Challenges to Global Nutrition

“There is shift towards highly refined foods and towards meat and dairy foods containing saturated fat especially in low and middle income countries turning it into a ‘double burden of disease’” said Dianne Stevens, a Nutrition Specialist of UNICEF addressing the technical session of a seminar organized by the College of Community Physicians recently in Colombo.

According to UNICEF Nutrition Specialist, one in four children in the world are underweight and 32% or 178 million suffering from chronic malnutrition or stunting. Another 10% or 55 million are acutely malnourished and 2 billion are suffering from deficiencies in vitamin A, iron, iodine and zinc. The highest burden is in South Asia. Owing to malnutrition 9.7 million children undergo death and 50% of these deaths (60.7% diarrhea, 57.3% malaria, 52.3% pneumonia and 44.8% measles) are attributable to under nutrition.

Maternal and child under-nutrition is the underlying cause of 3.5 million child deaths and 11% of total global disease burden. The number of global deaths in children less than 5 years old attributed to stunting, severe wasting and intrauterine growth restriction constitutes the largest percentage of any risk factor in this age group. Vitamin A and zinc deficiencies have by far the largest disease burden among the micronutrients. Iodine and iron deficiencies have small disease burdens and suboptimal breastfeeding results in 1.4 million deaths in children younger than 5 years.

By 2020 an estimated two thirds of the global disease burden will be attributable to non-communicable disease, most of them strongly associated with diet.

Reasons for nutrition transition are longer life expectancies, urbanization, lifestyle changes, the industrialization of food production and globalization of food marketing and distribution.

Dual threat of under nutrition and chronic disease linked to unhealthy diets are poor households spending less on fruits, vegetables and high quality sources of protein. In urban areas fatty or sugar filled foods become the cheapest way to fill empty stomachs. In rural areas families are forced to rely on low-energy, nutrient-poor staple foods etc.

There are proven effective interventions to reduce stunting and micronutrient deficiencies; As regards to Child Interventions – Breast feeding promotion- 9.1%, Vitamin A Supplementation- 7.2%, Zinc Supplementation- 3.6%, Treatment of severe malnutrition- 2.2% and complementary feeding promotion/supplementation- 1.5%.

As regards to Maternal Interventions - energy/protein supplementation-2.9%, intermittent preventative malaria prevention- 1.9% and multiple micronutrients- 1.6%.

Other interventions could be Zinc supplementation- 17% reduction in stunting, complementary feeding promotion/supplementation – 15% reduction in stunting and iron and foliate supplementation – 20% for reduction of maternal deaths and hygiene promotion – 2.4% for reduction of stunting.

A well nourished child means better physical and mental development, better educational outcomes, and better economic productivity. All this means a chance for children to realize their human potential, and for countries to realize their economic potential.

Therefore, it is necessary to ensure high level of advocacy by utilizing the powerful evidence that already exists. To ensure that policies government food and agriculture are anchored in nutritional needs and shaped by health concerns, there should be positive political leadership. Similarly to address malnutrition, adequate resources should be generated.

Stevens highlighted the importance of developing close relationship between nutrition interventions and good development practices targeting cost-effective initiatives that aim at the poor while encouraging community participation.

“Involvement of women both as service providers and beneficiaries while providing synergies for improvements in other sectors is vital. Contribution of private sector with correct political association too is very important in this regard” Stevens added.

- Asian Tribune -