. These deaths per year constituted the third leading cause of death in the United States - after deaths from heart disease and cancer, and way ahead of the next leading cause of death - cerebrovascular disease. (Starfield B. JAMA, 2000)

While recognizing that allopathic medicine has brought health gains to the country, it is obvious that it is becoming increasing difficult to sustain this form of healthcare.

Serious efforts should be given to considering other systems and to incorporating them into the mainstream healthcare delivery system. In other words, there should be pluralism in healthcare delivery.

We will not be alone, as many other countries are already promoting and integrating traditional systems of medicine into their national healthcare and delivery systems.

For instance, in China, traditional medicine systems are officially recognized and integrated into the healthcare system both centrally and at the provincial levels. Hospitals and colleges have been designated for the training in traditional systems.

China and Korea invested in establishing high quality educational and research institutions years ago. China runs over 40 top-level research institutions exclusively for traditional medicine.

India has been significantly increasing its budget for the promotion of traditional medicine practices such as ayurveda, sidha, unani, naturopathy, Tibetan medicine and homeopathy.

It has been reported that one in eight Singaporeans prefers traditional medical treatment over established Western medicines. There have been calls for increased research into these ancient cures.

Malaysia, being a multiracial country, had a rich base of traditional systems of healthcare which include Malay, Chinese, Indian and indigenous medicine. These non-Western or traditional systems of medicine were practiced for thousands of years before the advent of the colonial era. It was with the arrival of colonialism that they were gradually sidelined in favour of the western concept of medicine.

Now, different health systems tend to be practiced mostly in isolation from each other. By right, there need not be a rigid separation of these delivery systems.

The World Health Organization (WHO) once pointed out that traditional medicine systems serve the health needs of about 80 percent of the world’s population and the goal of health for all cannot be achieved without traditional medicines.

There is a need to move away from the present obsession with only the modern system of medicine and turn to other systems that do not depend on sophisticated technology and other expensive modes of treatment delivery.

Traditional medicine colleges could be set up within existing university frameworks. Some training in Traditional Medicine systems could also be included in the present curriculum of medical schools and teaching hospitals. This would foster better understanding of traditional medicine practices.

There could also be active promotion of traditional systems of medicine by Ministries of Health in their national health programmes. Grants, incentives and other support mechanisms for training, research and setting up of facilities could also be encouraged.

More national and international conferences on traditional medical systems could be convened in order to promote and enhance the importance and to further encourage the understanding of these health systems.


Original article from:
Consumers Association of Penang (CAP),
No. 10, Jalan Masjid Negeri
11600 Penang, Malaysia.