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Undernutrition: the invisible killer of 3 million children a year Undernutrition: the invisible killer of 3 million children a year
(7 months later)
Undernutrition remains one of the biggest development challenges because its effects are so long-lasting. This week the EU set out new policies on the issue. In children the problem expresses itself in many ways. The media focus on children who are desperately thin and obviously wasting away means that chronic undernutrition – just as deadly – can be overlooked.Undernutrition remains one of the biggest development challenges because its effects are so long-lasting. This week the EU set out new policies on the issue. In children the problem expresses itself in many ways. The media focus on children who are desperately thin and obviously wasting away means that chronic undernutrition – just as deadly – can be overlooked.
These children may look normal but their brain development and immune systems most certainly are not. Approximately 40% of all children under five in south Asia and sub-Saharan Africa are short for their age. Their stunted height is a grisly marker of multiple deprivations regarding food intake, care and play, clean water, good sanitation and health care. In the same regions, about 7%-15% of children suffer from wasting.These children may look normal but their brain development and immune systems most certainly are not. Approximately 40% of all children under five in south Asia and sub-Saharan Africa are short for their age. Their stunted height is a grisly marker of multiple deprivations regarding food intake, care and play, clean water, good sanitation and health care. In the same regions, about 7%-15% of children suffer from wasting.
Stunting and wasting in the first 1,000 days after conception represents a blatant squandering of human potential. This is because in these crucial days, the body is laying down fundamental human hardware and software – and doing it very quickly, with demanding nutrient requirements. Immune-system and brain-synapse development are particularly vulnerable. Any disturbance of this frantic activity leaves a terrible mark. Consider the results of this dark legacy:Stunting and wasting in the first 1,000 days after conception represents a blatant squandering of human potential. This is because in these crucial days, the body is laying down fundamental human hardware and software – and doing it very quickly, with demanding nutrient requirements. Immune-system and brain-synapse development are particularly vulnerable. Any disturbance of this frantic activity leaves a terrible mark. Consider the results of this dark legacy:
• Undernourished children are more likely to get sick, frequently resulting in death. The prevention of stunting in young children would prevent a third of child deaths. Maternal and child undernutrition is the underlying cause of approximately 3 million child deaths a year.• Undernourished children are more likely to get sick, frequently resulting in death. The prevention of stunting in young children would prevent a third of child deaths. Maternal and child undernutrition is the underlying cause of approximately 3 million child deaths a year.
• Undernourished children of five years or over are more likely to be overweight and to develop chronic diseases such as diabetes and heart disease later in life. This counter-intuitive conclusion is because undernutrition very early in life disrupts the body's lifelong ability to regulate energy balance.• Undernourished children of five years or over are more likely to be overweight and to develop chronic diseases such as diabetes and heart disease later in life. This counter-intuitive conclusion is because undernutrition very early in life disrupts the body's lifelong ability to regulate energy balance.
• The prevention of stunting improves performance in school. Children who avoid stunting in the first two to three years of life have been shown to perform better.• The prevention of stunting improves performance in school. Children who avoid stunting in the first two to three years of life have been shown to perform better.
• The prevention of malnutrition in infants is associated with better mental health in adolescence. Adolescents who were malnourished as two-year-olds show higher levels of anxiety and depression (controlling for potentially confounding factors).• The prevention of malnutrition in infants is associated with better mental health in adolescence. Adolescents who were malnourished as two-year-olds show higher levels of anxiety and depression (controlling for potentially confounding factors).
• The prevention of stunting improves wage rates, earned income and employment rates, boosts own-enterprise start-ups, reduces poverty and adds to economic growth. UN estimates from Central American countries place the economic burden of malnutrition at between 2 and 11% of the value of GDP.• The prevention of stunting improves wage rates, earned income and employment rates, boosts own-enterprise start-ups, reduces poverty and adds to economic growth. UN estimates from Central American countries place the economic burden of malnutrition at between 2 and 11% of the value of GDP.
• Malnourished women are at a greater risk of giving birth to malnourished babies. Hence malnutrition has the ability to travel not just throughout a life cycle but also to jump across them.• Malnourished women are at a greater risk of giving birth to malnourished babies. Hence malnutrition has the ability to travel not just throughout a life cycle but also to jump across them.
If we can prevent malnutrition in the first 1,000 days we turn this dark legacy into a bright one. We will have locked in these benefits for ever – throughout the life cycle and across the generations. If these benefits are so tangible and so uncontested, why are they so difficult to realise?If we can prevent malnutrition in the first 1,000 days we turn this dark legacy into a bright one. We will have locked in these benefits for ever – throughout the life cycle and across the generations. If these benefits are so tangible and so uncontested, why are they so difficult to realise?
First, income growth does not take care of malnutrition automatically. It helps, but it is not nearly enough. Second, most parents cannot do it on their own. They don't have the money, time, information or knowhow. Third, markets cannot be relied on to resolve the situation: most malnutrition is invisible, irreversible and intergenerational – all features that resist market solutions and demand public action.First, income growth does not take care of malnutrition automatically. It helps, but it is not nearly enough. Second, most parents cannot do it on their own. They don't have the money, time, information or knowhow. Third, markets cannot be relied on to resolve the situation: most malnutrition is invisible, irreversible and intergenerational – all features that resist market solutions and demand public action.
Public action has to occur on the following levels. We must scale up a set of proven nutrition interventions and design programmes that attack the underlying causes of malnutrition in agriculture, social welfare, education, women's empowerment, water, sanitation and hygiene. And we must develop an enabling environment to advocate for and support these interventions.Public action has to occur on the following levels. We must scale up a set of proven nutrition interventions and design programmes that attack the underlying causes of malnutrition in agriculture, social welfare, education, women's empowerment, water, sanitation and hygiene. And we must develop an enabling environment to advocate for and support these interventions.
Leadership is needed if we are to stop the silent wrecker of lives that is malnutrition, and encourage the growth of children, adults and societies. It is the vital missing ingredient. Malnutrition is often said to be no one's responsibility but everyone's business. We must make it everybody's responsibility. Leaders are needed if we are to make the legacy of the first 1,000 days last for ever.Leadership is needed if we are to stop the silent wrecker of lives that is malnutrition, and encourage the growth of children, adults and societies. It is the vital missing ingredient. Malnutrition is often said to be no one's responsibility but everyone's business. We must make it everybody's responsibility. Leaders are needed if we are to make the legacy of the first 1,000 days last for ever.
• This article was commissioned after a suggestion by afancdogge. If there's a subject you'd like to see covered on Comment is free, please visit our You Tell Us page• This article was commissioned after a suggestion by afancdogge. If there's a subject you'd like to see covered on Comment is free, please visit our You Tell Us page
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