Hunger is Rising, COVID-19 Will Make it Worse

The economic crisis and food system disruptions from the Covid-19 pandemic will worsen the lack of nutrition in women and children, with the potential to cost the world almost $30 billion in future productivity losses. As many as 3 billion people may be unable to afford a healthy diet due to the pandemic, according to a study published in Nature Food journal. This will exacerbate maternal and child under-nutrition in low- and middle-income countries, causing stunting, wasting, mortality and maternal anemia.

Nearly 690 million people were undernourished in 2019, up by almost 60 million since 2014. Nearly half of all deaths in children under age five are attributable to undernutrition and, regrettably, stunting and wasting still have strong impacts worldwide.

In 2019, 21 per cent of all children under age five (144 million) were stunted and 49.5 million children experienced wasting.The effects of the pandemic will increase child hunger, and an additional 6.7 million children are predicted to be wasted by the end of 2020 due to the pandemic’s impact.

The situation continues to be most alarming in Africa: 19 per cent of its population is under-nourished (more than 250 million people), with the highest prevalence of undernourishment among all global regions. Africa is the only region where the number of stunted children has risen since 2000.

Women and girls represent more than 70 per cent of people facing chronic hunger. They are more likely to reduce their meal intake in times of food scarcity and may be pushed to engage in negative coping mechanisms, such as transactional sex and child, early and forced marriage.

Extreme climatic events drove almost 34 million people into food crisis in 25 countries in 2019, 77 per cent of them in Africa. The number of people pushed into food crisis by economic shocks more than doubled to 24 million in eight countries in 2019 (compared to 10 million people in six countries the previous year).

Food insecurity is set to get much worse unless unsustainable global food systems are addressed. Soils around the world are heading for exhaustion and depletion. An estimated 33 per cent of global soils are already degraded, endangering food production and the provision of vital ecosystem services.

Evidence from food security assessments and analysis shows that COVID-19 has had a compounding effect on pre-existing vulnerabilities and stressors in countries with pre-existing food crises. In Sudan, an estimated 9.6 million people (21 per cent of the population) were experiencing crisis or worse levels of food insecurity (IPC/CH Phase 3 or above) in the third quarter of 2020 and needed urgent action. This is the highest figure ever recorded for Sudan.

Food security needs are set to increase dramatically in 2021 as the pandemic and global response measures seriously affect food systems worldwide. Entire food supply chains have been disrupted, and the cost of a basic food basket increased by more than 10 per cent in 20 countries in the second quarter of 2020.

Delays in the farming season due to disruptions in supply chains and restrictions on labour movement are resulting in below-average harvests across many countries and regions.  This is magnified by pre-existing or seasonal threats and vulnerabilities, such as conflict and violence, looming hurricane and monsoon seasons, and locust infestations. Further climatic changes are expected from La Niña.

Forecasters predict a 55 per cent change in climate conditions through the first quarter of 2021, impacting sea temperatures, rainfall patterns and hurricane activity. The ensuing floods and droughts that could result from La Niña will affect farming seasons worldwide, potentially decreasing crop yields and increasing food insecurity levels.

The devastating impact of COVID-19 is still playing out in terms of rising unemployment, shattered livelihoods and increasing hunger. Families are finding it harder to put healthy food on a plate, child malnutrition is threatening millions. The risk of famine is real in places like Burkina Faso, north-eastern Nigeria, South Sudan and Yemen.

COVID-19 has ushered hunger into the lives of more urban communities while placing the vulnerable, such as IDPs, refugees, migrants, older persons, women and girls, people caught in conflict, and those living at the sharp end of climate change at higher risk of starvation. The pandemic hit at a time when the number of acutely food-insecure people in the world had already risen since 2014, largely due to conflict, climate change and economic shocks.

Acute food-insecurity is projected to increase by more than 80 percent – from 149 million pre-COVID-19, to 270 million by the end of 2020 – in 79 of the countries where WFP works. The number of people in crisis or worse (IPC/CH Phase 3 or above) almost tripled in Burkina Faso compared to the 2019 peak of the food insecurity situation, with 11,000 people facing catastrophic hunger (IPC/CH Phase 5) in mid-2020.

For populations in IPC3 and above, urgent and sustained humanitarian assistance is required to prevent a deterioration in the hunger situation. It is alarming that in 2020, insufficient funds left food security partners unable to deliver the assistance required. For example, sustained food ration reductions in Yemen have directly contributed to reduced food consumption since March. Today, Yemen is one of four countries at real risk of famine.

Source: https://gho.unocha.org/

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Critics:

During the COVID-19 pandemic, food security has been a global concern – in the second quarter of 2020 there were multiple warnings of famine later in the year. According to early predictions, hundreds of thousands of people would likely die and millions more experience hunger without concerted efforts to address issues of food security.

As of October 2020, these efforts were reducing the risk of widespread starvation due to the COVID-19 pandemic. Famines were feared as a result of the COVID-19 recession and some of the measures taken to prevent the spread of COVID-19. Additionally, the 2019–2021 locust infestation, ongoing wars and political turmoil in some nations were also viewed as local causes of hunger.

In September 2020, David Beasley, Executive Director of the World Food Programme, addressed the United Nations Security Council, stating that measures taken by donor countries over the course of the preceding five months, including the provision of $17 trillion in fiscal stimulus and central bank support, the suspension of debt repayments instituted by the IMF and G20 countries for the benefit of poorer countries, and donor support for WFP programmes, had averted impending famine, helping 270 million people at risk of starvation.

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How To Harness The Pain Blocking Effects of Exercise

Athletes have a very complicated relationship with pain. For endurance athletes in particular, pain is an absolutely non-negotiable element of their competitive experience. You fear it, but you also embrace it. And then you try to understand it.

But pain isn’t like heart rate or lactate levels—things you can measure and meaningfully compare from one session to the next. Every painful experience is different, and the factors that contribute to those differences seem to be endless. A recent study in the Journal of Sports Sciences, from researchers in Iraq, Australia, and Britain, adds a new one to the list: viewing images of athletes in pain right before a cycling test led to higher pain ratings and worse performance than viewing images of athletes enjoying themselves.

That finding is reminiscent of a result I wrote about last year, in which subjects who were told that exercise increases pain perception experienced greater pain, while those told that exercise decreases pain perception experienced less pain. In that case, the researchers were studying pain perception after exercise rather than during it, trying to understand a phenomenon called exercise-induced hypoalgesia (which just means that you experience less pain after exercise).

This phenomenon has been studied for more than 40 years: one of the first attempts to unravel it was published in 1979 under the title “The Painlessness of the Long Distance Runner,” in which an Australian researcher named Garry Egger did a series of 15 runs over six months after being injected with either an opioid blocker called naloxone or a placebo. Running did indeed increase his pain threshold, but naloxone didn’t seem to make any difference, suggesting that endorphins—the body’s own opioids—weren’t responsible for the effect. (Subsequent research has been plentiful but not very conclusive, and it’s currently thought that both opioid and other mechanisms are responsible.)

But the very nature of pain—the fact that seeing an image of pain or being told that something will be painful can alter the pain you feel—makes it extremely tricky to study. If you put someone through a painful experiment twice, their experience the first time will inevitably color their perceptions the second time.

As a result, according to the authors of another new study, the only results you can really trust are from randomized trials in which the effects of exercise on pain are compared to the results of the same sequence of tests with no exercise—a standard that excludes much of the existing research.

The new study, published in the Journal of Pain by Michael Wewege and Matthew Jones of the University of New South Wales, is a meta-analysis that sets out to determine whether exercise-induced hypoalgesia is a real thing, and if so, what sorts of exercise induce it, and in whom. While there have been several previous meta-analyses on this topic, this one was restricted to randomized controlled trials, which meant that just 13 studies from the initial pool of 350 were included.

The good news is that, in healthy subjects, aerobic exercise did indeed seem to cause a large increase in pain threshold. Here’s a forest plot, in which dots to the left of the line indicate that an individual study saw increased pain tolerance after aerobic exercise, while dots to the right indicate that pain tolerance worsened. 

The big diamond at the bottom is the overall combination of the data from those studies. It’s interesting to look at a few of the individual studies. The first dot at the top, for example, saw basically no change from a six-minute walk. The second and third dots, with the most positive results, involved 30 minutes of cycling and 40 minutes of treadmill running, respectively. The dosage probably matters, but there’s not enough data to draw definitive conclusions.

After that, things get a little tricker. Dynamic resistance exercise (standard weight-room stuff, for the most part) seems to have a small positive effect, but that’s based on just two studies. Isometric exercises (i.e. pushing or pulling without moving, or holding a static position), based on three studies, have no clear effect.

There are also three studies that look at subjects with chronic pain. This is where researchers are really hoping to see effects, because it’s very challenging to find ways of managing ongoing pain, especially now that the downsides of long-term opioid use are better understood. In this case, the subjects had knee osteoarthritis, plantar fasciitis, or tennis elbow, and neither dynamic nor isometric exercises seemed to help. There were no studies—or at least none that met the criteria for this analysis—that tried aerobic exercise for patients with chronic pain.

The main takeaway, for me, is how little we really know for sure about the relationship between exercise and pain perception. It seems likely that the feeling of dulled pain that follows a good run is real (and thus that you shouldn’t conclude that your minor injury has really been healed just because it feels okay when you finish).

Exactly why this happens, what’s required to trigger it, and who can benefit from it remains unclear. But if you’ve got a race or a big workout coming up, based on the study with pain imagery, I’d suggest not thinking about it too much. Hat tip to Chris Yates for additional research. For more Sweat Science, join me on Twitter and Facebook, sign up for the email newsletter, and check out my book Endure: Mind, Body, and the Curiously Elastic Limits of Human Performance.

By: Alex Hutchinson

Source: How to Harness the Pain-Blocking Effects of Exercise | Outside Online

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Critics:

Exercise-associated muscle cramps (EAMC) are defined as cramping (painful muscle spasms) during or immediately following exercise. Muscle cramps during exercise are very common, even in elite athletes. EAMC are a common condition that occurs during or after exercise, often during endurance events such as a triathlon or marathon.

Although EAMC are extremely common among athletes, the cause is still not fully understood because muscle cramping can occur as a result of many underlying conditions. Elite athletes experience cramping due to paces at higher intensities.The cause of exercise-associated muscle cramps is hypothesized to be due to altered neuromuscular control, dehydration, or electrolyte depletion.

It is widely believed that excessive sweating due to strenuous exercise can lead to muscle cramps. Deficiency of sodium and other electrolytes may lead to contracted interstitial fluid compartments, which may exacerbate the muscle cramping. According to this theory, the increased blood plasma osmolality from sweating sodium losses causes a fluid shift from the interstitial space to the intervascular space, which causes the interstitial fluid compartment to deform and contributes to muscle hyperexcitability and risk of spontaneous muscle activity.

The second hypothesis is altered neuromuscular control. In this hypothesis, it is suggested that cramping is due to altered neuromuscular activity. The proposed underlying cause of the altered neuromuscular control is due to fatigue. There are several disturbances, at various levels of the central and peripheral nervous system, and the skeletal muscle that contribute to cramping.

These disturbances can be described by a series of several key events. First and foremost, repetitive muscle exercise can lead to the development of fatigue due to one or more of the following: inadequate conditioning, hot and or humid environments, increased intensity, increased duration, and decreased supply of energy. Muscle fatigue itself causes increased excitatory afferent activity within the muscle spindles and decreased inhibitory afferent activity within the Golgi tendon.

The coupling of these events leads to altered neuromuscular control from the spinal cord. A cascade of events follow the altered neuromuscular control; this includes increased alpha-motor neuron activity in the spinal cord, which overloads the lower motor neurons, and increased muscle cell membrane activity. Thus, the resultant of this cascade is a muscle cramp.

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