Food insecurity worldwide derived from food supply patterns

International Journal of Pediatrics, 2015

Adequate nutrition is essential in early childhood to ensure healthy growth, proper organ formation and function, a strong immune system, and neurological and cognitive development. Child malnutrition – as measured by poor child growth – is an important indicator for monitoring population nutritional status and health. In 2013, about 17%, or 98 million children under five years of age in developing countries were underweight (low weight-for-age according to the WHO child growth standards). Underweight prevalence is highest in the United Nation (UN) region of Southern Asia (30%), followed by Western Africa (21%), Oceania and Eastern Africa (both 19%) and South-Eastern Asia and Middle Africa (both 16%), and Southern Africa 12%. Prevalence below 10% for 2013 is estimated for the UN regions of Eastern, Central and Western Asia, Northern Africa and Latin America and the Caribbean. Childhood malnutrition, including fetal growth restriction, suboptimum breastfeeding, stunting, wasting and ...

Maternal & Child Nutrition

Although the prevalence of obesity has rapidly increased in the low-and middleincome countries of the Middle East and North Africa (MENA) and Latin America and the Caribbean (LAC) regions, child undernutrition remains a public-health challenge. We examined region-specific sociodemographic determinants of this double burden of malnutrition, specifically, the co-occurrence of child stunting and overweight, using Demographic and Health Survey and Multiple Indicator Cluster Survey data (2003-2016) from 11 countries in the MENA (n = 118,585) and 13 countries in the LAC (n = 77,824) regions. We used multiple logistic regressions to model regionspecific associations of maternal education and household wealth with child nutritional outcomes (6-59 months). The prevalence of stunting, overweight, and their co-occurrence was 24%, 10%, and 4.3% in children in the MENA region, respectively, and 19%, 5%, and 0.5% in children in the LAC region, respectively. In both regions, higher maternal education and household wealth were significantly associated with lower odds of stunting and higher odds of overweight. As compared with the poorest wealth quintiles, decreased odds of co-occurring stunting and overweight were observed among children from the second, third, and fourth wealth quintiles in the LAC region. In the MENA region, this association was only statistically significant for the second wealth quintile. In both regions, double burden was not statistically significantly associated with maternal education. The social patterning of cooccurring stunting and overweight in children varied across the two regions, indicating potential differences in the underlying aetiology of the double burden across regions and stages of the nutrition transition.

JPEN J Parenter Enteral Nutr, 2013

Disease-related malnutrition (DRM) represents a critical public health concern worldwide. Numerous surveys indicate a prevalence of 20%-30% at the time of admission to hospital. The impact of important aspects, such as the policy of the state, its economy, as well as the historical burden, which may influence the prevalence of DRM, has rarely been analyzed. Our study proved that all those factors do have an important impact on the problem and that DRM represents an issue, comparable in terms of scale, worldwide. Moreover, the research showed that the intensity and methods adopted to fight malnutrition differ significantly among countries. This appears to be directly associated with real successes in some countries, and little progress elsewhere. This should be discussed in an open forum, so that countries can learn from each other.

2008

Malnutrition is manifested in various degrees of both underweight and overweight, with large differences and rapid changes in their prevalence and severity. This paper introduces a new approach to characterizing the distribution of a population's nutritional status, to help analyze changes in that distribution over time and across countries. Our method draws on the poverty literature to construct Foster-Greer-Thorbecke measures for the incidence and severity of underand overweight, based on deviations in either direction from the median of a healthy population. We apply this median-based measure to the nutritional status of over 400,000 preschool children, as measured in 130 DHS surveys covering 53 countries over a period from 1986 to 2006. Unlike conventional threshold-based methods, the new approach counts changes in every child's bodyweight. We find that this offers a more sensitive measure of differences across countries and changes over time, showing in particular that children's bodyweights are closely linked to local agricultural output and gender equality as well as real GDP per capita.

Nature medicine, 2020

T he profound impacts of childhood malnutrition, including both undernutrition and overweight, affect the economic, social and medical well-being of individuals, families, communities and nations 1,2. Undernutrition has been the most common form of malnutrition in LMICs 3 , but as populations experience economic growth, urbanization and demographic change, overweight is an emerging problem, leading to a double burden of malnutrition (DBM). DBM may be manifested at the individual level as stunting in childhood followed by overweight in adulthood 4. At the household level, research has focused on maternal and child indicators of malnutrition, whereas at the population level, prevalence of both undernutrition with overweight has been reported 5. In children, DBM can be defined using different combinations of the various indicators of undernutrition (wasting and/or stunting) and overweight, obesity and diet-related noncommunicable diseases (NCDs) 6. While the most studied type of double burden is that of stunting and obesity, it is mostly applicable at the individual level among overweight adults who were previously stunted from chronic undernutrition during childhood. Wasting is associated with high rate of child mortality, whereas stunting has significant negative impact across the life course and is highly predictive of economic outcomes 7. Public health nutrition programs designed to address undernutrition may exacerbate overweight 8 , thus a comprehensive understanding of DBM at the population level is crucial for the design of effective interventions. Our aim was to determine the prevalence of overweight among children under 5 years old in LMICs (N = 105) for policy-relevant administrative units (district, state, and national level) and determine DBM by combining these estimates with those of wasting prevalence. As there is no broad consensus on the preferred international child growth standards for assessing overweight and obesity among children under 5 (refs. 9,10), we used weight-for-height above established cutoff points defined by the World Health Organization (WHO). This was to analyze overweight estimates in relation to the Global Nutrition Targets (GNTs), which were developed based on WHO standards. Prevalence of early childhood overweight (including obesity) is defined as the proportion of children under 5 with a weight-for-height z score (WHZ) more than two standard deviations (s.d.) above the WHO sex-and age-specific median growth reference standards 10. This is different from the definition for children between the ages of 5-18 years, which is above one s.d. for overweight and above two s.d. for obese. We selected wasting as the comparative indicator against overweight, as both share recommended population prevalence ranges, which can be used to create bivariate categories for DBM. Child wasting prevalence is defined as the proportion of children under 5 with a WHZ more than two s.d. below the median WHO growth standards 10. Using WHZs allowed modeling of the three categories in the same distribution and thus enabled us to reliably determine the relative proportions for each category using an ordinal approach. Based on WHO and United Nations Children's Fund (UNICEF)-defined thresholds, a moderate level of separate or dual conditions is defined as >5-10%, a high level as >10-15% and a very high level as >15% estimated prevalence 11. Finally, we have defined DBM in this study as the simultaneous occurrence of >5% estimated prevalence for both wasting and overweight within the same locations in the same year. Reversing the rise in childhood overweight is indicated in the United Nations (UN) Sustainable Development Goal 2.2 (ref. 12) and WHO's GNTs to improve maternal, infant and young child nutrition 13. WHO has also set an international target to reduce wasting to <5% by 2025 (ref. 14). Quantifying changes in childhood overweight and wasting prevalence can be used to measure progress toward these targets, while identifying locales with simultaneous overweight and wasting will better inform intervention planning. In addition, mapping changes in DBM prevalence will provide a deeper understanding of the impact of past intervention strategies, including insight into overweight in children under 5. Global and local variation in malnutrition trends Globally in 2017, an estimated 38.3 million (5.6%) children under 5 were overweight and 50.5 million (7.5%) were wasted 15. The majority (91%) of children under 5 affected by wasting and nearly half A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low-and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1-70.8) million) to 6.4% (58.3 (47.6-70.7) million), but is predicted to remain above the World Health Organization's Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8-38.5) million) in 2000 to 6.0% (55.5 (44.8-67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic. Nature MeDiCiNe | www.nature.com/naturemedicine Content courtesy of Springer Nature, terms of use apply. Rights reserved

Global Crises, Global Solutions, 2004

Documentos De Trabajo, 2011

Rapid economic development and increasing urbanisation have led to a dramatic rise in overweight among adults in many low-income countries. Paradoxically, overweight often coexists with persisting under-nutrition among members of the same household. The aim of this study was to assess whether child under-nutrition combined with maternal over-nutrition is a health concern among a sample of propoor households, and whether urban residence is associated with the phenomenon. The occurrence of stunted and/or underweight children and overweight mothers within the same household was studied in cohorts of 2,000 children aged between 4.5 and 5.5 years in each of Ethiopia, India (Andhra Pradesh), Vietnam and Peru. Multivariate logistic regression was used to estimate the effect of urban residence controlling for potential confounding factors. The prevalence of child stunting combined with maternal overweight was very low in Ethiopia, India and Vietnam, but as high as 14 per cent in Peru. Underweight child / overweight mother pairs were uncommon in all four countries. Urban residence significantly increased the likelihood of dual burden households only in India. In Peru and Vietnam, living in urban neighbourhoods decreased the coexistence of child stunting and maternal overweight non-significantly. In conclusion, the dual burden of over-and under-nutrition seems to be a health concern only among poor households in Peru. Interventions specifically designed for resource-poor settings that address the nutritional status of each household member individually and promote a healthy lifestyle are needed.

Public Health Nutrition, 1998

To review current information on under- and over-malnutrition and the consequences of socioeconomic disparities on global nutrition and health. Malnutrition, both under and over, can no longer be addressed without considering global food insecurity, socioeconomic disparity, both globally and nationally, and global cultural, social and epidemiological transitions. The economic gap between the more and less affluent nations is growing. At the same time income disparity is growing within most countries, both developed and developing. Concurrently, epidemiological, demographic and nutrition transitions are taking place in many countries. Fully one-third of young children in the world&amp;#39;s low-income countries are stunted because of malnutrition. One-half of all deaths among young children are, in part, a consequence of malnutrition. Forty percent of women in the developing world suffer from iron deficiency anaemia, a major cause of maternal mortality and low birth weight infants. Despite such worrying trends, there have been significant increases in life expectancy in nearly all countries of the world, and continuing improvements in infant mortality rates. The proportion of children malnourished has generally decreased, although actual numbers have not in sub-Saharan Africa and south Asia. Inequalities are increasing between the richest developed countries and the poorest developing countries. Social inequality is an important factor in differential mortality in both developed and developing countries. Many countries have significant pockets of malnutrition and increased mortality of children, while obesity and non-communicable diseases (NCDs) prevalences are increasing. Not infrequently it is the poor and relatively disadvantaged sectors of the population who are suffering both. In the industrialized countries, cardiovascular disease incidence has declined, but less so in the poorer socioeconomic strata. The apparent contradictions found represent a particular point in time (population responses generally lag behind social and environmental transitions). They do also show encouraging evidence that interventions can have a positive impact, sometimes despite disadvantageous circumstances. However, it seems increasingly unlikely that food production will continue to keep up with population growth. It is also unlikely present goals for reducing protein-energy malnutrition prevalence will be reached. The coexistence of diseases of undernutrition and NCDs will have an impact on allocation of resources. Action needs to be continued and maintained at the international, national and individual level.

International Journal of Pediatrics, 2016

Background: It is necessary to get information on nutrition situation in children and epidemiology of the malnutrition to use for planning and health policy making, therefore this study aimed to identify the role of human development on nutrition situation in children under-five years of old worldwide.Methods: This ecological study was performed on the relation of the nutrition situation of children under 5 years of old and HDI. Data about the HDI and other indices were obtained from the UNDP database and Data about prevalence of wasting, stunting and overweight in children under 5 (%) were obtained from WHO. Correlation bivariate method were used to assessment of the correlation between the prevalence of nutrition status and the HDI.Results: Globally mean prevalence of stunting, wasting and overweight were 23.4, 6.2 and 7.1 percent respectively. There was a negative significant correlation between prevalence of stunting and wasting with HDI, Life expectancy at birth, Mean year of s...

Maternal and Child Nutrition, 2005

The purpose of this paper is to document the prevalence of the phenomenon of the coexistence of a stunted child and an overweight mother (SCOWT) in the same household in low-and middle-income countries. We also explore whether this phenomenon is associated with a country's level of economic development and urbanization and highlight policy directions for public nutrition. Data from 36 Demographic and Health Surveys (DHS) were used (23 in Africa, 8 in Latin America, and 5 in Asia). Stunting was defined as height-forage <-2 SD of the reference population and maternal overweight as a body mass index (BMI) of > 25 kg m-2. World Bank and United Nations figures were used for gross national product per capita (an indicator of economic development) and for level of urbanization respectively. Descriptive statistics were derived, and multivariate linear regression analysis was used to model the association between economic development, urbanization and the prevalence of SCOWT. The prevalence of SCOWT is generally below 10%, except in four countries, of which three are in Latin America. Among our sample of countries, SCOWT is generally more prevalent in Latin America than in Africa, and is near or below 5% in all five countries of Asia. Contrary to our expectations, SCOWT is not necessarily more prevalent in urban than rural areas. We also find that when economic development is controlled for, SCOWT is associated with urbanization only in Latin America. In Africa and Asia, SCOWT is associated with economic development, but not urbanization. The concrete recognition of the SCOWT phenomenon is an important step to delineating more effective and integrated strategies to address problems of over-and undernutrition and dietary quality within countries, regions and households. This gives special importance to designing programmes and policies that will address the food and nutrition needs of each individual, rather than assuming that those needs are addressed by targeting programmes or policies to the household as a whole.