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What is Hunger? calories vs. macronutrients

Approximately one billion persons worldwide do not have sufficient food, on a continuing basis. Month after month, year after year, in many different areas of the world, a substantial portion of the population is undernourished. They have enough food to survive, but not enough food for good health. This problem is called world hunger.

Some definitions of hunger include persons suffering from famine. But in this book, I will distinguish between hunger and famine. Persons who do not have enough food to survive are in a state of famine. Persons who have enough food to survive, but not enough food for good health, are in a state of hunger.

Famine is a much less prevalent problem than hunger. According to the World Food Programme, only about 8% of the undernourished of the world are in a state of famine:

“Acute hunger or starvation are often highlighted on TV screens: hungry mothers too weak to breastfeed their children in drought-hit Ethiopia, refugees in war-torn Darfur queuing for food rations, helicopters airlifting high energy biscuits to earthquake victims in Pakistan or Indonesia. These situations are the result of high profile crises like war or natural disasters, which starve a population of food, yet emergencies account for less than eight percent of hunger’s victims. Daily undernourishment is a less visible form of hunger — but it affects many more people, from the shanty towns of Jakarta in Indonesia and the Cambodian capital Phnom Penh to the mountain villages of Bolivia and Nepal. In these places, hunger is much more than an empty stomach.” [United Nations World Food Programme, “What is hunger?”]

Famine tends to be acute (brief and severe). Something happens, such as drought or war, and agriculture is disrupted, resulting in a sudden insufficiency of food. But this severe insufficiency of food cannot continue indefinitely. If the famine is not relieved, the people will die. By comparison, world hunger is chronic; it is a continuous problem. It is less severe than famine, since the people have enough food for survival. But, in the present world food economy, hunger tends to continue long-term.

What causes hunger? Many different factors are involved. One important factor is poverty. It is inherent to the commercial nature of modern civilization that people need money to obtain various types of goods, including food. Even if a population grows its own food, they need money for fertilizer, seed, agricultural machinery, and more. So, among the poorest populations in the world, the lack of money results in a lack of food. Lacking sufficient food to survive, a population falls into a state of famine. Lacking sufficient food for good health, a population falls into a state of hunger. (More on the causes of hunger is found in chapter 7.)

The nutrients essential for survival and health can be divided into two types: which-foodsmacronutrients and micronutrients. The macronutrient-nutrients are three: protein, fat, carbohydrates. The micronutrients are many: the various vitamins, minerals, phytochemicals, and antioxidants needed for survival and good health. Serious problems can result from a lack of certain micronutrients. For example, vitamin A deficiency causes blindness in children. A lack of iodine can cause goiters in a population. However, the term hunger typically denotes a population that lacks macronutrients; it is not used if the population lacks only micronutrients. The FAO estimates, in its 2012 Hunger Report, that “the negative health consequences of micronutrient deficiencies continue to affect around 2 billion people.” [FAO Hunger Report 2012] But the number of hungry in the world (as we will discuss below) is typically one billion or less.

The United Nation’s Food and Agricultural Organization (FAO) says:

“People who are chronically hungry are undernourished. They don’t eat enough to get the energy they need to lead active lives. Their undernourishment makes it hard to study, work or otherwise perform physical activities. Undernourishment is particularly harmful for women and children. Undernourished children do not grow as quickly as healthy children. Mentally, they may develop more slowly. Constant hunger weakens the immune system and makes them more vulnerable to diseases and infections. Mothers living with constant hunger often give birth to underweight and weak babies, and are themselves facing increased risk of death. Every day, millions of people around the world eat only the bare minimum of food to keep themselves alive.” [FAO: FAO Hunger Portal, “FAQs: What is chronic hunger?”]

Does this mean that a deficiency of any or all of the three macronutrients results in hunger? No, for if a population does not have enough food to survive, the problem is famine, not hunger. Only when the population has enough macronutrients to survive long-term, but not enough for good health, does the term hunger apply. So any population afflicted by hunger must have some of each of the three macronutrients, otherwise they would not survive long term. Famine is a different problem from hunger.

Moreover, these three macronutrients are not equal. The human person can survive with a limited intake of protein, or a limited intake of fat, or even a limited intake of both protein and fat. But the body does not survive on a limited intake of carbohydrates over an extended period of time. Insufficient carbs in the diet is usually accompanied by insufficient total calories. Without enough calories, the body must use its store of fat for energy. When that store is depleted, the body will convert protein from muscle into energy (very inefficiently). The result is that the person’s body wastes away.

Suppose that a person has plenty of protein and fat in the diet, but insufficient carbs, over a long period of time. This situation is very unhealthy and can result in death. Carbohydrates are needed to metabolize fat for energy; insufficient carbs in the diet will result in an incomplete processing of fat, and a buildup of ketones in the bloodstream. If this continues, the person can die from ketoacidosis. Excess protein in the diet can cause problems with the kidneys and liver. So one cannot compensate for a severe deficiency of carbs, on a continuing basis, by simply eating more protein and fat.

Of the three macronutrients, only a deficiency of protein or fat, or both, results in that chronic undernourishment called hunger. If the population has a severe deficiency of carbs, the result is famine. The problem cannot continue long-term because the affected persons will die without enough carbohydrates in the diet.

The 2008 FAO Hunger Report is the most recent report (as of this writing) to present a detailed nation-by-nation analysis of the hunger problem in each nation. The report lists the average per person macronutrient intake in each hungry nation, and whether the percent of that macronutrient is low, within recommended limits, or high. For every nation with a substantial hunger problem, the percent of carbs was either high or within recommended limits, whereas the percent of protein and/or fat was always low. This data proves the point that hunger is not primarily due to a lack of carbs, but a lack of protein and/or fat.

World hunger is the chronic undernourishment of a large population due to insufficient protein and/or fat in the diet. The affected persons generally have sufficient carbohydrates and total calories for long-term survival. If their diet falls short of sufficient carbs for good health (sometimes this is the case, and other times not), providing them with the additional protein and dietary fat they need will usually raise their total caloric intake to within normal limits. In some cases, when a population is teetering on the edge between famine and hunger, the people may need additional carbohydrates, as well as fat and protein, to achieve a normal diet and sufficient total calories (dietary energy supply). But the main cause of hunger is a lack of protein and/or dietary fat.

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