On 9 February 2014, Swiss voters narrowly approved by 50.3% a ballot initiative launched by the national conservative Swiss People's Party (SVP/UDC) to restrict immigration, and thus reintroducing a quota system on the influx of foreigners. This initiative was mostly backed by rural (57.6% approvals), suburban (51.2% approvals), and isolated cities (51.3% approvals) of Switzerland as well as by a strong majority (69.2% approval) in the canton of Ticino, while metropolitan centres (58.5% rejection) and the French-speaking part (58.5% rejection) of Switzerland rather rejected it. Some news commentators claim that this proposal de facto contradicts the bilateral agreements on the free movement of persons from these respective countries.


The former ten-year moratorium on the construction of new nuclear power plants was the result of a citizens' initiative voted on in 1990 which had passed with 54.5% Yes vs. 45.5% No votes. Plans for a new nuclear plant in the Canton of Bern have been put on hold after the accident at the Fukushima Daiichi power plant in 2011. The Swiss Federal Office of Energy (SFOE) is the office responsible for all questions relating to energy supply and energy use within the Federal Department of Environment, Transport, Energy and Communications (DETEC). The agency is supporting the 2000-watt society initiative to cut the nation's energy use by more than half by the year 2050.


On 25 May 2011 the Swiss government announced that it plans to end its use of nuclear energy in the next 2 or 3 decades. "The government has voted for a phaseout because we want to ensure a secure and autonomous supply of energy", Energy Minister Doris Leuthard said that day at a press conference in Bern. "Fukushima showed that the risk of nuclear power is too high, which in turn has also increased the costs of this energy form." The first reactor would reportedly be taken offline in 2019 and the last one in 2034. Parliament will discuss the plan in June 2011, and there could be a referendum as well.


The most dense rail network in Europe of 5,063 km (3,146 mi) carries over 350 million passengers annually. In 2007, each Swiss citizen travelled on average 2,258 km (1,403 mi) by rail, which makes them the keenest rail users. The network is administered mainly by the Federal Railways, except in Graubünden, where the 366 km (227 mi) narrow gauge railway is operated by the Rhaetian Railways and includes some World Heritage lines. The building of new railway base tunnels through the Alps is under way to reduce the time of travel between north and south through the AlpTransit project.


Swiss private-public managed road network is funded by road tolls and vehicle taxes. The Swiss autobahn/autoroute system requires the purchase of a vignette (toll sticker)—which costs 40 Swiss francs—for one calendar year in order to use its roadways, for both passenger cars and trucks. The Swiss autobahn/autoroute network has a total length of 1,638 km (1,018 mi) (as of 2000) and has, by an area of 41,290 km2 (15,940 sq mi), also one of the highest motorway densities in the world. Zürich Airport is Switzerland's largest international flight gateway, which handled 22.8 million passengers in 2012. The other international airports are Geneva Airport (13.9 million passengers in 2012), EuroAirport Basel-Mulhouse-Freiburg which is located in France, Bern Airport, Lugano Airport, St. Gallen-Altenrhein Airport and Sion Airport. Swiss International Air Lines is the flag carrier of Switzerland. Its main hub is Zürich.


Switzerland has one of the best environmental records among nations in the developed world; it was one of the countries to sign the Kyoto Protocol in 1998 and ratified it in 2003. With Mexico and the Republic of Korea it forms the Environmental Integrity Group (EIG). The country is heavily active in recycling and anti-littering regulations and is one of the top recyclers in the world, with 66% to 96% of recyclable materials being recycled, depending on the area of the country. The 2014 Global Green Economy Index ranked Switzerland among the top 10 green economies in the world.


In many places in Switzerland, household rubbish disposal is charged for. Rubbish (except dangerous items, batteries etc.) is only collected if it is in bags which either have a payment sticker attached, or in official bags with the surcharge paid at the time of purchase. This gives a financial incentive to recycle as much as possible, since recycling is free. Illegal disposal of garbage is not tolerated but usually the enforcement of such laws is limited to violations that involve the unlawful disposal of larger volumes at traffic intersections and public areas. Fines for not paying the disposal fee range from CHF 200–500.


In 2012, resident foreigners made up 23.3% of the population. Most of these (64%) were from European Union or EFTA countries. Italians were the largest single group of foreigners with 15.6% of total foreign population. They were closely followed by Germans (15.2%), immigrants from Portugal (12.7%), France (5.6%), Serbia (5.3%), Turkey (3.8%), Spain (3.7%), and Austria (2%). Immigrants from Sri Lanka, most of them former Tamil refugees, were the largest group among people of Asian origin (6.3%). Additionally, the figures from 2012 show that 34.7% of the permanent resident population aged 15 or over in Switzerland, i.e. 2,335,000 persons, had an immigrant background. A third of this population (853,000) held Swiss citizenship. Four fifths of persons with an immigration background were themselves immigrants (first generation foreigners and native-born and naturalised Swiss citizens), whereas one fifth were born in Switzerland (second generation foreigners and native-born and naturalised Swiss citizens). In the 2000s, domestic and international institutions expressed concern about what they perceived as an increase in xenophobia, particularly in some political campaigns. In reply to one critical report the Federal Council noted that "racism unfortunately is present in Switzerland", but stated that the high proportion of foreign citizens in the country, as well as the generally unproblematic integration of foreigners", underlined Switzerland's openness.


Switzerland has four official languages: principally German (63.5% total population share, with foreign residents, in 2013); French (22.5%) in the west; and Italian (8.1%) in the south. The fourth official language, Romansh (0.5%), is a Romance language spoken locally in the southeastern trilingual canton of Graubünden, and is designated by Article 4 of the Federal Constitution as a national language along with German, French, and Italian, and in Article 70 as an official language if the authorities communicate with persons who speak Romansh. However, federal laws and other official acts do not need to be decreed in Romansh.


Aside from the official forms of their respective languages, the four linguistic regions of Switzerland also have their local dialectal forms. The role played by dialects in each linguistic region varies dramatically: in the German-speaking regions, Swiss German dialects have become ever more prevalent since the second half of the 20th century, especially in the media, such as radio and television, and are used as an everyday language, while the Swiss variety of Standard German is almost always used instead of dialect for written communication (c.f. diglossic usage of a language). Conversely, in the French-speaking regions the local dialects have almost disappeared (only 6.3% of the population of Valais, 3.9% of Fribourg, and 3.1% of Jura still spoke dialects at the end of the 20th century), while in the Italian-speaking regions dialects are mostly limited to family settings and casual conversation.


The principal official languages (German, French, and Italian) have terms, not used outside of Switzerland, known as Helvetisms. German Helvetisms are, roughly speaking, a large group of words typical of Swiss Standard German, which do not appear either in Standard German, nor in other German dialects. These include terms from Switzerland's surrounding language cultures (German Billette from French), from similar term in another language (Italian azione used not only as act but also as discount from German Aktion). The French spoken in Switzerland has similar terms, which are equally known as Helvetisms. The most frequent characteristics of Helvetisms are in vocabulary, phrases, and pronunciation, but certain Helvetisms denote themselves as special in syntax and orthography likewise. Duden, one of the prescriptive sources for Standard German, is aware of about 3000 Helvetisms. Current French dictionaries, such as the Petit Larousse, include several hundred Helvetisms.


Swiss citizens are universally required to buy health insurance from private insurance companies, which in turn are required to accept every applicant. While the cost of the system is among the highest it compares well with other European countries in terms of health outcomes; patients who are citizens have been reported as being, in general, highly satisfied with it. In 2012, life expectancy at birth was 80.4 years for men and 84.7 years for women — the highest in the world. However, spending on health is particularly high at 11.4% of GDP (2010), on par with Germany and France (11.6%) and other European countries, and notably less than spending in the USA (17.6%). From 1990, a steady increase can be observed, reflecting the high costs of the services provided. With an ageing population and new healthcare technologies, health spending will likely continue to rise.


Between two thirds and three quarters of the population live in urban areas. Switzerland has gone from a largely rural country to an urban one in just 70 years. Since 1935 urban development has claimed as much of the Swiss landscape as it did during the previous 2,000 years. This urban sprawl does not only affect the plateau but also the Jura and the Alpine foothills and there are growing concerns about land use. However, from the beginning of the 21st century, the population growth in urban areas is higher than in the countryside.


Switzerland has a dense network of cities, where large, medium and small cities are complementary. The plateau is very densely populated with about 450 people per km2 and the landscape continually shows signs of human presence. The weight of the largest metropolitan areas, which are Zürich, Geneva–Lausanne, Basel and Bern tend to increase. In international comparison the importance of these urban areas is stronger than their number of inhabitants suggests. In addition the two main centers of Zürich and Geneva are recognized for their particularly great quality of life.


Christianity is the predominant religion of Switzerland (about 71% of resident population and 75% of Swiss citizens), divided between the Catholic Church (38.21% of the population), the Swiss Reformed Church (26.93%), further Protestant churches (2.89%) and other Christian denominations (2.79%). There has been a recent rise in Evangelicalism. Immigration has brought Islam (4.95%) and Eastern Orthodoxy (around 2%) as sizeable minority religions. According to a 2015 poll by Gallup International, 12% of Swiss people self-identified as "convinced atheists."


As of the 2000 census other Christian minority communities include Neo-Pietism (0.44%), Pentecostalism (0.28%, mostly incorporated in the Schweizer Pfingstmission), Methodism (0.13%), the New Apostolic Church (0.45%), Jehovah's Witnesses (0.28%), other Protestant denominations (0.20%), the Old Catholic Church (0.18%), other Christian denominations (0.20%). Non-Christian religions are Hinduism (0.38%), Buddhism (0.29%), Judaism (0.25%) and others (0.11%); 4.3% did not make a statement. 21.4% in 2012 declared themselves as unchurched i.e. not affiliated with any church or other religious body (Agnostic, Atheist, or just not related to any official religion).


The country was historically about evenly balanced between Catholic and Protestant, with a complex patchwork of majorities over most of the country. Geneva converted to Protestantism in 1536, just before John Calvin arrived there. One canton, Appenzell, was officially divided into Catholic and Protestant sections in 1597. The larger cities and their cantons (Bern, Geneva, Lausanne, Zürich and Basel) used to be predominantly Protestant. Central Switzerland, the Valais, the Ticino, Appenzell Innerrhodes, the Jura, and Fribourg are traditionally Catholic. The Swiss Constitution of 1848, under the recent impression of the clashes of Catholic vs. Protestant cantons that culminated in the Sonderbundskrieg, consciously defines a consociational state, allowing the peaceful co-existence of Catholics and Protestants. A 1980 initiative calling for the complete separation of church and state was rejected by 78.9% of the voters. Some traditionally Protestant cantons and cities nowadays have a slight Catholic majority, not because they were growing in members, quite the contrary, but only because since about 1970 a steadily growing minority became not affiliated with any church or other religious body (21.4% in Switzerland, 2012) especially in traditionally Protestant regions, such as Basel-City (42%), canton of Neuchâtel (38%), canton of Geneva (35%), canton of Vaud (26%), or Zürich city (city: >25%; canton: 23%).


Three of Europe's major languages are official in Switzerland. Swiss culture is characterised by diversity, which is reflected in a wide range of traditional customs. A region may be in some ways strongly culturally connected to the neighbouring country that shares its language, the country itself being rooted in western European culture. The linguistically isolated Romansh culture in Graubünden in eastern Switzerland constitutes an exception, it survives only in the upper valleys of the Rhine and the Inn and strives to maintain its rare linguistic tradition.


Alpine symbolism has played an essential role in shaping the history of the country and the Swiss national identity. Nowadays some concentrated mountain areas have a strong highly energetic ski resort culture in winter, and a hiking (ger: das Wandern) or Mountain biking culture in summer. Other areas throughout the year have a recreational culture that caters to tourism, yet the quieter seasons are spring and autumn when there are fewer visitors. A traditional farmer and herder culture also predominates in many areas and small farms are omnipresent outside the cities. Folk art is kept alive in organisations all over the country. In Switzerland it is mostly expressed in music, dance, poetry, wood carving and embroidery. The alphorn, a trumpet-like musical instrument made of wood, has become alongside yodeling and the accordion an epitome of traditional Swiss music.


The government exerts greater control over broadcast media than print media, especially due to finance and licensing. The Swiss Broadcasting Corporation, whose name was recently changed to SRG SSR, is charged with the production and broadcast of radio and television programs. SRG SSR studios are distributed throughout the various language regions. Radio content is produced in six central and four regional studios while the television programs are produced in Geneva, Zürich and Lugano. An extensive cable network also allows most Swiss to access the programs from neighboring countries.


Skiing, snowboarding and mountaineering are among the most popular sports in Switzerland, the nature of the country being particularly suited for such activities. Winter sports are practiced by the natives and tourists since the second half of the 19th century with the invention of bobsleigh in St. Moritz. The first world ski championships were held in Mürren (1931) and St. Moritz (1934). The latter town hosted the second Winter Olympic Games in 1928 and the fifth edition in 1948. Among the most successful skiers and world champions are Pirmin Zurbriggen and Didier Cuche.


Swiss are fans of football and the national team is nicknamed the 'Nati'. The headquarters of the sport's governing body, the International Federation of Association Football (FIFA), is located in Zürich. Switzerland hosted the 1954 FIFA World Cup, and was the joint host, with Austria, of the Euro 2008 tournament. The Swiss Super League is the nation's professional club league. For the Brasil 2014 World Cup finals tournament, the country's German-speaking cantons will be closely monitored by local police forces to prevent celebrations beyond one hour after matches end. Europe's highest football pitch, at 2,000 metres (6,600 ft) above sea level, is located in Switzerland and is named the Ottmar Hitzfeld Stadium.


Many Swiss also follow ice hockey and support one of the 12 clubs in the League A, which is the most attended league in Europe. In 2009, Switzerland hosted the IIHF World Championship for the 10th time. It also became World Vice-Champion in 2013. The numerous lakes make Switzerland an attractive place for sailing. The largest, Lake Geneva, is the home of the sailing team Alinghi which was the first European team to win the America's Cup in 2003 and which successfully defended the title in 2007. Tennis has become an increasingly popular sport, and Swiss players such as Martina Hingis, Roger Federer, and most recently, Stanislas Wawrinka have won multiple Grand Slams. Swiss professional wrestler Claudio Castagnoli is currently signed with WWE, and is a former United States champion.


Motorsport racecourses and events were banned in Switzerland following the 1955 Le Mans disaster with exception to events such as Hillclimbing. During this period, the country still produced successful racing drivers such as Clay Regazzoni, Sebastian Buemi, Jo Siffert, Dominique Aegerter, successful World Touring Car Championship driver Alain Menu, 2014 24 Hours of Le Mans winner Marcel Fässler and 2015 24 Hours Nürburgring winner Nico Müller. Switzerland also won the A1GP World Cup of Motorsport in 2007–08 with driver Neel Jani. Swiss motorcycle racer Thomas Lüthi won the 2005 MotoGP World Championship in the 125cc category. In June 2007 the Swiss National Council, one house of the Federal Assembly of Switzerland, voted to overturn the ban, however the other house, the Swiss Council of States rejected the change and the ban remains in place.


Traditional sports include Swiss wrestling or "Schwingen". It is an old tradition from the rural central cantons and considered the national sport by some. Hornussen is another indigenous Swiss sport, which is like a cross between baseball and golf. Steinstossen is the Swiss variant of stone put, a competition in throwing a heavy stone. Practiced only among the alpine population since prehistoric times, it is recorded to have taken place in Basel in the 13th century. It is also central to the Unspunnenfest, first held in 1805, with its symbol the 83.5 kg stone named Unspunnenstein.


The cuisine of Switzerland is multifaceted. While some dishes such as fondue, raclette or rösti are omnipresent through the country, each region developed its own gastronomy according to the differences of climate and languages.  Traditional Swiss cuisine uses ingredients similar to those in other European countries, as well as unique dairy products and cheeses such as Gruyère or Emmental, produced in the valleys of Gruyères and Emmental. The number of fine-dining establishments is high, particularly in western Switzerland.


The most popular alcoholic drink in Switzerland is wine. Switzerland is notable for the variety of grapes grown because of the large variations in terroirs, with their specific mixes of soil, air, altitude and light. Swiss wine is produced mainly in Valais, Vaud (Lavaux), Geneva and Ticino, with a small majority of white wines. Vineyards have been cultivated in Switzerland since the Roman era, even though certain traces can be found of a more ancient origin. The most widespread varieties are the Chasselas (called Fendant in Valais) and Pinot noir. The Merlot is the main variety produced in Ticino.


Mali (i/ˈmɑːli/; French: [maˈli]), officially the Republic of Mali (French: République du Mali), is a landlocked country in West Africa. Mali is the eighth-largest country in Africa, with an area of just over 1,240,000 square kilometres (480,000 sq mi). The population of Mali is 14.5 million. Its capital is Bamako. Mali consists of eight regions and its borders on the north reach deep into the middle of the Sahara Desert, while the country's southern part, where the majority of inhabitants live, features the Niger and Senegal rivers. The country's economy centers on agriculture and fishing. Some of Mali's prominent natural resources include gold, being the third largest producer of gold in the African continent, and salt. About half the population lives below the international poverty line of $1.25 (U.S.) a day. A majority of the population (55%) are non-denominational Muslims.


Present-day Mali was once part of three West African empires that controlled trans-Saharan trade: the Ghana Empire, the Mali Empire (for which Mali is named), and the Songhai Empire. During its golden age, there was a flourishing of mathematics, astronomy, literature, and art. At its peak in 1300, the Mali Empire covered an area about twice the size of modern-day France and stretched to the west coast of Africa. In the late 19th century, during the Scramble for Africa, France seized control of Mali, making it a part of French Sudan. French Sudan (then known as the Sudanese Republic) joined with Senegal in 1959, achieving independence in 1960 as the Mali Federation. Shortly thereafter, following Senegal's withdrawal from the federation, the Sudanese Republic declared itself the independent Republic of Mali. After a long period of one-party rule, a coup in 1991 led to the writing of a new constitution and the establishment of Mali as a democratic, multi-party state.


In January 2012, an armed conflict broke out in northern Mali, which Tuareg rebels took control of by April and declared the secession of a new state, Azawad. The conflict was complicated by a military coup that took place in March and later fighting between Tuareg and Islamist rebels. In response to Islamist territorial gains, the French military launched Opération Serval in January 2013. A month later, Malian and French forces recaptured most of the north. Presidential elections were held on 28 July 2013, with a second round run-off held on 11 August, and legislative elections were held on 24 November and 15 December 2013.


In the late 14th century, the Songhai gradually gained independence from the Mali Empire and expanded, ultimately subsuming the entire eastern portion of the Mali Empire. The Songhai Empire's eventual collapse was largely the result of a Moroccan invasion in 1591, under the command of Judar Pasha. The fall of the Songhai Empire marked the end of the region's role as a trading crossroads. Following the establishment of sea routes by the European powers, the trans-Saharan trade routes lost significance.


On 19 November 1968, following progressive economic decline, the Keïta regime was overthrown in a bloodless military coup led by Moussa Traoré, a day which is now commemorated as Liberation Day. The subsequent military-led regime, with Traoré as president, attempted to reform the economy. His efforts were frustrated by political turmoil and a devastating drought between 1968 to 1974, in which famine killed thousands of people. The Traoré regime faced student unrest beginning in the late 1970s and three coup attempts. The Traoré regime repressed all dissenters until the late 1980s.


Anti-government protests in 1991 led to a coup, a transitional government, and a new constitution. Opposition to the corrupt and dictatorial regime of General Moussa Traoré grew during the 1980s. During this time strict programs, imposed to satisfy demands of the International Monetary Fund, brought increased hardship upon the country's population, while elites close to the government supposedly lived in growing wealth. Peaceful student protests in January 1991 were brutally suppressed, with mass arrests and torture of leaders and participants. Scattered acts of rioting and vandalism of public buildings followed, but most actions by the dissidents remained nonviolent.


From 22 March through 26 March 1991, mass pro-democracy rallies and a nationwide strike was held in both urban and rural communities, which became known as les evenements ("the events") or the March Revolution. In Bamako, in response to mass demonstrations organized by university students and later joined by trade unionists and others, soldiers opened fire indiscriminately on the nonviolent demonstrators. Riots broke out briefly following the shootings. Barricades as well as roadblocks were erected and Traoré declared a state of emergency and imposed a nightly curfew. Despite an estimated loss of 300 lives over the course of four days, nonviolent protesters continued to return to Bamako each day demanding the resignation of the dictatorial president and the implementation of democratic policies.


26 March 1991 is the day that marks the clash between military soldiers and peaceful demonstrating students which climaxed in the massacre of dozens under the orders of then President Moussa Traoré. He and three associates were later tried and convicted and received the death sentence for their part in the decision-making of that day. Nowadays, the day is a national holiday in order to remember the tragic events and the people that were killed.[unreliable source?] The coup is remembered as Mali's March Revolution of 1991.


By 26 March, the growing refusal of soldiers to fire into the largely nonviolent protesting crowds turned into a full-scale tumult, and resulted into thousands of soldiers putting down their arms and joining the pro-democracy movement. That afternoon, Lieutenant Colonel Amadou Toumani Touré announced on the radio that he had arrested the dictatorial president, Moussa Traoré. As a consequence, opposition parties were legalized and a national congress of civil and political groups met to draft a new democratic constitution to be approved by a national referendum.


In January 2012 a Tuareg rebellion began in Northern Mali, led by the National Movement for the Liberation of Azawad. In March, military officer Amadou Sanogo seized power in a coup d'état, citing Touré's failures in quelling the rebellion, and leading to sanctions and an embargo by the Economic Community of West African States. The MNLA quickly took control of the north, declaring independence as Azawad. However, Islamist groups including Ansar Dine and Al-Qaeda in the Islamic Maghreb (AQIM), who had helped the MNLA defeat the government, turned on the Tuareg and took control of the North with the goal of implementing sharia in Mali.


Mali lies in the torrid zone and is among the hottest countries in the world. The thermal equator, which matches the hottest spots year-round on the planet based on the mean daily annual temperature, crosses the country. Most of Mali receives negligible rainfall and droughts are very frequent. Late June to early December is the rainy season in the southernmost area. During this time, flooding of the Niger River is common, creating the Inner Niger Delta. The vast northern desert part of Mali has a hot desert climate (Köppen climate classification (BWh) with long, extremely hot summers and scarce rainfall which decreases northwards. The central area has a hot semi-arid climate (Köppen climate classification (BSh) with very high temperatures year-round, a long, intense dry season and a brief, irregular rainy season. The little southern band possesses a tropical wet and dry climate (Köppen climate classification (Aw) very high temperatures year-round with a dry season and a rainy season.


Until the military coup of 22 March 2012 and a second military coup in December 2012, Mali was a constitutional democracy governed by the Constitution of 12 January 1992, which was amended in 1999. The constitution provides for a separation of powers among the executive, legislative, and judicial branches of government. The system of government can be described as "semi-presidential". Executive power is vested in a president, who is elected to a five-year term by universal suffrage and is limited to two terms.


The president serves as a chief of state and commander in chief of the armed forces. A prime minister appointed by the president serves as head of government and in turn appoints the Council of Ministers. The unicameral National Assembly is Mali's sole legislative body, consisting of deputies elected to five-year terms. Following the 2007 elections, the Alliance for Democracy and Progress held 113 of 160 seats in the assembly. The assembly holds two regular sessions each year, during which it debates and votes on legislation that has been submitted by a member or by the government.


Mali's constitution provides for an independent judiciary, but the executive continues to exercise influence over the judiciary by virtue of power to appoint judges and oversee both judicial functions and law enforcement. Mali's highest courts are the Supreme Court, which has both judicial and administrative powers, and a separate Constitutional Court that provides judicial review of legislative acts and serves as an election arbiter. Various lower courts exist, though village chiefs and elders resolve most local disputes in rural areas.


Mali underwent economic reform, beginning in 1988 by signing agreements with the World Bank and the International Monetary Fund. During 1988 to 1996, Mali's government largely reformed public enterprises. Since the agreement, sixteen enterprises were privatized, 12 partially privatized, and 20 liquidated. In 2005, the Malian government conceded a railroad company to the Savage Corporation. Two major companies, Societé de Telecommunications du Mali (SOTELMA) and the Cotton Ginning Company (CMDT), were expected to be privatized in 2008.


In 2007, about 48 percent of Malians were younger than 12 years old, 49 percent were 15–64 years old, and 3 percent were 65 and older. The median age was 15.9 years. The birth rate in 2014 is 45.53 births per 1,000, and the total fertility rate (in 2012) was 6.4 children per woman. The death rate in 2007 was 16.5 deaths per 1,000. Life expectancy at birth was 53.06 years total (51.43 for males and 54.73 for females). Mali has one of the world's highest rates of infant mortality, with 106 deaths per 1,000 live births in 2007.


In the far north, there is a division between Berber-descendent Tuareg nomad populations and the darker-skinned Bella or Tamasheq people, due the historical spread of slavery in the region. An estimated 800,000 people in Mali are descended from slaves. Slavery in Mali has persisted for centuries. The Arabic population kept slaves well into the 20th century, until slavery was suppressed by French authorities around the mid-20th century. There still persist certain hereditary servitude relationships, and according to some estimates, even today approximately 200,000 Malians are still enslaved.


Although Mali has enjoyed a reasonably good inter-ethnic relationships based on the long history of coexistence, some hereditary servitude and bondage relationship exist, as well as ethnic tension between settled Songhai and nomadic Tuaregs of the north. Due to a backlash against the northern population after independence, Mali is now in a situation where both groups complain about discrimination on the part of the other group. This conflict also plays a role in the continuing Northern Mali conflict where there is a tension between both Tuaregs and the Malian government, and the Tuaregs and radical Islamists who are trying to establish sharia law.


Mali faces numerous health challenges related to poverty, malnutrition, and inadequate hygiene and sanitation. Mali's health and development indicators rank among the worst in the world. Life expectancy at birth is estimated to be 53.06 years in 2012. In 2000, 62–65 percent of the population was estimated to have access to safe drinking water and only 69 percent to sanitation services of some kind. In 2001, the general government expenditures on health totalled about US$4 per capita at an average exchange rate.


Efforts have been made to improve nutrition, and reduce associated health problems, by encouraging women to make nutritious versions of local recipes. For example, the International Crops Research Institute for the Semi-Arid Tropics (ICRISAT) and the Aga Khan Foundation, trained women's groups to make equinut, a healthy and nutritional version of the traditional recipe di-dèguè (comprising peanut paste, honey and millet or rice flour). The aim was to boost nutrition and livelihoods by producing a product that women could make and sell, and which would be accepted by the local community because of its local heritage.


Medical facilities in Mali are very limited, and medicines are in short supply. Malaria and other arthropod-borne diseases are prevalent in Mali, as are a number of infectious diseases such as cholera and tuberculosis. Mali's population also suffers from a high rate of child malnutrition and a low rate of immunization. An estimated 1.9 percent of the adult and children population was afflicted with HIV/AIDS that year, among the lowest rates in Sub-Saharan Africa. An estimated 85–91 percent of Mali's girls and women have had female genital mutilation (2006 and 2001 data).


Malian musical traditions are derived from the griots, who are known as "Keepers of Memories". Malian music is diverse and has several different genres. Some famous Malian influences in music are kora virtuoso musician Toumani Diabaté, the late roots and blues guitarist Ali Farka Touré, the Tuareg band Tinariwen, and several Afro-pop artists such as Salif Keita, the duo Amadou et Mariam, Oumou Sangare, and Habib Koité. Dance also plays a large role in Malian culture. Dance parties are common events among friends, and traditional mask dances are performed at ceremonial events.


Raleigh (/ˈrɑːli/; RAH-lee) is the capital of the state of North Carolina as well as the seat of Wake County in the United States. It is the second most populous city in North Carolina, after Charlotte. Raleigh is known as the "City of Oaks" for its many oak trees, which line the streets in the heart of the city. The city covers a land area of 142.8 square miles (370 km2). The U.S. Census Bureau estimated the city's population to be 439,896 as of July 1, 2014. It is also one of the fastest-growing cities in the country. The city of Raleigh is named after Sir Walter Raleigh, who established the lost Roanoke Colony in present-day Dare County.


Raleigh is home to North Carolina State University and is part of the Research Triangle area, together with Durham (home of Duke University) and Chapel Hill (home of the University of North Carolina at Chapel Hill). The "Triangle" nickname originated after the 1959 creation of the Research Triangle Park, located in Durham & Wake Counties partway between the three cities and their universities. The Research Triangle region encompasses the U.S. Census Bureau's Raleigh-Durham-Chapel Hill Combined Statistical Area (CSA), which had an estimated population of 2,037,430 in 2013. The Raleigh Metropolitan Statistical Area (MSA) had an estimated population of 1,214,516 in 2013.


Raleigh is an early example in the United States of a planned city, chosen as the site of the state capital in 1788 and incorporated in 1792 as such. The city was originally laid out in a grid pattern with the North Carolina State Capitol in Union Square at the center. In the United States Civil War the city was spared from any significant battle, only falling in the closing days of the war, though it did not escape the economic hardships that plagued the rest of the American South during the Reconstruction Era. The twentieth century saw the opening of the Research Triangle Park in 1959, and with the jobs it created the region and city saw a large influx of population, making it one of the fastest growing communities in the United States by the early 21st century.


Raleigh is home to numerous cultural, educational, and historic sites. The Duke Energy Center for the Performing Arts in Downtown Raleigh features three theater venues and serves as the home for the North Carolina Symphony and the Carolina Ballet. Walnut Creek Amphitheatre is a large music amphitheater located in Southeast Raleigh. Museums in Raleigh include the North Carolina Museum of Art in West Raleigh, as well as the North Carolina Museum of History and North Carolina Museum of Natural Sciences located next to each other near the State Capitol in Downtown Raleigh. Several major universities and colleges call Raleigh home, including North Carolina State University, the largest public university in the state, and Shaw University, the first historically black university in the American South and site of the foundation of the Student Nonviolent Coordinating Committee, an important civil rights organization of the 1960s. One U.S. president, Andrew Johnson, was born in Raleigh.


The city's location was chosen, in part, for being within 11 mi (18 km) of Isaac Hunter's Tavern, a popular tavern frequented by the state legislators. No known city or town existed previously on the chosen city site. Raleigh is one of the few cities in the United States that was planned and built specifically to serve as a state capital. Its original boundaries were formed by the downtown streets of North, East, West and South streets. The plan, a grid with two main axes meeting at a central square and an additional square in each corner, was based on Thomas Holme's 1682 plan for Philadelphia.


After the Civil War began, Governor Zebulon Baird Vance ordered the construction of breastworks around the city as protection from Union troops. During General Sherman's Carolinas Campaign, Raleigh was captured by Union cavalry under the command of General Hugh Judson Kilpatrick on April 13, 1865. As the Confederate cavalry retreated west, the Union soldiers followed, leading to the nearby Battle of Morrisville. The city was spared significant destruction during the War, but due to the economic problems of the post-war period and Reconstruction, with a state economy based on agriculture, it grew little over the next several decades.


In 1880, the newspapers News and Observer combined to form The News & Observer. It remains Raleigh's primary daily newspaper. The North Carolina College of Agriculture and Mechanic Arts, now known as North Carolina State University, was founded as a land-grant college in 1887. The city's Rex Hospital opened in 1889 and included the state's first nursing school. The Baptist Women's College, now known as Meredith College, opened in 1891, and in 1898, The Academy of Music, a private music conservatory, was established.


In the late nineteenth century, two black Congressmen were elected from North Carolina's 2nd district, the last in 1898. George Henry White sought to promote civil rights for blacks and to challenge efforts by white Democrats to reduce black voting by new discriminatory laws. They were unsuccessful. In 1900, the state legislature passed a new constitution, with voter registration rules that disfranchised most blacks and many poor whites. The state succeeded in reducing black voting to zero by 1908. Loss of the ability to vote disqualified black men (and later women) from sitting on juries and serving in any office, local, state or federal. The rising black middle-class in Raleigh and other areas was politically silenced and shut out of local governance, and the Republican Party was no longer competitive. It was not until after federal civil rights legislation was passed in the mid-1960s that the majority of blacks in North Carolina would again be able to vote, sit on juries and serve in local offices. No African American was elected to Congress until 1992.


During the difficult 1930s of the Great Depression, government at all levels was integral to creating jobs. The city provided recreational and educational programs, and hired people for public works projects. In 1932, Raleigh Memorial Auditorium was dedicated. The North Carolina Symphony, founded the same year, performed in its new home. From 1934 to 1937, the federal Civilian Conservation Corps constructed the area now known as William B. Umstead State Park. In 1939, the State General Assembly chartered the Raleigh-Durham Aeronautical Authority to build a larger airport between Raleigh and Durham, with the first flight occurring in 1943.


Raleigh is located in the northeast central region of North Carolina, where the Piedmont and Atlantic Coastal Plain regions meet. This area is known as the "fall line" because it marks the elevation inland at which waterfalls begin to appear in creeks and rivers. As a result, most of Raleigh features gently rolling hills that slope eastward toward the state's flat coastal plain. Its central Piedmont location situates Raleigh about two hours west of Atlantic Beach, North Carolina, by car and four hours east of the Great Smoky Mountains. The city is 155 miles (249 km) south of Richmond, Virginia, 263 miles (423 km) south of Washington, D.C., and 150 miles (240 km) northeast of Charlotte, North Carolina.


Downtown area is home to historic neighborhoods and buildings such as the Sir Walter Raleigh Hotel built in the early 20th century, the restored City Market, the Fayetteville Street downtown business district, which includes the PNC Plaza and Wells Fargo Capitol Center buildings, as well as the North Carolina Museum of History, North Carolina Museum of Natural Sciences, North Carolina State Capitol, Peace College, the Raleigh City Museum, Raleigh Convention Center, Shaw University, and St. Augustine's College. The neighborhoods in Old Raleigh include Cameron Park, Boylan Heights, Country Club Hills, Coley Forest, Five Points, Budleigh, Glenwood-Brooklyn, Hayes Barton Historic District, Moore Square, Mordecai, Rosengarten Park, Belvidere Park, Woodcrest, and Historic Oakwood. In the 2000s, an effort by the Downtown Raleigh Alliance was made to separate this area of the city into five smaller districts: Fayetteville Street, Moore Square, Glenwood South, Warehouse (Raleigh), and Capital District (Raleigh). Some of the names have become common place among locals such as the Warehouse, Fayetteville Street, and Glenwood South Districts.


Midtown Raleigh is a residential and commercial area just North of the I-440 Beltline and is part of North Raleigh. It is roughly framed by Glenwood/Creedmoor Road to the West, Wake Forest Road to the East, and Millbrook Road to the North. It includes shopping centers such as North Hills and Crabtree Valley Mall. It also includes North Hills Park and part of the Raleigh Greenway System. The term was coined by the Greater Raleigh Chamber of Commerce, developer John Kane and planning director Mitchell Silver. The News & Observer newspaper started using the term for marketing purposes only. The Midtown Raleigh Alliance was founded on July 25, 2011 as a way for community leaders to promote the area.


West Raleigh lies along Hillsborough Street and Western Boulevard. The area is bordered to the west by suburban Cary. It is home to North Carolina State University, Meredith College, Pullen Park, Pullen Memorial Baptist Church, Cameron Village, Lake Johnson, the North Carolina Museum of Art and historic Saint Mary's School. Primary thoroughfares serving West Raleigh, in addition to Hillsborough Street, are Avent Ferry Road, Blue Ridge Road, and Western Boulevard. The PNC Arena is also located here adjacent to the North Carolina State Fairgrounds. These are located approximately 2 miles from Rex Hospital.


North Raleigh is an expansive, diverse, and fast-growing suburban area of the city that is home to established neighborhoods to the south along with many newly built subdivisions and along its northern fringes. The area generally falls North of Millbrook Road. It is primarily suburban with large shopping areas. Primary neighborhoods and subdivisions in North Raleigh include Harrington Grove, Springdale, Dominion Park, Bedford, Bent Tree, Brentwood, Brier Creek, Brookhaven, Black Horse Run, Coachman's Trail, Crossgate, Crosswinds, Falls River, Hidden Valley, Lake Park, North Haven, North Ridge, Oakcroft, Shannon Woods, Six Forks Station, Springdale, Stonebridge, Stone Creek, Stonehenge, Summerfield, Valley Estates, Wakefield, Weathersfield, Windsor Forest, and Wood Valley. The area is served by a number of primary transportation corridors including Glenwood Avenue U.S. Route 70, Interstate 540, Wake Forest Road, Millbrook Road, Lynn Road, Six Forks Road, Spring Forest Road, Creedmoor Road, Leesville Road, Strickland Road, and North Hills Drive.


South Raleigh is located along U.S. 401 south toward Fuquay-Varina and along US 70 into suburban Garner. This area is the least developed and least dense area of Raleigh (much of the area lies within the Swift Creek watershed district, where development regulations limit housing densities and construction). The area is bordered to the west by Cary, to the east by Garner, and to the southwest by Holly Springs. Neighborhoods in South Raleigh include Renaissance Park, Lake Wheeler, Swift Creek, Carolina Pines, Rhamkatte, Riverbrooke, and Enchanted Oaks.


Southeast Raleigh is bounded by downtown on the west, Garner on the southwest, and rural Wake County to the southeast. The area includes areas along Rock Quarry Road, Poole Road, and New Bern Avenue. Primary neighborhoods include Chastain, Chavis Heights, Raleigh Country Club, Southgate, Kingwood Forest, Rochester Heights, Emerald Village and Biltmore Hills. Time Warner Cable Music Pavilion (formerly Alltel Pavilion and Walnut Creek Amphitheatre) is one of the region's major outdoor concert venues and is located on Rock Quarry Road. Shaw University is located in this part of the city.


Like much of the southeastern United States, Raleigh has a humid subtropical climate (Köppen Cfa), with four distinct seasons. Winters are short and generally cool, with a January daily average of 41.0 °F (5.0 °C). On average, there are 69 nights per year that drop to or below freezing, and only 2.7 days that fail to rise above freezing. April is the driest month, with an average of 2.91 inches (73.9 mm) of precipitation. Precipitation is well distributed around the year, with a slight maximum between July and September; on average, July is the wettest month, owing to generally frequent, sometimes heavy, showers and thunderstorms. Summers are hot and humid, with a daily average in July of 80.0 °F (26.7 °C). There are 48 days per year with highs at or above 90 °F (32 °C). Autumn is similar to spring overall but has fewer days of rainfall. Extremes in temperature have ranged from −9 °F (−23 °C) on January 21, 1985 up to 105 °F (41 °C), most recently on July 8, 2012.


Raleigh receives an average of 6.0 inches (15.2 cm) of snow in winter. Freezing rain and sleet also occur most winters, and occasionally the area experiences a major damaging ice storm. On January 24–25, 2000, Raleigh received its greatest snowfall from a single storm – 20.3 inches (52 cm) – the Winter Storm of January 2000. Storms of this magnitude are generally the result of cold air damming that affects the city due to its proximity to the Appalachian Mountains. Winter storms have caused traffic problems in the past as well.


The region also experiences occasional periods of drought, during which the city sometimes has restricted water use by residents. During the late summer and early fall, Raleigh can experience hurricanes. In 1996, Hurricane Fran caused severe damage in the Raleigh area, mostly from falling trees. The most recent hurricane to have a considerable effect on the area was Isabel in 2003. Tornadoes also have on occasion affected the city of Raleigh most notably the November 28, 1988 tornado which occurred in the early morning hours and rated an F4 on the Fujita Tornado Scale and affected Northwestern portions of the city. Also the April 16, 2011 F3 Tornado which affected portions of downtown and North east Raleigh and the suburb of Holly Springs.


As of the 2000 United States census, there were 276,093 persons (July 2008 estimate was 380,173) and 61,371 families residing in Raleigh. The population density was 2,409.2 people per square mile (930.2/km²). There were 120,699 housing units at an average density of 1,053.2 per square mile (406.7/km²). The racial composition of the city was: 63.31% White, 27.80% Black or African American, 7.01% Hispanic or Latino American, 3.38% Asian American, 0.36% Native American, 0.04% Native Hawaiian or Other Pacific Islander, 3.24% some other race, and 1.88% two or more races.


There were 112,608 households in the city in 2000, of which 26.5% included children below the age of 18, 39.5% were composed of married couples living together, 11.4% reported a female householder with no husband present, and 45.5% classified themselves as nonfamily. Unmarried partners were present in 2.2% of households. In addition, 33.1% of all households were composed of individuals living alone, of which 6.2% was someone 65 years of age or older. The average household size in Raleigh was 2.30 persons, and the average family size was 2.97 persons.


Raleigh is home to a wide variety of religious practitioners. As of 2013, 46.41% of people in Raleigh are affiliated with a religion. The predominant religion in Raleigh is Christianity, with the largest numbers of adherents being Roman Catholic (11.3%), Baptist (10.85%), and Methodist (7.08%). Others include Presbyterian (2.52%), Pentecostal (1.99%), Episcopalian (1.12%), Lutheran (1.06%), Latter-Day Saints (0.99%), and other Christian denominations (6.68%) including Eastern Orthodox, Coptic Orthodox, Jehovah's Witness, Christian Science, Christian Unitarianism, other Mainline Protestant groups, and non-denominational.


Raleigh's industrial base includes banking/financial services; electrical, medical, electronic and telecommunications equipment; clothing and apparel; food processing; paper products; and pharmaceuticals. Raleigh is part of North Carolina's Research Triangle, one of the country's largest and most successful research parks, and a major center in the United States for high-tech and biotech research, as well as advanced textile development. The city is a major retail shipping point for eastern North Carolina and a wholesale distributing point for the grocery industry.


The Time Warner Cable Music Pavilion at Walnut Creek hosts major international touring acts. In 2011, the Downtown Raleigh Amphitheater opened (now sponsored as the Red Hat Amphitheater), which hosts numerous concerts primarily in the summer months. An additional amphitheater sits on the grounds of the North Carolina Museum of Art, which hosts a summer concert series and outdoor movies. Nearby Cary is home to the Koka Booth Amphitheatre which hosts additional summer concerts and outdoor movies, and serves as the venue for regularly scheduled outdoor concerts by the North Carolina Symphony based in Raleigh. During the North Carolina State Fair, Dorton Arena hosts headline acts. The private Lincoln Theatre is one of several clubs in downtown Raleigh that schedules many concerts throughout the year in multiple formats (rock, pop, country).


The Duke Energy Center for the Performing Arts complex houses the Raleigh Memorial Auditorium, the Fletcher Opera Theater, the Kennedy Theatre, and the Meymandi Concert Hall. In 2008, a new theatre space, the Meymandi Theatre at the Murphey School, was opened in the restored auditorium of the historic Murphey School. Theater performances are also offered at the Raleigh Little Theatre, Long View Center, Ira David Wood III Pullen Park Theatre, and Stewart and Thompson Theaters at North Carolina State University.


North Carolina Museum of Art, occupying a large suburban campus on Blue Ridge Road near the North Carolina State Fairgrounds, maintains one of the premier public art collections located between Washington, D.C., and Atlanta. In addition to its extensive collections of American Art, European Art and ancient art, the museum recently has hosted major exhibitions featuring Auguste Rodin (in 2000) and Claude Monet (in 2006-07), each attracting more than 200,000 visitors. Unlike most prominent public museums, the North Carolina Museum of Art acquired a large number of the works in its permanent collection through purchases with public funds. The museum's outdoor park is one of the largest such art parks in the country. The museum facility underwent a major expansion which greatly expanded the exhibit space that was completed in 2010. The 127,000 sf new expansion is designed by NYC architect Thomas Phifer and Partners.


The National Hockey League's Carolina Hurricanes franchise moved to Raleigh in 1997 from Hartford, Connecticut (where it was known as the Hartford Whalers). The team played its first two seasons more than 60 miles away at Greensboro Coliseum while its home arena, Raleigh Entertainment and Sports Arena (later RBC Center and now PNC Arena), was under construction. The Hurricanes are the only major league (NFL, NHL, NBA, MLB) professional sports team in North Carolina to have won a championship, winning the Stanley Cup in 2006, over the Edmonton Oilers. The city played host to the 2011 NHL All-Star Game.


Several other professional sports leagues have had former franchises (now defunct) in Raleigh, including the Raleigh IceCaps of the ECHL (1991–1998); Carolina Cobras of the Arena Football League (2000–2004); the Raleigh–Durham Skyhawks of the World League of American Football (1991); the Raleigh Bullfrogs of the Global Basketball Association (1991–1992); the Raleigh Cougars of the United States Basketball League (1997–1999); and most recently, the Carolina Courage of the Women's United Soccer Association (2000–2001 in Chapel Hill, 2001–2003 in suburban Cary), which won that league's championship Founders Cup in 2002.


North Carolina State University is located in southwest Raleigh where the Wolfpack competes nationally in 24 intercollegiate varsity sports as a member of the Atlantic Coast Conference. The university's football team plays in Carter-Finley Stadium, the third largest football stadium in North Carolina, while the men's basketball team shares the PNC Arena with the Carolina Hurricanes hockey club. The Wolfpack women's basketball, volleyball, and gymnastics as well as men's wrestling events are held on campus at Reynolds Coliseum. The men's baseball team plays at Doak Field.


The Raleigh Parks and Recreation Department offers a wide variety of leisure opportunities at more than 150 sites throughout the city, which include: 8,100 acres (33 km2) of park land, 78 miles (126 km) of greenway, 22 community centers, a BMX championship-caliber race track, 112 tennis courts among 25 locations, 5 public lakes, and 8 public aquatic facilities. The J. C. Raulston Arboretum, an 8-acre (32,000 m²) arboretum and botanical garden in west Raleigh administered by North Carolina State University, maintains a year-round collection that is open daily to the public without charge.


According to the Federal Bureau of Investigation's Uniform Crime Reports, in 2010 the Raleigh Police Department and other agencies in the city reported 1,740 incidents of violent crime and 12,995 incidents of property crime – far below both the national average and the North Carolina average. Of the violent crimes reported, 14 were murders, 99 were forcible rapes and 643 were robberies. Aggravated assault accounted for 984 of the total violent crimes. Property crimes included burglaries which accounted for 3,021, larcenies for 9,104 and arson for 63 of the total number of incidents. Motor vehicle theft accounted for 870 incidents out of the total.


Public schools in Raleigh are operated by the Wake County Public School System. Observers have praised the Wake County Public School System for its innovative efforts to maintain a socially, economically and racial balanced system by using income as a prime factor in assigning students to schools. Raleigh is home to three magnet high schools and three high schools offering the International Baccalaureate program. There are four early college high schools in Raleigh. Raleigh also has two alternative high schools.


Raleigh-Durham International Airport, the region's primary airport and the second-largest in North Carolina, located northwest of downtown Raleigh via Interstate-40 between Raleigh and Durham, serves the city and greater Research Triangle metropolitan region, as well as much of eastern North Carolina. The airport offers service to more than 35 domestic and international destinations and serves approximately 10 million passengers a year. The airport also offers facilities for cargo and general aviation. The airport authority tripled the size of its Terminal 2 (formerly Terminal C) in January 2011.


Raleigh is also served by Triangle Transit (known formerly as the Triangle Transit Authority, or TTA). Triangle Transit offers scheduled, fixed-route regional and commuter bus service between Raleigh and the region's other principal cities of Durham, Cary and Chapel Hill, as well as to and from the Raleigh-Durham International Airport, Research Triangle Park and several of the region's larger suburban communities. Triangle Transit also coordinates an extensive vanpool and rideshare program that serves the region's larger employers and commute destinations.


Registered dietitian nutritionists (RDs or RDNs) are health professionals qualified to provide safe, evidence-based dietary advice which includes a review of what is eaten, a thorough review of nutritional health, and a personalized nutritional treatment plan. They also provide preventive and therapeutic programs at work places, schools and similar institutions. Certified Clinical Nutritionists or CCNs, are trained health professionals who also offer dietary advice on the role of nutrition in chronic disease, including possible prevention or remediation by addressing nutritional deficiencies before resorting to drugs. Government regulation especially in terms of licensing, is currently less universal for the CCN than that of RD or RDN. Another advanced Nutrition Professional is a Certified Nutrition Specialist or CNS. These Board Certified Nutritionists typically specialize in obesity and chronic disease. In order to become board certified, potential CNS candidate must pass an examination, much like Registered Dieticians. This exam covers specific domains within the health sphere including; Clinical Intervention and Human Health.


According to Walter Gratzer, the study of nutrition probably began during the 6th century BC. In China, the concept of Qi developed, a spirit or "wind" similar to what Western Europeans later called pneuma. Food was classified into "hot" (for example, meats, blood, ginger, and hot spices) and "cold" (green vegetables) in China, India, Malaya, and Persia. Humours developed perhaps first in China alongside qi. Ho the Physician concluded that diseases are caused by deficiencies of elements (Wu Xing: fire, water, earth, wood, and metal), and he classified diseases as well as prescribed diets. About the same time in Italy, Alcmaeon of Croton (a Greek) wrote of the importance of equilibrium between what goes in and what goes out, and warned that imbalance would result disease marked by obesity or emaciation.


The first recorded nutritional experiment with human subjects is found in the Bible's Book of Daniel. Daniel and his friends were captured by the king of Babylon during an invasion of Israel. Selected as court servants, they were to share in the king's fine foods and wine. But they objected, preferring vegetables (pulses) and water in accordance with their Jewish dietary restrictions. The king's chief steward reluctantly agreed to a trial. Daniel and his friends received their diet for 10 days and were then compared to the king's men. Appearing healthier, they were allowed to continue with their diet.


One mustn't overlook the doctrines of Galen: In use from his life in the 1st century AD until the 17th century, it was heresy to disagree with him for 1500 years. Galen was physician to gladiators in Pergamon, and in Rome, physician to Marcus Aurelius and the three emperors who succeeded him. Most of Galen's teachings were gathered and enhanced in the late 11th century by Benedictine monks at the School of Salerno in Regimen sanitatis Salernitanum, which still had users in the 17th century. Galen believed in the bodily humours of Hippocrates, and he taught that pneuma is the source of life. Four elements (earth, air, fire and water) combine into "complexion", which combines into states (the four temperaments: sanguine, phlegmatic, choleric, and melancholic). The states are made up of pairs of attributes (hot and moist, cold and moist, hot and dry, and cold and dry), which are made of four humours: blood, phlegm, green (or yellow) bile, and black bile (the bodily form of the elements). Galen thought that for a person to have gout, kidney stones, or arthritis was scandalous, which Gratzer likens to Samuel Butler's Erehwon (1872) where sickness is a crime.


In the 1500s, Paracelsus was probably the first to criticize Galen publicly. Also in the 16th century, scientist and artist Leonardo da Vinci compared metabolism to a burning candle. Leonardo did not publish his works on this subject, but he was not afraid of thinking for himself and he definitely disagreed with Galen. Ultimately, 16th century works of Andreas Vesalius, sometimes called the father of modern medicine, overturned Galen's ideas. He was followed by piercing thought amalgamated with the era's mysticism and religion sometimes fueled by the mechanics of Newton and Galileo. Jan Baptist van Helmont, who discovered several gases such as carbon dioxide, performed the first quantitative experiment. Robert Boyle advanced chemistry. Sanctorius measured body weight. Physician Herman Boerhaave modeled the digestive process. Physiologist Albrecht von Haller worked out the difference between nerves and muscles.


Sometimes overlooked during his life, James Lind, a physician in the British navy, performed the first scientific nutrition experiment in 1747. Lind discovered that lime juice saved sailors that had been at sea for years from scurvy, a deadly and painful bleeding disorder. Between 1500 and 1800, an estimated two million sailors had died of scurvy. The discovery was ignored for forty years, after which British sailors became known as "limeys." The essential vitamin C within citrus fruits would not be identified by scientists until 1932.


In 1816, François Magendie discovered that dogs fed only carbohydrates (sugar), fat (olive oil), and water died evidently of starvation, but dogs also fed protein survived, identifying protein as an essential dietary component. William Prout in 1827 was the first person to divide foods into carbohydrates, fat, and protein. During the 19th century, Jean-Baptiste Dumas and Justus von Liebig quarrelled over their shared belief that animals get their protein directly from plants (animal and plant protein are the same and that humans do not create organic compounds). With a reputation as the leading organic chemist of his day but with no credentials in animal physiology, Liebig grew rich making food extracts like beef bouillon and infant formula that were later found to be of questionable nutritious value. In the 1860s, Claude Bernard discovered that body fat can be synthesized from carbohydrate and protein, showing that the energy in blood glucose can be stored as fat or as glycogen.


In the early 1880s, Kanehiro Takaki observed that Japanese sailors (whose diets consisted almost entirely of white rice) developed beriberi (or endemic neuritis, a disease causing heart problems and paralysis), but British sailors and Japanese naval officers did not. Adding various types of vegetables and meats to the diets of Japanese sailors prevented the disease, (not because of the increased protein as Takaki supposed but because it introduced a few parts per million of thiamine to the diet, later understood as a cure).


In 1896, Eugen Baumann observed iodine in thyroid glands. In 1897, Christiaan Eijkman worked with natives of Java, who also suffered from beriberi. Eijkman observed that chickens fed the native diet of white rice developed the symptoms of beriberi but remained healthy when fed unprocessed brown rice with the outer bran intact. Eijkman cured the natives by feeding them brown rice, discovering that food can cure disease. Over two decades later, nutritionists learned that the outer rice bran contains vitamin B1, also known as thiamine.


In the early 20th century, Carl von Voit and Max Rubner independently measured caloric energy expenditure in different species of animals, applying principles of physics in nutrition. In 1906, Edith G. Willcock and Frederick Hopkins showed that the amino acid tryptophan aids the well-being of mice but it did not assure their growth. In the middle of twelve years of attempts to isolate them, Hopkins said in a 1906 lecture that "unsuspected dietetic factors," other than calories, protein, and minerals, are needed to prevent deficiency diseases. In 1907, Stephen M. Babcock and Edwin B. Hart conducted the single-grain experiment, which took nearly four years to complete.


In 1913, Elmer McCollum discovered the first vitamins, fat-soluble vitamin A, and water-soluble vitamin B (in 1915; now known to be a complex of several water-soluble vitamins) and named vitamin C as the then-unknown substance preventing scurvy. Lafayette Mendel and Thomas Osborne also performed pioneering work on vitamins A and B. In 1919, Sir Edward Mellanby incorrectly identified rickets as a vitamin A deficiency because he could cure it in dogs with cod liver oil. In 1922, McCollum destroyed the vitamin A in cod liver oil, but found that it still cured rickets. Also in 1922, H.M. Evans and L.S. Bishop discover vitamin E as essential for rat pregnancy, originally calling it "food factor X" until 1925.


The list of nutrients that people are known to require is, in the words of Marion Nestle, "almost certainly incomplete". As of 2014, nutrients are thought to be of two types: macro-nutrients which are needed in relatively large amounts, and micronutrients which are needed in smaller quantities. A type of carbohydrate, dietary fiber, i.e. non-digestible material such as cellulose, is required, for both mechanical and biochemical reasons, although the exact reasons remain unclear. Other micronutrients include antioxidants and phytochemicals, which are said to influence (or protect) some body systems. Their necessity is not as well established as in the case of, for instance, vitamins.


The macronutrients are carbohydrates, fats, protein, and water. The macronutrients (excluding fiber and water) provide structural material (amino acids from which proteins are built, and lipids from which cell membranes and some signaling molecules are built) and energy. Some of the structural material can be used to generate energy internally, and in either case it is measured in Joules or kilocalories (often called "Calories" and written with a capital C to distinguish them from little 'c' calories). Carbohydrates and proteins provide 17 kJ approximately (4 kcal) of energy per gram, while fats provide 37 kJ (9 kcal) per gram, though the net energy from either depends on such factors as absorption and digestive effort, which vary substantially from instance to instance. Vitamins, minerals, fiber, and water do not provide energy, but are required for other reasons.


Molecules of carbohydrates and fats consist of carbon, hydrogen, and oxygen atoms. Carbohydrates range from simple monosaccharides (glucose, fructose, galactose) to complex polysaccharides (starch). Fats are triglycerides, made of assorted fatty acid monomers bound to a glycerol backbone. Some fatty acids, but not all, are essential in the diet: they cannot be synthesized in the body. Protein molecules contain nitrogen atoms in addition to carbon, oxygen, and hydrogen. The fundamental components of protein are nitrogen-containing amino acids, some of which are essential in the sense that humans cannot make them internally. Some of the amino acids are convertible (with the expenditure of energy) to glucose and can be used for energy production, just as ordinary glucose, in a process known as gluconeogenesis. By breaking down existing protein, the carbon skeleton of the various amino acids can be metabolized to intermediates in cellular respiration; the remaining ammonia is discarded primarily as urea in urine. This occurs normally only during prolonged starvation.


Traditionally, simple carbohydrates are believed to be absorbed quickly, and therefore to raise blood-glucose levels more rapidly than complex carbohydrates. This, however, is not accurate. Some simple carbohydrates (e.g., fructose) follow different metabolic pathways (e.g., fructolysis) that result in only a partial catabolism to glucose, while, in essence, many complex carbohydrates may be digested at the same rate as simple carbohydrates. Glucose stimulates the production of insulin through food entering the bloodstream, which is grasped by the beta cells in the pancreas.


Dietary fiber is a carbohydrate that is incompletely absorbed in humans and in some animals. Like all carbohydrates, when it is metabolized it can produce four Calories (kilocalories) of energy per gram. However, in most circumstances it accounts for less than that because of its limited absorption and digestibility. Dietary fiber consists mainly of cellulose, a large carbohydrate polymer which is indigestible as humans do not have the required enzymes to disassemble it. There are two subcategories: soluble and insoluble fiber. Whole grains, fruits (especially plums, prunes, and figs), and vegetables are good sources of dietary fiber. There are many health benefits of a high-fiber diet. Dietary fiber helps reduce the chance of gastrointestinal problems such as constipation and diarrhea by increasing the weight and size of stool and softening it. Insoluble fiber, found in whole wheat flour, nuts and vegetables, especially stimulates peristalsis – the rhythmic muscular contractions of the intestines, which move digesta along the digestive tract. Soluble fiber, found in oats, peas, beans, and many fruits, dissolves in water in the intestinal tract to produce a gel that slows the movement of food through the intestines. This may help lower blood glucose levels because it can slow the absorption of sugar. Additionally, fiber, perhaps especially that from whole grains, is thought to possibly help lessen insulin spikes, and therefore reduce the risk of type 2 diabetes. The link between increased fiber consumption and a decreased risk of colorectal cancer is still uncertain.


A molecule of dietary fat typically consists of several fatty acids (containing long chains of carbon and hydrogen atoms), bonded to a glycerol. They are typically found as triglycerides (three fatty acids attached to one glycerol backbone). Fats may be classified as saturated or unsaturated depending on the detailed structure of the fatty acids involved. Saturated fats have all of the carbon atoms in their fatty acid chains bonded to hydrogen atoms, whereas unsaturated fats have some of these carbon atoms double-bonded, so their molecules have relatively fewer hydrogen atoms than a saturated fatty acid of the same length. Unsaturated fats may be further classified as monounsaturated (one double-bond) or polyunsaturated (many double-bonds). Furthermore, depending on the location of the double-bond in the fatty acid chain, unsaturated fatty acids are classified as omega-3 or omega-6 fatty acids. Trans fats are a type of unsaturated fat with trans-isomer bonds; these are rare in nature and in foods from natural sources; they are typically created in an industrial process called (partial) hydrogenation. There are nine kilocalories in each gram of fat. Fatty acids such as conjugated linoleic acid, catalpic acid, eleostearic acid and punicic acid, in addition to providing energy, represent potent immune modulatory molecules.


Saturated fats (typically from animal sources) have been a staple in many world cultures for millennia. Unsaturated fats (e. g., vegetable oil) are considered healthier, while trans fats are to be avoided. Saturated and some trans fats are typically solid at room temperature (such as butter or lard), while unsaturated fats are typically liquids (such as olive oil or flaxseed oil). Trans fats are very rare in nature, and have been shown to be highly detrimental to human health, but have properties useful in the food processing industry, such as rancidity resistance.[citation needed]


Most fatty acids are non-essential, meaning the body can produce them as needed, generally from other fatty acids and always by expending energy to do so. However, in humans, at least two fatty acids are essential and must be included in the diet. An appropriate balance of essential fatty acids—omega-3 and omega-6 fatty acids—seems also important for health, although definitive experimental demonstration has been elusive. Both of these "omega" long-chain polyunsaturated fatty acids are substrates for a class of eicosanoids known as prostaglandins, which have roles throughout the human body. They are hormones, in some respects. The omega-3 eicosapentaenoic acid (EPA), which can be made in the human body from the omega-3 essential fatty acid alpha-linolenic acid (ALA), or taken in through marine food sources, serves as a building block for series 3 prostaglandins (e.g., weakly inflammatory PGE3). The omega-6 dihomo-gamma-linolenic acid (DGLA) serves as a building block for series 1 prostaglandins (e.g. anti-inflammatory PGE1), whereas arachidonic acid (AA) serves as a building block for series 2 prostaglandins (e.g. pro-inflammatory PGE 2). Both DGLA and AA can be made from the omega-6 linoleic acid (LA) in the human body, or can be taken in directly through food. An appropriately balanced intake of omega-3 and omega-6 partly determines the relative production of different prostaglandins, which is one reason why a balance between omega-3 and omega-6 is believed important for cardiovascular health. In industrialized societies, people typically consume large amounts of processed vegetable oils, which have reduced amounts of the essential fatty acids along with too much of omega-6 fatty acids relative to omega-3 fatty acids.


The conversion rate of omega-6 DGLA to AA largely determines the production of the prostaglandins PGE1 and PGE2. Omega-3 EPA prevents AA from being released from membranes, thereby skewing prostaglandin balance away from pro-inflammatory PGE2 (made from AA) toward anti-inflammatory PGE1 (made from DGLA). Moreover, the conversion (desaturation) of DGLA to AA is controlled by the enzyme delta-5-desaturase, which in turn is controlled by hormones such as insulin (up-regulation) and glucagon (down-regulation). The amount and type of carbohydrates consumed, along with some types of amino acid, can influence processes involving insulin, glucagon, and other hormones; therefore, the ratio of omega-3 versus omega-6 has wide effects on general health, and specific effects on immune function and inflammation, and mitosis (i.e., cell division).


Proteins are structural materials in much of the animal body (e.g. muscles, skin, and hair). They also form the enzymes that control chemical reactions throughout the body. Each protein molecule is composed of amino acids, which are characterized by inclusion of nitrogen and sometimes sulphur (these components are responsible for the distinctive smell of burning protein, such as the keratin in hair). The body requires amino acids to produce new proteins (protein retention) and to replace damaged proteins (maintenance). As there is no protein or amino acid storage provision, amino acids must be present in the diet. Excess amino acids are discarded, typically in the urine. For all animals, some amino acids are essential (an animal cannot produce them internally) and some are non-essential (the animal can produce them from other nitrogen-containing compounds). About twenty amino acids are found in the human body, and about ten of these are essential and, therefore, must be included in the diet. A diet that contains adequate amounts of amino acids (especially those that are essential) is particularly important in some situations: during early development and maturation, pregnancy, lactation, or injury (a burn, for instance). A complete protein source contains all the essential amino acids; an incomplete protein source lacks one or more of the essential amino acids.


It is possible with protein combinations of two incomplete protein sources (e.g., rice and beans) to make a complete protein source, and characteristic combinations are the basis of distinct cultural cooking traditions. However, complementary sources of protein do not need to be eaten at the same meal to be used together by the body. Excess amino acids from protein can be converted into glucose and used for fuel through a process called gluconeogenesis. The amino acids remaining after such conversion are discarded.


Early recommendations for the quantity of water required for maintenance of good health suggested that 6–8 glasses of water daily is the minimum to maintain proper hydration. However the notion that a person should consume eight glasses of water per day cannot be traced to a credible scientific source. The original water intake recommendation in 1945 by the Food and Nutrition Board of the National Research Council read: "An ordinary standard for diverse persons is 1 milliliter for each calorie of food. Most of this quantity is contained in prepared foods." More recent comparisons of well-known recommendations on fluid intake have revealed large discrepancies in the volumes of water we need to consume for good health. Therefore, to help standardize guidelines, recommendations for water consumption are included in two recent European Food Safety Authority (EFSA) documents (2010): (i) Food-based dietary guidelines and (ii) Dietary reference values for water or adequate daily intakes (ADI). These specifications were provided by calculating adequate intakes from measured intakes in populations of individuals with “desirable osmolarity values of urine and desirable water volumes per energy unit consumed.” For healthful hydration, the current EFSA guidelines recommend total water intakes of 2.0 L/day for adult females and 2.5 L/day for adult males. These reference values include water from drinking water, other beverages, and from food. About 80% of our daily water requirement comes from the beverages we drink, with the remaining 20% coming from food. Water content varies depending on the type of food consumed, with fruit and vegetables containing more than cereals, for example. These values are estimated using country-specific food balance sheets published by the Food and Agriculture Organisation of the United Nations. Other guidelines for nutrition also have implications for the beverages we consume for healthy hydration- for example, the World Health Organization (WHO) recommend that added sugars should represent no more than 10% of total energy intake.


The EFSA panel also determined intakes for different populations. Recommended intake volumes in the elderly are the same as for adults as despite lower energy consumption, the water requirement of this group is increased due to a reduction in renal concentrating capacity. Pregnant and breastfeeding women require additional fluids to stay hydrated. The EFSA panel proposes that pregnant women should consume the same volume of water as non-pregnant women, plus an increase in proportion to the higher energy requirement, equal to 300 mL/day. To compensate for additional fluid output, breastfeeding women require an additional 700 mL/day above the recommended intake values for non-lactating women.


Dietary minerals are inorganic chemical elements required by living organisms, other than the four elements carbon, hydrogen, nitrogen, and oxygen that are present in nearly all organic molecules. The term "mineral" is archaic, since the intent is to describe simply the less common elements in the diet. Some are heavier than the four just mentioned, including several metals, which often occur as ions in the body. Some dietitians recommend that these be supplied from foods in which they occur naturally, or at least as complex compounds, or sometimes even from natural inorganic sources (such as calcium carbonate from ground oyster shells). Some minerals are absorbed much more readily in the ionic forms found in such sources. On the other hand, minerals are often artificially added to the diet as supplements; the most famous is likely iodine in iodized salt which prevents goiter.


As with the minerals discussed above, some vitamins are recognized as organic essential nutrients, necessary in the diet for good health. (Vitamin D is the exception: it can be synthesized in the skin, in the presence of UVB radiation.) Certain vitamin-like compounds that are recommended in the diet, such as carnitine, are thought useful for survival and health, but these are not "essential" dietary nutrients because the human body has some capacity to produce them from other compounds. Moreover, thousands of different phytochemicals have recently been discovered in food (particularly in fresh vegetables), which may have desirable properties including antioxidant activity (see below); however, experimental demonstration has been suggestive but inconclusive. Other essential nutrients that are not classified as vitamins include essential amino acids (see above), choline, essential fatty acids (see above), and the minerals discussed in the preceding section.


As cellular metabolism/energy production requires oxygen, potentially damaging (e.g., mutation causing) compounds known as free radicals can form. Most of these are oxidizers (i.e., acceptors of electrons) and some react very strongly. For the continued normal cellular maintenance, growth, and division, these free radicals must be sufficiently neutralized by antioxidant compounds. Recently, some researchers suggested an interesting theory of evolution of dietary antioxidants. Some are produced by the human body with adequate precursors (glutathione, Vitamin C), and those the body cannot produce may only be obtained in the diet via direct sources (Vitamin C in humans, Vitamin A, Vitamin K) or produced by the body from other compounds (Beta-carotene converted to Vitamin A by the body, Vitamin D synthesized from cholesterol by sunlight). Phytochemicals (Section Below) and their subgroup, polyphenols, make up the majority of antioxidants; about 4,000 are known. Different antioxidants are now known to function in a cooperative network. For example, Vitamin C can reactivate free radical-containing glutathione or Vitamin E by accepting the free radical itself. Some antioxidants are more effective than others at neutralizing different free radicals. Some cannot neutralize certain free radicals. Some cannot be present in certain areas of free radical development (Vitamin A is fat-soluble and protects fat areas, Vitamin C is water-soluble and protects those areas). When interacting with a free radical, some antioxidants produce a different free radical compound that is less dangerous or more dangerous than the previous compound. Having a variety of antioxidants allows any byproducts to be safely dealt with by more efficient antioxidants in neutralizing a free radical's butterfly effect.


Animal intestines contain a large population of gut flora. In humans, the four dominant phyla are Firmicutes, Bacteroidetes, Actinobacteria, and Proteobacteria. They are essential to digestion and are also affected by food that is consumed. Bacteria in the gut perform many important functions for humans, including breaking down and aiding in the absorption of otherwise indigestible food; stimulating cell growth; repressing the growth of harmful bacteria, training the immune system to respond only to pathogens; producing vitamin B12; and defending against some infectious diseases.


Heart disease, cancer, obesity, and diabetes are commonly called "Western" diseases because these maladies were once rarely seen in developing countries. An international study in China found some regions had virtually no cancer or heart disease, while in other areas they reflected "up to a 100-fold increase" coincident with shifts from diets that were found to be entirely plant-based to heavily animal-based, respectively. In contrast, diseases of affluence like cancer and heart disease are common throughout the developed world, including the United States. Adjusted for age and exercise, large regional clusters of people in China rarely suffered from these "Western" diseases possibly because their diets are rich in vegetables, fruits, and whole grains, and have little dairy and meat products. Some studies show these to be, in high quantities, possible causes of some cancers. There are arguments for and against this controversial issue.


The United Healthcare/Pacificare nutrition guideline recommends a whole plant food diet, and recommends using protein only as a condiment with meals. A National Geographic cover article from November 2005, entitled The Secrets of Living Longer, also recommends a whole plant food diet. The article is a lifestyle survey of three populations, Sardinians, Okinawans, and Adventists, who generally display longevity and "suffer a fraction of the diseases that commonly kill people in other parts of the developed world, and enjoy more healthy years of life." In sum, they offer three sets of 'best practices' to emulate. The rest is up to you. In common with all three groups is to "Eat fruits, vegetables, and whole grains."


Carnivore and herbivore diets are contrasting, with basic nitrogen and carbon proportions vary for their particular foods. "The nitrogen content of plant tissues averages about 2%, while in fungi, animals, and bacteria it averages about 5% to 10%." Many herbivores rely on bacterial fermentation to create digestible nutrients from indigestible plant cellulose, while obligate carnivores must eat animal meats to obtain certain vitamins or nutrients their bodies cannot otherwise synthesize. All animals' diets must provide sufficient amounts of the basic building blocks they need, up to the point where their particular biology can synthesize the rest. Animal tissue contains chemical compounds, such as water, carbohydrates (sugar, starch, and fiber), amino acids (in proteins), fatty acids (in lipids), and nucleic acids (DNA and RNA). These compounds in turn consist of elements such as carbon, hydrogen, oxygen, nitrogen, phosphorus, calcium, iron, zinc, magnesium, manganese, and so on. All of these chemical compounds and elements occur in various forms and combinations (e.g. hormones, vitamins, phospholipids, hydroxyapatite).


Animal tissue consists of elements and compounds ingested, digested, absorbed, and circulated through the bloodstream to feed the cells of the body. Except in the unborn fetus, the digestive system is the first system involved[vague]. Digestive juices break chemical bonds in ingested molecules, and modify their conformations and energy states. Though some molecules are absorbed into the bloodstream unchanged, digestive processes release them from the matrix of foods. Unabsorbed matter, along with some waste products of metabolism, is eliminated from the body in the feces.


Studies of nutritional status must take into account the state of the body before and after experiments, as well as the chemical composition of the whole diet and of all material excreted and eliminated from the body (in urine and feces). Comparing the food to the waste can help determine the specific compounds and elements absorbed and metabolized in the body. The effects of nutrients may only be discernible over an extended period, during which all food and waste must be analyzed. The number of variables involved in such experiments is high, making nutritional studies time-consuming and expensive, which explains why the science of animal nutrition is still slowly evolving.


Plants uptake essential elements from the soil through their roots and from the air (consisting of mainly nitrogen and oxygen) through their leaves. Green plants obtain their carbohydrate supply from the carbon dioxide in the air by the process of photosynthesis. Carbon and oxygen are absorbed from the air, while other nutrients are absorbed from the soil. Nutrient uptake in the soil is achieved by cation exchange, wherein root hairs pump hydrogen ions (H+) into the soil through proton pumps. These hydrogen ions displace cations attached to negatively charged soil particles so that the cations are available for uptake by the root. In the leaves, stomata open to take in carbon dioxide and expel oxygen. The carbon dioxide molecules are used as the carbon source in photosynthesis.


Research in the field of nutrition has greatly contributed in finding out the essential facts about how environmental depletion can lead to crucial nutrition-related health problems like contamination, spread of contagious diseases, malnutrition, etc. Moreover, environmental contamination due to discharge of agricultural as well as industrial chemicals like organocholrines, heavy metal, and radionucleotides may adversely affect the human and the ecosystem as a whole. As far as safety of the human health is concerned, then these environmental contaminants can reduce people's nutritional status and health. This could directly or indirectly cause drastic changes in their diet habits. Hence, food-based remedial as well as preventive strategies are essential to address global issues like hunger and malnutrition and to enable the susceptible people to adapt themselves to all these environmental as well as socio-economic alterations.


In the US, dietitians are registered (RD) or licensed (LD) with the Commission for Dietetic Registration and the American Dietetic Association, and are only able to use the title "dietitian," as described by the business and professions codes of each respective state, when they have met specific educational and experiential prerequisites and passed a national registration or licensure examination, respectively. In California, registered dietitians must abide by the "Business and Professions Code of Section 2585-2586.8". Anyone may call themselves a nutritionist, including unqualified dietitians, as this term is unregulated. Some states, such as the State of Florida, have begun to include the title "nutritionist" in state licensure requirements. Most governments provide guidance on nutrition, and some also impose mandatory disclosure/labeling requirements for processed food manufacturers and restaurants to assist consumers in complying with such guidance.


In the US, nutritional standards and recommendations are established jointly by the US Department of Agriculture and US Department of Health and Human Services. Dietary and physical activity guidelines from the USDA are presented in the concept of MyPlate, which superseded the food pyramid, which replaced the Four Food Groups. The Senate committee currently responsible for oversight of the USDA is the Agriculture, Nutrition and Forestry Committee. Committee hearings are often televised on C-SPAN.


An example of a state initiative to promote nutrition literacy is Smart Bodies, a public-private partnership between the state’s largest university system and largest health insurer, Louisiana State Agricultural Center and Blue Cross and Blue Shield of Louisiana Foundation. Launched in 2005, this program promotes lifelong healthful eating patterns and physically active lifestyles for children and their families. It is an interactive educational program designed to help prevent childhood obesity through classroom activities that teach children healthful eating habits and physical exercise.


Nutrition is taught in schools in many countries. In England and Wales, the Personal and Social Education and Food Technology curricula include nutrition, stressing the importance of a balanced diet and teaching how to read nutrition labels on packaging. In many schools, a Nutrition class will fall within the Family and Consumer Science or Health departments. In some American schools, students are required to take a certain number of FCS or Health related classes. Nutrition is offered at many schools, and, if it is not a class of its own, nutrition is included in other FCS or Health classes such as: Life Skills, Independent Living, Single Survival, Freshmen Connection, Health etc. In many Nutrition classes, students learn about the food groups, the food pyramid, Daily Recommended Allowances, calories, vitamins, minerals, malnutrition, physical activity, healthful food choices, portion sizes, and how to live a healthy life.


At the time of this entry, we were not able to identify any specific nutrition literacy studies in the U.S. at a national level. However, the findings of the 2003 National Assessment of Adult Literacy (NAAL) provide a basis upon which to frame the nutrition literacy problem in the U.S. NAAL introduced the first ever measure of "the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions" – an objective of Healthy People 2010 and of which nutrition literacy might be considered an important subset. On a scale of below basic, basic, intermediate and proficient, NAAL found 13 percent of adult Americans have proficient health literacy, 44% have intermediate literacy, 29 percent have basic literacy and 14 percent have below basic health literacy. The study found that health literacy increases with education and people living below the level of poverty have lower health literacy than those above it.


Another study examining the health and nutrition literacy status of residents of the lower Mississippi Delta found that 52 percent of participants had a high likelihood of limited literacy skills. While a precise comparison between the NAAL and Delta studies is difficult, primarily because of methodological differences, Zoellner et al. suggest that health literacy rates in the Mississippi Delta region are different from the U.S. general population and that they help establish the scope of the problem of health literacy among adults in the Delta region. For example, only 12 percent of study participants identified the My Pyramid graphic two years after it had been launched by the USDA. The study also found significant relationships between nutrition literacy and income level and nutrition literacy and educational attainment further delineating priorities for the region.


These statistics point to the complexities surrounding the lack of health/nutrition literacy and reveal the degree to which they are embedded in the social structure and interconnected with other problems. Among these problems are the lack of information about food choices, a lack of understanding of nutritional information and its application to individual circumstances, limited or difficult access to healthful foods, and a range of cultural influences and socioeconomic constraints such as low levels of education and high levels of poverty that decrease opportunities for healthful eating and living.


Malnutrition refers to insufficient, excessive, or imbalanced consumption of nutrients by an organism. In developed countries, the diseases of malnutrition are most often associated with nutritional imbalances or excessive consumption. In developing countries, malnutrition is more likely to be caused by poor access to a range of nutritious foods or inadequate knowledge. In Mali the International Crops Research Institute for the Semi-Arid Tropics (ICRISAT) and the Aga Khan Foundation, trained women's groups to make equinut, a healthy and nutritional version of the traditional recipe di-dèguè (comprising peanut paste, honey and millet or rice flour). The aim was to boost nutrition and livelihoods by producing a product that women could make and sell, and which would be accepted by the local community because of its local heritage.


Nutritionism is the view that excessive reliance on food science and the study of nutrition can lead to poor nutrition and to ill health. It was originally credited to Gyorgy Scrinis, and was popularized by Michael Pollan. Since nutrients are invisible, policy makers rely on nutrition experts to advise on food choices. Because science has an incomplete understanding of how food affects the human body, Pollan argues, nutritionism can be blamed for many of the health problems relating to diet in the Western World today.


Some organizations have begun working with teachers, policymakers, and managed foodservice contractors to mandate improved nutritional content and increased nutritional resources in school cafeterias from primary to university level institutions. Health and nutrition have been proven to have close links with overall educational success. Currently, less than 10% of American college students report that they eat the recommended five servings of fruit and vegetables daily. Better nutrition has been shown to have an impact on both cognitive and spatial memory performance; a study showed those with higher blood sugar levels performed better on certain memory tests. In another study, those who consumed yogurt performed better on thinking tasks when compared to those that consumed caffeine-free diet soda or confections. Nutritional deficiencies have been shown to have a negative effect on learning behavior in mice as far back as 1951.


Cancer is now common in developing countries. According to a study by the International Agency for Research on Cancer, "In the developing world, cancers of the liver, stomach and esophagus were more common, often linked to consumption of carcinogenic preserved foods, such as smoked or salted food, and parasitic infections that attack organs." Lung cancer rates are rising rapidly in poorer nations because of increased use of tobacco. Developed countries "tended to have cancers linked to affluence or a 'Western lifestyle' — cancers of the colon, rectum, breast and prostate — that can be caused by obesity, lack of exercise, diet and age."