The term malnutrition tends to conjure up images of the about 800 million people who go hungry every day — the 156 million children under the age of 5 whose growth is stunted because they are chronically undernourished and the 50 million children who are affected by life-threatening acute malnutrition.
We often forget that malnutrition means more than not eating enough. It also extends to the 42 million children and 1.9 billion adults around the world who are overweight or obese.
Because malnutrition is, quite simply, bad nutrition.
It can be caused by eating too little food, too much food, the wrong combination of foods or foods with no or little nutritional value, as well as foods that are contaminated with disease-causing microbes.
Too little food results in undernourishment, which can stunt children’s growth and development and even kill them, often compounded with infectious diseases and poor child care. Too much food — especially food that is high in sugars and fats — causes overweight and obesity and increases people’s risk of diabetes, heart disease and certain cancers. A diet lacking nutritious foods can lead to vitamin and mineral deficiencies that cause a range of health problems. Eating foods contaminated with harmful bacteria, viruses or parasites can cause diarrhoea and result in dangerous weight loss.
Globally about one out of three people is affected by some form of malnutrition.
It’s not as simple as hunger affecting people in poor countries, or obesity being an issue for people in rich countries — malnutrition in all its forms is a global problem. It is not unusual to find people with different forms of malnutrition living side-by-side in one country, in one community, sometimes even in the same household.
That’s why, when governments drew up the world’s first global development agenda in 2015, the Sustainable Development Goals, they agreed they must end all forms of malnutrition by 2030. To ensure this commitment is achieved, the United Nations in April 2016 announced a Decade of Action on Nutrition — a period to redouble efforts to rid the world of the blight of malnutrition.
Addressing malnutrition: a global challenge
Poverty lies at the heart of the problem. Poor people are the most likely to be malnourished. Stunting — children being too short compared to others of the same age — and obesity are most common in low- and middle-income countries and among the poorest communities in high-income countries.
Eradicating poverty is key to ending malnutrition in all its forms. At the same time, eradicating malnutrition is key to economic development: A well-nourished population is a healthier and more productive population.
Although hunger and obesity might look very different, their root causes are actually the same. This means that often one set of actions can address both problems, so-called double-duty actions. Programs that provide nutritious foods in schools are an example of what governments can do to address malnutrition in all its forms.
Ensuring that mothers are well nourished is another important action to take. Malnourished mothers are more likely to have malnourished babies. An underweight mother risks having a baby with low birthweight. The child of an overweight or obese mother, in turn, is at risk of becoming overweight as an adolescent or adult. And, paradoxically, the underweight child of an underweight mother has a higher risk of overweight later in life than a child who had a healthy weight. That is why the first 1,000 days from pregnancy to a child’s 2nd birthday is such an important time to get it right, as far as nutrition is concerned.
Decade to act
The purpose of the U.N. Decade of Action on Nutrition — from 2016 to 2025 — is to inject new energy into efforts to improve people’s nutrition worldwide. We should transform our food systems (the way food is produced, processed, distributed) to ensure that all people have access to nutritious food and healthy diets. We should ensure that social protection systems reduce inequalities and give everyone around the world access to healthier diets. We should strengthen our health systems so that everybody has access to essential nutrition services. And we should ensure that women are educated and that schools offer nutritious food to all children.
But the effort will, first and foremost, be country-driven, building on existing national plans. Countries must put policies in place that will transform the food and health systems, so that, within a decade, we can all have sustainably produced, fairly traded, nutritious foods on our plates.
The U.N. Decade of Action on Nutrition is an unprecedented, once-in-a-lifetime opportunity to transform lives through better nutrition on a grand scale: We must live up to our individual and collective responsibility to build a more just, healthy and the sustainable future we want.
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Dr. Francesco Branca is the director of nutrition for health and development at the World Health Organization. He has worked as a senior scientist at the Italian Food and Nutrition Research Institute and was president of the Federation of the European Nutrition Societies in 2003-2007. He finished medicine and surgery and specialized in diabetology and metabolic diseases at the Universita' Cattolica del Sacro Cuore, Roma, and obtained a doctorate in nutrition at Aberdeen University.
Anna Lartey is the director of nutrition and food systems division at the Food and Agriculture Organization of the United Nations. She joined FAO in October 2013. Currently she wears another global hat as the president of the International Union of Nutritional Sciences.
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