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Thu, 20 Feb 2020

Northeast Today

Global Burden Of Malnutrition In Children

Global Burden Of Malnutrition In Children
September 28
13:46 2019


Dr. Nilratan Majumder


Malnutrition is a state of nutrition in which there is a deficiency or excess of nutrition. Thus a deficiency or excess of energy, protein and other nutrients with measurable adverse effects on body function and clinical outcomes is malnutrition.

The malnutrition, both under nutrition and over nutrition, is a significant dual health burden worldwide from childhood to adult hood. Indian children are not lagging behind from there worldwide counterpart of developing this double burden of nutrition. It is one of the leading issues on paediatric health of Northeast Indian children too. However, we sometimes fail to point out the effect of regional, social and economic ramification of malnutrition in children. This is why it is important to understand the double burden of nutrition in this age group of children.

As per report published in Lancet in 2008 important causes of under  five childhood mortality are pneumonia 20%, diarrhoea 12%, malaria 8%, measles 5%, AIDS 4%, perinatal 22% and others 29%. Among these death 35% cases are associated with under nutrition.

The report also demonstrated that malnutrition in childhood presents the highest amount of economic burden on a country, while other nutrition related issues like sub-optimal breast feeding, vitamin deficiency also forms a major chunk of the economic burden. When UN had asked 10 renowned Nobel Laureates, winners of the Nobel Prize for economics, to try to pinpoint the most cost effective way to improve the economy of the world, 9 out of 10 laureates indicated that tackling malnutrition would be it.

Availability of better nutrition in childhood allows the children for their proper biological growth and psychological development, which helps the child to learn, play, participate and contribute to their best in future. While malnutrition robes children of their futures and leaves young lives hanging in the balance. Wasting, stunting and overweight /obesity are the important clinical presentations of malnutrition.




Wasting or acute malnutrition (low weight for height) a form of malnutrition in children is a life threatening results of hunger and or disease. Children suffering from wasting have weakened the body immunity, are susceptible to long term developmental delays, and face an increased risk of death and for that they require urgent treatment and care to survive. Global report suggested that an estimated 52 million children under the five years of age were wasted (weight for height below -2SD) in 2011. The prevalence of wasted children sharply decreases (11%) in 2011 compared to an estimated 58 million in 1990. According to the 2011 report of WHO seventy percent of the worlds wasted children live in Asia, most of the children belonging from South Central Asia. These children are at substantial increased risk of severe acute malnutrition and death. The recent report of UNICEF/WHO/World Bank Group estimates that in 2016, wasting continued to threaten the lives of an estimated 7.7 percent or nearly 52 million children under 5 globally. 75% of all wasted children live in lower middle income countries.



Stunting (height for age below -2SD), is another form of chronic under nutrition in children. Stunting is the devastating results of poor nutrition in early childhood. Children suffering from stunting may never grow to their full height and their brain may never develop to their full cognitive potential. According to the global report an estimated 165 million children less than five years of age, or 26% were stunted in 2011 – a 35% decrease from an estimated 253 million in 1990. High prevalence of stunting among children under five years of age are found in Africa (36% in 2011) and Asia (27% in 2011) remain a major public health problem, one which often goes unrecognized. Very recent report suggested that stunting affected estimated 22.9% or 154.8 million children under 5 globally in 2016.


Overweight and obesity:  

There is also an emerging issues of malnutrition is childhood overweight and obesity. Overweight and obesity refers to a child who is too heavy for his or her height. This form of malnutrition results from expanding too few calories for the amount consumed from food and drinks. This burden of malnutrition causes the increase of the risk of different non communicable disease burden like cardiovascular disease, diabetes, asthma and cancer later in life.

Globally an estimated 43 million children under five years of age, or 7% were overweight (i, e., weight for height above +2SD) in 2011- a 54% increase from an estimated 28 million in 1990. Increasing trends in childhood overweight have been noted in most world regions, not only developed nations, where prevalence is highest (15% in 2011). In Africa, the estimated prevalence of under five overweight increased from 4% in 1990 to 7% in 2011. The prevalence of overweight was lower in Asia (5% in 2011) than in Africa, but the number of affected children was higher in Asia (17 million) than in Africa (12 million). Proper nutrition contributes significantly to declines in under five mortality rates. Improving nutritional status is essential for achieving the Millennium Development Goal (MDGs). An estimated 6.0 percent or 40.6 million children under age 5 around the world were overweight in 2016. 44% of all overweight children live in lower middle income countries.

While malnutrition can manifest in multiple ways, the path to prevention is virtually identical: adequate maternal nutrition before and during pregnancy and lactation; optimal breast feeding in the first two years of life, nutritious and safe food in early childhood and a health environment including access to basic services and opportunities for physical activity. These key ingredients can deliver a world where children are free from all forms of malnutrition.




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