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"Lysine values calculated from protein availability data.

6Under-5 mortality rate: deaths at less than 5 years of age per 1000 live births.

"Lysine values calculated from protein availability data.

6Under-5 mortality rate: deaths at less than 5 years of age per 1000 live births.

declined between 1969-1971 and 1990-1992 (1). Because of population growth, however, there were increases in the absolute numbers of the undernourished in both sub-Saharan Africa and in southern Asia. For 1990-1992 these numbered 215 (43%) and 255 million (22%), respectively. Proportions are lower in eastern Asia (16%), Latin America and the Caribbean (15%), and the Middle East and North Africa (12%). When viewed on an agroecological basis, food deprivation has tended to be highest in the arid regions of the world. Poverty is a central characteristic of the food insecure. Although the numbers of undernourished are likely to decline, only slowly and insufficiently, from the current 839 million to possibly 680 million (1) by 2010, this would represent a significant decline from 21% to 12% of the total population of the developing countries.

and the basic (Table 5). Although many food and nutrition activities continue to operate at the immediate level, basic level changes are essential to any significant global progress in eliminating malnutrition.

Diet and disease interact in a mutually reinforcing way so that it is usually impossible to distinguish either as the primary cause of malnutrition (10). Infection can result in a loss of appetite and hence initiate food deficiency; it can also result in the depletion of body stores of specific nutrients and thus cause malnutrition. Through effects on the immune system, malnutrition can make infection more likely and increase its severity. Because poverty influences both the availability of food and the quality of public health, these interactions are of major worldwide significance.

MALNUTRITION AND NUTRITIONAL DISORDERS Causation of Malnutrition

A complex set of factors determines the prevalence of hunger and malnutrition. The lack of food and/or nutrients acts in combination with other environmental factors, in particular with infectious diseases, to produce a spectrum of health problems with a whole range of intensities and outcomes. Determinants of malnutrition exist at three key levels of causation (8,9): the immediate, the underlying,

Consequences of Malnutrition

Malnutrition results in a variety of conditions such as weight loss, growth failure, anemia, learning disabilities, lower activity levels and work capacity, increased susceptibility to other diseases, blindness, and various chronic conditions. These conditions translate into social and economic costs that no country can afford (1). Malnutrition is both a symptom of broader poverty and underdevelopment problems and a cause of these same problems (2). Recently the United Nations (UN) has explicitly stated that wide-

Table 4. Profile of the Industrialized, Developing, and Least Developed Countries (Data for 1995)

Variable

Industrialized countries

Developing countries"

LDCs6

World

Number of countries

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