Stunting was defined as the proportion of children below two standard deviations from the WHO length- or height-for-age standards median. Linear mixed-effects modelling was used to estimate rates and numbers of affected children from 1990 to 2010, and projections to 2020.In 2010, it is estimated that 171 million children (167 million in developing countries) were stunted. Globally, childhood stunting decreased from 39.7 in 1990 to 26.7% in 2010. This trend is expected to reach 21.8 or 142 million, in 2020.
Good nutrition is the cornerstone for survival, health and development. Well-nourished children perform better in school, grow into healthy adults and in turn give their children a better start in life. Well-nourished women face fewer risks during pregnancy and childbirth, and their children set off on firmer developmental paths, both physically and mentally.
Globally, more than one third of child deaths are attributable to undernutrition
Undernourished children have lowered resistance to infection and are more likely to die from common childhood ailments like diarrhoeal diseases and respiratory infections. Frequent illness saps the nutritional status of those who survive, locking them into a vicious cycle of recurring sickness and faltering growth.
Poverty, low levels of education and poor access to health services are major contributors to childhood undernutrition, a complex issue that requires tackling on a wide number of fronts.
Approaches that work
• Reductions in stunting and other forms of undernutrition can be achieved through proven interventions. These include improving women’s nutrition, especially before, during and after pregnancy; early and exclusive breastfeeding; timely, safe, appropriate and high-quality complementary food; and appropriate micronutrient interventions.
• Timing is important – interventions should focus on the critical 1,000-day window including pregnancy and before a child turns 2. After that window closes, disproportionate weight gain may increase the child’s risk of becoming overweight and developing other health problems.
• Efforts to scale up nutrition programmes are working, benefiting women and children and their communities in many countries. Such programmes all have common elements: political commitment, national policies and programmes based on sound evidence and analysis, the presence of trained and skilled community workers collaborating with communities, effective communication and advocacy, and multi-sectoral, integrated service delivery
Global momentum to scale up nutrition
• Globally, interest in nutrition has increased dramatically. Recurrent food shortages, rising food prices, strengthened evidence and rising obesity have created the impetus for widespread concern and action.
• More than ever, investing in nutrition is seen as a key development priority to benefit global welfare. The Group of 8 (G8) of the world’s wealthiest countries has put nutrition high on its development agenda, and the United Nations Secretary-General’s Zero Hunger Challenge includes the elimination of stunting as a goal.
• The global nutrition community is uniting around the Scaling Up Nutrition (SUN) movement, which supports nationally driven processes for the reduction of stunting and other forms of malnutrition.
Adding micronutrients to staple foods, complementary foods and condiments in factories and other production sites is a cost-effective way to improve the micronutrient status of populations. For example, flour is commonly fortified with iron, zinc, folic acid and other B vitamins such as thiamine, riboflavin, niacin and vitamin B12. As of December 2012, wheat flour fortification is mandated by law in 75 countries compared with only 33 countries in 2004. The amount of flour currently fortified represents about 30 per cent of the global production of wheat flour from industrial mills.
Expanded interventions and more research is needed
An expanded range of interventions is needed in many countries to address stunting and other nutrition indicators. Maternal nutrition has a large impact on infant nutritional status, and not enough interventions to improve maternal nutrition are being implemented at scale across countries. Many countries have an official iron-folic acid supplementation programme for pregnant women, but in most cases its implementation is not optimal. Other proven options are not being used to the fullest extent, such as multi-micronutrient supplements, improving nutrient intake using locally available foods, providing food supplements where appropriate, and deworming
Globally, one quarter of under-five children are stunted or an estimated 162 million in 2012. Sub-Saharan Africa and South Asia have particularly high prevalence, at about 38 per cent in both. This indicates an urgent need to accelerate integrated programmes addressing nutrition during the mother’s pregnancy and before the child reaches two years of age, the period of children’s most rapid physical and mental growth and development.
Fifteen per cent of the under-five children globally are estimated to be underweight in 2012.
The high prevalence of underweight in South Asia stands out in comparison to other regions of the world. Latin America and the Caribbean and Central and Eastern Europe/Commonwealth of Independent States have the lowest rate, which at 3 per cent and 2 per cent respectively is only a small fraction of underweight prevalence in most other regions.
Children who suffer from wasting face a markedly increased risk of death. In 2012, nearly 70 per cent of the world’s wasted children lived in Asia. These children are at substantial increased risk of severe acute malnutrition and death. In 19 out of 80 countries with recent estimates, wasting prevalence is 10 per cent or higher, requiring immediate intervention, such as emergency feeding programmes. In South Asia, prevalence of wasting is at an alarmingly high level of 16 per cent.
Increasing trends in child overweight have been noted in most world regions, not only developed countries. Globally, an estimated 44 million (7 per cent) of children under-five years of age were overweight in 2012, a 43 per cent increase from an estimated 31 million in 1990.
More than 1 in 10 children are overweight in two regions