Caloric Undernutrition and Starvation, With Notes on Protein Deficiency

INTRODUCTION Justifiable enthusiasm about discoveries of specific nutrients and their metabolic consequence has distracted attention from the oldest problem in nutrition—simple caloric inadequacy. General undernutrition, with or without major deficiences of individual nutrients, has always been widespread in the world at large the tragedy of famine periodically emphasizes how slender is the margin of safety. In the United States and Canada food production has been so abundant for many years that the direct impact of famine is unknown; the consequences of food shortages elsewhere, however, increasingly demand attention and effort here. Moreover, the importance of secondary undernutrition in disease is beginning to be realized. Caloric undernutrition has been generally assumed to involve a parallel protein deficiency in most cases. In Asia, the area of most frequently recurring famine, the diet is low in protein in the best of times. Any food shortage quickly reduces such sources of proteins as