WHO, nutrition experts take action on malnutrition

child malnutrition
WHO/Marko Kokic

16 March, 2011 | Geneva -- To fight all forms of malnutrition, the World Health Organization and international experts are recommending new actions and revising global guidance on under-nutrition, obesity and overweight, micronutrient deficiency and other forms of malnutrition which affect hundreds of millions of people worldwide.

"Worldwide, malnutrition accounts for 11% of all diseases and causes long-term poor health and disability," says Dr Francesco Branca, WHO's Director of Nutrition for Health and Development. "But malnutrition also threatens a child's education and the development of the world's most vulnerable countries."

WHO provides global leadership on nutritional standards and guidance. The World Health Assembly in 2010 called on WHO to update and consolidate all such advice, and create new measures where needed, to help countries and all others involved in nutrition to provide appropriate nutritional support to people in need, particularly infants, young children and women.

The WHO Nutrition Guidance Expert Advisory Group (NUGAG) is working from 14-18 March 2011 in Geneva to update this guidance, particularly in the areas of micronutrients, diet and health, nutrition in the life course and under-nutrition. The group is finalizing recommendations on areas including iron supplementation for diets, which can impact greatly on anaemia. In developing countries every second pregnant woman and about 40% of preschool children are estimated to be anaemic, while anaemia also contributes to 20% of all maternal deaths.

Some 13 million babies are born each year with low birth weight, meaning they did not grow to their full potential during gestation. Low birth weight babies are more likely to die in infancy, and many also suffer irreversible cognitive impairments and increased risk of developing noncommunicable diseases later in adulthood. "An estimated 2.5 million of these low birth weight babies - nearly one in five - are born this way because their mothers did not have adequate amounts of iron in their diet," says Prof Rebecca Stoltzfus of Cornell University and member of the WHO expert group. "Such evidence is helping us devise recommendations that can help protect the lives of millions of newborns."

Dr Branca adds: "A wealth of knowledge and guidance exists to tackle the many forms of malnutrition. For example, improvement of exclusive breastfeeding practices, adequate and timely complementary feeding, and continued breastfeeding for up to two years or beyond can save the lives of 1.5 million children aged under five every year."

He adds: "But this advice must be updated and consolidated so it can be used by all who work to protect the nutritional status of the world's most vulnerable people. Countries must be committed to implementing this guidance, and the Global strategy for infant and young child feeding."

Malnutrition causes:

  • 171 million children aged under 5 years to be stunted annually;
  • 115 million children to suffer from wasting.
  • 20 million children to suffer from the most deadly form of severe acute malnutrition;
  • The deaths of 3.9 million children (35% of total deaths) through exposure to nutritional risk including underweight, suboptimal breastfeeding and vitamin and mineral deficiencies, particularly of vitamin A, iron, iodine and zinc.
  • 1.5 billion people to be overweight worldwide, of whom 500 million are obese. Some 43 million children aged under 5 years were overweight in 2010, with 35 million being in developing countries and largest numbers in Asia and fastest growth rates in Africa.

Some 36 countries are home to 90% of the world's children who suffer from stunting, or chronic malnutrition. Increasingly, many countries are witnessing increasing public health problems posed by the double burden of malnutrition --both under-nutrition and overweight. Trends of child stunting, or chronic malnutrition, remain high throughout Africa and Asia, particularly in comparison to developed countries.

But, there are marked increases in the numbers of overweight children. In Africa, for example, the percentage of children overweight has more than doubled from 4% in 1990 to 8.5% in 2010 (4 million children compared to 13.5 million). Similarly in Asia, children suffering from overweight increased from 3.2% in 1990 to 4.9% in 2010, accounting for a jump from 13 million children to 15 million children being overweight. During the same period, Latin America recorded no real change (6.8% in 1990 compared to 6.9% in 2010, or 4 million children annually.)

"The kinds of food available in developing countries includes more highly refined, processed, high-energy density foods," says Dr Branca. "There are also decreasing breastfeeding rates in low- and middle-income countries. We are worried about the vast numbers of infants and young children who are still poorly fed and whose nutritional status, growth and development, health and survival are thereby compromised."

Nutrition is a critical part of health and development. Better nutrition is related to improved infant, child and maternal health, stronger immune systems, safer pregnancy and childbirth, lower risk of noncommunicable diseases (such as diabetes and cardiovascular disease), and longevity. Healthy children learn better. People with adequate nutrition are more productive and can create opportunities to gradually break the cycles of poverty and hunger.