Malnutrition occurs when an organism gets too few or too many nutrients, resulting in health problems. Specifically, it is "a

deficiency A deficiency is generally a lack of something. It may also refer to: *A deficient number, in mathematics, a number ''n'' for which ''σ''(''n'') < 2''n'' * energy, protein and other nutrients" which adversely affects the body's tissues and form. Malnutrition is not receiving the correct amount of nutrition. Malnutrition is increasing in children under the age of five due to providers who cannot afford or do not have access to adequate nutrition. Malnutrition is a category of diseases that includes

undernutrition Malnutrition occurs when an organism gets too few or too many nutrients, resulting in health problems. Specifically, it is "a deficiency, excess, or imbalance of energy, protein and other nutrients" which adversely affects the body's tissues ...

and

overnutrition Overnutrition (also known as hyperalimentation) is a form of malnutrition in which the intake of nutrients is oversupplied. The amount of nutrients exceeds the amount required for normal growth, development, and metabolism. The term can also ref ...

. Undernutrition is a lack of nutrients, which can result in

stunted growth Stunted growth is a reduced growth rate in human development. It is a primary manifestation of malnutrition (or more precisely undernutrition) and recurrent infections, such as diarrhea and helminthiasis, in early childhood and even before birth, ...

wasting In medicine, wasting, also known as wasting syndrome, refers to the process by which a debilitating disease causes muscle and fat tissue to "waste" away. Wasting is sometimes referred to as "acute malnutrition" because it is believed that epis ...

, and

underweight An underweight person is a person whose body weight is considered too low to be healthy. A person who is underweight is malnourished. Assessment The body mass index, a ratio of a person's weight to their height, has traditionally been used t ...

. A surplus of nutrients causes overnutrition, which can result in obesity. In some

developing countries A developing country is a sovereign state with a lesser developed industrial base and a lower Human Development Index (HDI) relative to other countries. However, this definition is not universally agreed upon. There is also no clear agree ...

, overnutrition in the form of obesity is beginning to appear within the same communities as undernutrition. Most clinical studies use the term 'malnutrition' to refer to undernutrition. However, the use of 'malnutrition' instead of 'undernutrition' makes it impossible to distinguish between undernutrition and overnutrition, a less acknowledged form of malnutrition. Accordingly, a 2019 report by The Lancet Commission suggested expanding the definition of malnutrition to include "all its forms, including obesity, undernutrition, and other

dietary In nutrition, diet is the sum of food consumed by a person or other organism. The word diet often implies the use of specific intake of nutrition for health or weight-management reasons (with the two often being related). Although humans are o ...

risks." The World Health Organization and The Lancet Commission have also identified " e double burden of malnutrition," which occurs from "the coexistence of overnutrition (overweight and obesity) alongside undernutrition (stunted growth and wasting)."Ghattas, H., Acharya, Y., Jamaluddine, Z., Assi, M., El Asmar, K. and Jones, A., 2020. The child-level double burden of malnutrition in the MENA and LAC regions: Prevalence and social determinants. Maternal & Child Nutrition, 16(2).

Prevalence

It is estimated that nearly one in three persons globally has at least one form of malnutrition: wasting, stunting, vitamin or mineral deficiency, overweight, obesity, or diet-related noncommunicable diseases. Undernutrition is more common in

. Stunting is more prevalent in urban slums than in rural areas.Murarkar, S., Gothankar, J., Doke, P., Pore, P., Lalwani, S., Dhumale, G., Quraishi, S., Patil, R., Waghachavare, V., Dhobale, R., Rasote, K., Palkar, S. and Malshe, N., 2020. Prevalence and determinants of undernutrition among under-five children residing in urban slums and rural area, Maharashtra, India: a community-based cross-sectional study. BMC Public Health, 20(1). Studies on malnutrition have the population categorised into different groups including infants, under-five children, children, adolescents, pregnant women, adults and the elderly population. The use of different growth references in different studies leads to variances in the undernutrition prevalence reported in different studies. Some of the growth references used in studies include the National Center for Health Statistics (NCHS) growth charts, WHO reference 2007, Centers for Disease Control and Prevention (CDC) growth charts, National Health and Nutrition Examination Survey (NHANES), WHO reference 1995, Obesity Task Force (IOTF) criteria and Indian Academy of Pediatrics (IAP) growth charts.

In children

The prevalence of undernutrition is highest among children under five. In 2020, 149 million children under five years old were stunted, 45 million were wasted, and 38.9 million were overweight or obese. The following year, an estimated 45% of deaths in children were linked to undernutrition. The prevalence of wasting among children under five in South Asia was reported to be 16% moderately or severely wasted. In Asia, India has one of the highest burden of wasting with over 20% wasted children. However, the burden of undernutrition among under-five children in African countries is much higher. A pooled analysis of the prevalence of chronic undernutrition among under-five children in East Africa was identified to be 33.3%. This prevalence of undernutrition among under-five children ranged from 21.9% in Kenya to 53% in Burundi. In Tanzania, the prevalence of stunting, among children under five varied from 41% in lowland and 64.5% in highland areas. Undernutrition by underweight and wasting was 11.5% and 2.5% in lowland and 22.% and 1.4% in the highland areas of Tanzania respectively. In South Sudan, the prevalence of undernutrition explained by stunting, underweight and wasting in under-five children were 23.8%, 4.8% and 2.3% respectively.

Vitamin A deficiency Vitamin A deficiency (VAD) or hypovitaminosis A is a lack of vitamin A in blood and tissues. It is common in poorer countries, especially among children and women of reproductive age, but is rarely seen in more developed countries. Nyctalopia (ni ...

affects one third of children under age 5 around the world,World Health Organization, Global prevalence of vitamin A deficiency in populations at risk 1995–2005, WHO orld health organisationglobal database on vitamin A deficiency. leading to 670,000 deaths and 250,000–500,000 cases of

blindness Visual impairment, also known as vision impairment, is a medical definition primarily measured based on an individual's better eye visual acuity; in the absence of treatment such as correctable eyewear, assistive devices, and medical treatment� ...

In adults

As of June 2021, 1.9 billion adults were overweight or obese, and 462 million adults were underweight. Globally, two billion people had

iodine deficiency Iodine deficiency is a lack of the trace element iodine, an essential nutrient in the diet. It may result in metabolic problems such as goiter, sometimes as an endemic goiter as well as congenital iodine deficiency syndrome due to untreated c ...

in 2017. In 2020, 900 million women and children had anemia, which is often caused by iron deficiency. Certain groups have higher rates of undernutrition, including

elderly Old age refers to ages nearing or surpassing the life expectancy of human beings, and is thus the end of the human life cycle. Terms and euphemisms for people at this age include old people, the elderly (worldwide usage), OAPs (British usage ...

people and women (in particular while pregnant or

breastfeeding Breastfeeding, or nursing, is the process by which human breast milk is fed to a child. Breast milk may be from the breast, or may be expressed by hand or pumped and fed to the infant. The World Health Organization (WHO) recommends that brea ...

children under five years of age). Undernutrition is an increasing health problem in people aged over 65 years, even in developed countries, especially among nursing home residents and in acute care hospitals. In the elderly, undernutrition is more commonly due to physical, psychological, and social factors, not a lack of food. Age-related reduced dietary intake due to chewing and swallowing problems, sensory decline, depression, imbalanced gut microbiome, poverty and loneliness are major contributors to undernutrition in the elderly population.

Recent increase

There has been an increase in world hunger over the past decade. In 2015, 795 million people (about one in ten people on earth) had undernutrition. In 2020, one in nine people in the world—or 820 million people worldwide—was hungry. These increases are partially related to the ongoing COVID-19 pandemic, which continues to highlight the weaknesses of current food and health systems. It has contributed to food insecurity, increasing hunger worldwide; meanwhile, lower physical activity during

lockdown A lockdown is a restriction policy for people, community or a country to stay where they are, usually due to specific risks (such as COVID-19) that could possibly harm the people if they move and interact freely. The term is used for a prison ...

s has contributed to increases in overweight and obesity. In 2020, experts estimated that by the end of the year, the pandemic could double the number of people at risk of suffering acute hunger. Similarly, experts estimate that the

prevalence In epidemiology, prevalence is the proportion of a particular population found to be affected by a medical condition (typically a disease or a risk factor such as smoking or seatbelt use) at a specific time. It is derived by comparing the number o ...

of moderate and severe wasting could increase by 14% due to COVID-19; coupled with reductions in nutrition and health services coverage, this could result in over 128,000 additional deaths among children under 5 in 2020 alone. Although COVID-19 is less severe in children than in adults, the risk of severe disease increases with undernutrition. Other major causes of hunger include manmade conflicts, climate changes, and economic downturns.

Definitions

Undernutrition

Undernutrition can occur either due to protein-energy wasting or as a result of micronutrient deficiencies.Morley, J., 2012. Undernutrition in older adults. Family Practice, 29(suppl 1), pp.i89-i93. It adversely affects physical and mental functioning, and causes changes in body composition and body cell mass. Undernutrition is a major health problem, causing the highest

mortality rate Mortality rate, or death rate, is a measure of the number of deaths (in general, or due to a specific cause) in a particular population, scaled to the size of that population, per unit of time. Mortality rate is typically expressed in units of de ...

in children, and is responsible for long-lasting

physiologic Physiology (; ) is the scientific study of functions and mechanisms in a living system. As a sub-discipline of biology, physiology focuses on how organisms, organ systems, individual organs, cells, and biomolecules carry out the chemical a ...

effects. It is a barrier to the complete physical and mental development of children. Undernutrition can manifest as stunting, wasting, and underweight. If undernutrition occurs during pregnancy, or before two years of age, it may result in permanent problems with physical and mental development. Extreme undernutrition can cause

starvation Starvation is a severe deficiency in caloric energy intake, below the level needed to maintain an organism's life. It is the most extreme form of malnutrition. In humans, prolonged starvation can cause permanent organ damage and eventually, ...

, chronic hunger,

Severe Acute Malnutrition Global Acute Malnutrition (GAM) is a measurement of the nutritional status of a population that is often used in protracted refugee situations. Along with the Crude Mortality Rate, it is one of the basic indicators for assessing the severity of a h ...

(SAM), and/or

Moderate Acute Malnutrition Moderate is an ideological category which designates a rejection of radical or extreme views, especially in regard to politics and religion. A moderate is considered someone occupying any mainstream position avoiding extreme views. In American p ...

(MAM). The signs and symptoms of

micronutrient deficiencies Micronutrient deficiency or dietary deficiency is not enough of one or more of the micronutrients required for optimal plant or animal health. In humans and other animals they include both vitamin deficiencies and mineral deficiencies, whereas in p ...

depend on which micronutrient is lacking. However, undernourished people are often thin and short, with very poor energy levels; and swelling in the legs and abdomen is also common. People who are undernourished often get infections and frequently feel cold.

Micronutrient malnutrition

Micronutrient malnutrition results from inadequate intake of vitamins and minerals. Worldwide, deficiencies in iodine, Vitamin A, and iron are the most common. Children and pregnant women in

low-income countries A developing country is a sovereign state with a lesser developed industrial base and a lower Human Development Index (HDI) relative to other countries. However, this definition is not universally agreed upon. There is also no clear agreem ...

are at especially high risk for micronutrient deficiencies.

Anemia Anemia or anaemia (British English) is a blood disorder in which the blood has a reduced ability to carry oxygen due to a lower than normal number of red blood cells, or a reduction in the amount of hemoglobin. When anemia comes on slowly, t ...

is most commonly caused by iron deficiency, but can also result from other micronutrient deficiencies and diseases. This condition can have major health consequences. It is possible to have overnutrition simultaneously with micronutrient deficiencies; this condition is termed the '
double burden of malnutrition
''.

Protein-energy malnutrition

'Undernutrition' sometimes refers specifically to protein–energy malnutrition (PEM). This condition involves both micronutrient deficiencies and an imbalance of protein intake and energy expenditure. It differs from

calorie restriction Calorie restriction (caloric restriction or energy restriction) is a dietary regimen that reduces intake of energy from caloric foods & beverages without incurring malnutrition. "Reduce" can be defined relative to the subject's previous intake b ...

in that calorie restriction may not result in negative health effects. Hypoalimentation (underfeeding) is one cause of undernutrition. Two forms of PEM are kwashiorkor and marasmus; both commonly coexist. Kwashiorkor 6180

''Kwashiorkor'' is primarily caused by inadequate protein intake. Its symptoms include edema, wasting, liver enlargement,

hypoalbuminaemia Hypoalbuminemia (or hypoalbuminaemia) is a medical sign in which the level of albumin in the blood is low. This can be due to decreased production in the liver, increased loss in the gastrointestinal tract or kidneys, increased use in the body, or ...

, and

steatosis Steatosis, also called fatty change, is abnormal retention of fat (lipids) within a cell or organ. Steatosis most often affects the liver – the primary organ of lipid metabolism – where the condition is commonly referred to as fatty liver dise ...

; the condition may also cause

depigmentation Depigmentation is the lightening of the skin or loss of pigment. Depigmentation of the skin can be caused by a number of local and systemic conditions. The pigment loss can be partial (injury to the skin) or complete (caused by vitiligo). It can b ...

of skin and hair. The disorder is further identified by a characteristic swelling of the belly, which disguises the patient's undernourished condition. 'Kwashiorkor' means 'displaced child' and is derived from the

Ga language Ga is a Kwa language spoken in Ghana, in and around the capital Accra. There are also some speakers in Togo, Benin and Western Nigeria. It has a phonemic distinction between three vowel lengths. Classification Ga is a Kwa language, part ...

of coastal Ghana in West Africa. It means "the sickness the baby gets when the next baby is born," as it often occurs when the older child is deprived of breastfeeding and

weaned Weaning is the process of gradually introducing an infant human or another mammal to what will be its adult diet while withdrawing the supply of its mother's milk. The process takes place only in mammals, as only mammals produce milk. The infan ...

to a diet composed largely of carbohydrates. ''Marasmus'' (meaning 'to waste away') can result from a sustained diet that is deficient in both protein and energy. This causes their metabolism to adapt in order to prolong survival. The primary symptoms are severe wasting, leaving little or no edema; minimal subcutaneous fat; and abnormal serum albumin levels. It is traditionally seen in cases of

famine A famine is a widespread scarcity of food, caused by several factors including war, natural disasters, crop failure, population imbalance, widespread poverty, an economic catastrophe or government policies. This phenomenon is usually accompani ...

, significant food restriction, or severe

anorexia Anorexia nervosa, often referred to simply as anorexia, is an eating disorder characterized by low weight, food restriction, body image disturbance, fear of gaining weight, and an overpowering desire to be thin. ''Anorexia'' is a term of Gre ...

. Conditions are characterized by extreme wasting of the muscles and a gaunt expression.

Overnutrition

Excessive consumption of energy-dense foods and drinks and limited physical activity causes overnutrition. It causes overweight, defined as a

body mass index (BMI) Body mass index (BMI) is a value derived from the mass (weight) and height of a person. The BMI is defined as the body mass divided by the square of the body height, and is expressed in units of kg/m2, resulting from mass in kilograms and hei ...

of 25 or more, and can lead to obesity (a BMI of 30 or more). Obesity has become a major health issue worldwide. Overnutrition is linked to chronic non-communicable diseases like diabetes, certain cancers, and

cardiovascular diseases Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack). Other CVDs include stroke, hea ...

. Hence identifying and addressing the immediate risk factors has become a major health priority. The recent evidence on the impact of diet-induced obesity in fathers and mothers around the time of conception is identified to negatively program the health outcomes of multiple generations.

Classifying malnutrition

Definition by Gomez & Galvan

In 1956, Gómez and Galvan studied factors associated with death in a group of undernourished children in a hospital in Mexico City, Mexico. They defined three categories of malnutrition: first, second, and third degree. The degree of malnutrition is calculated based on a child's body size compared to the median weight for their age. The risk of death increases with increasing degrees of malnutrition. An adaptation of Gomez's original classification is still used today. While it provides a way to compare malnutrition within and between populations, this classification system has been criticized for being "

arbitrary Arbitrariness is the quality of being "determined by chance, whim, or impulse, and not by necessity, reason, or principle". It is also used to refer to a choice made without any specific criterion or restraint. Arbitrary decisions are not necess ...

" and for not considering overweight as a form of malnutrition. Also, height alone may not be the best indicator of malnutrition; children who are born prematurely may be considered short for their age even if they have good nutrition.

Definition by Waterlow

In the 1970s, John Conrad Waterlow established a new classification system for malnutrition. Instead of using just weight for age measurements, Waterlow's system combines weight-for-height (indicating acute episodes of malnutrition) with height-for-age to show the stunting that results from chronic malnutrition. One advantage of the Waterlow classification is that weight for height can be calculated even if a child's age is unknown. The World Health Organization frequently uses these classifications of malnutrition, with some modifications.

Effects

Sharecropper's child LC-USF33-002002-M2 (6288133677) (cropped) (cropped)

Malnutrition weakens every part of the immune system. Protein and energy malnutrition increases susceptibility to infection; so do deficiencies of specific micronutrients (including iron, zinc, and vitamins). In communities or areas that lack access to safe drinking water, these additional health risks present a critical problem. Malnutrition plays a major role in the onset of active tuberculosis. It also raises the risk of

HIV The human immunodeficiency viruses (HIV) are two species of ''Lentivirus'' (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune ...

transmission from mother to child, and increases replication of the virus. Malnutrition can cause vitamin-deficiency-related diseases like scurvy and rickets. As malnutrition worsens, those affected have less energy and experience impairment in brain functions. This can make it difficult (or impossible) for them to perform the tasks needed to acquire food, earn an income, or gain an education. Malnutrition can also cause acute problems, like

hypoglycemia Hypoglycemia, also called low blood sugar, is a fall in blood sugar to levels below normal, typically below 70 mg/dL (3.9 mmol/L). Whipple's triad is used to properly identify hypoglycemic episodes. It is defined as blood glucose belo ...

(low

blood sugar Glycaemia, also known as blood sugar level, blood sugar concentration, or blood glucose level is the measure of glucose concentrated in the blood of humans or other animals. Approximately 4 grams of glucose, a simple sugar, is present in the bl ...

). This condition can cause lethargy, limpness,

seizure An epileptic seizure, informally known as a seizure, is a period of symptoms due to abnormally excessive or synchronous neuronal activity in the brain. Outward effects vary from uncontrolled shaking movements involving much of the body with los ...

s, and

loss of consciousness Loss may refer to: Arts, entertainment, and media Music * ''Loss'' (Bass Communion album) (2006) * ''Loss'' (Mull Historical Society album) (2001) *"Loss", a song by God Is an Astronaut from their self-titled album (2008) * Losses "(Lil Tjay son ...

. Children are particularly at risk and can become hypoglycemic after 4 to 6 hours without food. Dehydration can also occur in malnourished people, and can be life-threatening, especially in babies and small children.

Signs

There are many different signs of dehydration in malnourished people. These can include sunken eyes; a very dry mouth; decreased urine output and/or dark urine; increased heart rate with decreasing blood pressure; and

altered mental status An altered level of consciousness is any measure of arousal other than normal. Level of consciousness (LOC) is a measurement of a person's arousability and responsiveness to stimuli from the environment. A mildly depressed level of consciousne ...

Cognitive development

Protein-calorie malnutrition can cause

cognitive impairment Cognitive deficit is an inclusive term to describe any characteristic that acts as a barrier to the cognition process. The term may describe * deficits in overall intelligence (as with intellectual disabilities), * specific and restricted defici ...

s. This most commonly occurs in people who were malnourished during a "critical period ... from the final third of gestation to the first 2 years of life". For example, in children under two years of age, iron deficiency anemia is likely to affect brain function acutely, and probably also chronically. Similarly, folate deficiency has been linked to

neural tube defect Neural tube defects (NTDs) are a group of birth defects in which an opening in the spine or cranium remains from early in human development. In the third week of pregnancy called gastrulation, specialized cells on the dorsal side of the embryo ...

s. Iodine deficiency is "the most common preventable cause of mental impairment worldwide." "Even moderate odinedeficiency, especially in pregnant women and infants, lowers intelligence by 10 to 15 I.Q. points, shaving incalculable potential off a nation's development." Among those affected, very few people experience the most visible and severe effects: disabling goiters,

cretinism Congenital iodine deficiency syndrome is a medical condition present at birth marked by impaired physical and mental development, due to insufficient thyroid hormone (hypothyroidism) often caused by insufficient dietary iodine during pregnancy. It ...

and dwarfism. These effects occur most commonly in mountain villages. However, 16 percent of the world's people have at least mild goiter (a swollen thyroid gland in the neck)."

Causes & risk factors

Social and political

Social conditions have a significant influence on the health of people. The social determinants of undernutrition mainly include poor education, poverty, disease burden and lack of women's empowerment.Bhutta, Z., Ahmed, T., Black, R., Cousens, S., Dewey, K., Giugliani, E., Haider, B., Kirkwood, B., Morris, S., Sachdev, H. and Shekar, M., 2008. What works? Interventions for maternal and child undernutrition and survival. The Lancet, 371(9610), pp.417-440. Identifying and addressing these determinants can eliminate undernutrition in the long term. Identification of the social conditions that causes malnutrition in children under five has received significant research attention as it is a major public health problem. Undernutrition most commonly results from a lack of access to high-quality, nutritious food. The household income is a socio-economic variable that influences the access to nutritious food and the probability of under and overnutrition in a community. In the study by Ghattas et al. (2020), the probability of overnutrition is significantly higher in higher-income families than in disadvantaged families. High food prices is a major factor preventing low income households from getting nutritious food For example, Khan and Kraemer (2009) found that in

Bangladesh Bangladesh (}, ), officially the People's Republic of Bangladesh, is a country in South Asia. It is the eighth-most populous country in the world, with a population exceeding 165 million people in an area of . Bangladesh is among the mos ...

, low socioeconomic status was associated with chronic malnutrition since it inhibited purchase of nutritious foods (like milk, meat, poultry, and fruits). Food shortages may also contribute to malnutritions in countries which lack technology. However, in the developing world, eighty percent of malnourished children live in countries that produce food surpluses, according to estimates from the Food and Agriculture Organization (FAO). The

economist An economist is a professional and practitioner in the social science discipline of economics. The individual may also study, develop, and apply theories and concepts from economics and write about economic policy. Within this field there are ...

Amartya Sen Amartya Kumar Sen (; born 3 November 1933) is an Indian economist and philosopher, who since 1972 has taught and worked in the United Kingdom and the United States. Sen has made contributions to welfare economics, social choice theory, economi ...

observes that, in recent decades, famine has always been a problem of

food distribution Food distribution is the process where a general population is supplied with food. The Food and Agriculture Organization (FAO) considers food distribution as a subset of the food system. The process and methodology behind food distribution varies ...

, purchasing power, and/or poverty, since there has always been enough food for everyone in the world. There are also

sociopolitical Political sociology is an interdisciplinary field of study concerned with exploring how governance and society interact and influence one another at the micro to macro levels of analysis. Interested in the social causes and consequences of how ...

causes of malnutrition. For example, the population of a community might be at increased risk for malnutrition if government is poor and the area lacks health-related services. On a smaller scale, certain households or individuals may be at an even higher risk due to differences in income levels, access to land, or levels of education. Community plays a crucial role in addressing the social causes of malnutrition. For example, communities with high social support and knowledge sharing about social protection programs can enable better public service demands. Better public service demands and social protection programs minimise the risk of malnutrition in these communities. It is argued that

commodity In economics, a commodity is an economic good, usually a resource, that has full or substantial fungibility: that is, the market treats instances of the good as equivalent or nearly so with no regard to who produced them. The price of a co ...

speculators In finance, speculation is the purchase of an asset (a commodity, goods, or real estate) with the hope that it will become more valuable shortly. (It can also refer to short sales in which the speculator hopes for a decline in value.) Many s ...

are increasing the cost of food. As the

real-estate bubble A real-estate bubble or property bubble (or housing bubble for residential markets) is a type of economic bubble that occurs periodically in local or global real-estate markets, and typically follow a land boom. A land boom is the rapid increase ...

in the United States was collapsing, it is said that trillions of dollars moved to

invest Investment is the dedication of money to purchase of an asset to attain an increase in value over a period of time. Investment requires a sacrifice of some present asset, such as time, money, or effort. In finance, the purpose of investing is ...

in food and primary commodities, causing the 2007–2008 food price crisis. The use of

biofuel Biofuel is a fuel that is produced over a short time span from biomass, rather than by the very slow natural processes involved in the formation of fossil fuels, such as oil. According to the United States Energy Information Administration (EIA ...

s as a replacement for traditional fuels raises the price of food. The

United Nations The United Nations (UN) is an intergovernmental organization whose stated purposes are to maintain international peace and security, develop friendly relations among nations, achieve international cooperation, and be a centre for harmonizi ...

special rapporteur on the

right to food The right to food, and its variations, is a human right protecting the right of people to feed themselves in dignity, implying that sufficient food is available, that people have the means to access it, and that it adequately meets the individual ...

Jean Ziegler Jean Ziegler (; born Hans Ziegler, 19 April 1934) is a Swiss former professor of sociology at the University of Geneva and the Sorbonne, Paris, and former vice-president of the Advisory Committee to the United Nations Human Rights Council. He ...

proposes that

agricultural waste Agricultural waste are plant residues from agriculture. These waste streams originate from arable land and horticulture. Agricultural waste are all parts of crops that are not used for human or animal food. Crop residues consist mainly of stems an ...

, such as

corn cobs Maize ( ; ''Zea mays'' subsp. ''mays'', from es, maíz after tnq, mahiz), also known as corn (North American and Australian English), is a cereal grain first domesticated by indigenous peoples in southern Mexico about 10,000 years ago. The ...

and

banana leaves The banana leaf is the leaf of the banana plant, which may produce up to 40 leaves in a growing cycle. The leaves have a wide range of applications because they are large, flexible, waterproof and decorative. They are used for cooking, wrapping ...

, should be used as fuel instead of

crop A crop is a plant that can be grown and harvested extensively for profit or subsistence. When the plants of the same kind are cultivated at one place on a large scale, it is called a crop. Most crops are cultivated in agriculture or hydroponi ...

s. In some developing countries, overnutrition (in the form of obesity) is beginning to appear in the same communities where malnutrition occurs. Overnutrition increases with urbanisation, food commercialisation and technological developments and increases physical inactivity. Variations in the health status of individuals in the same society are associated with the societal structure and an individual's socioeconomic status which leads to income inequality, racism, educational differences and lack of opportunities.

Diseases & conditions

Infectious diseases which increase nutrient requirements, such as gastroenteritis, pneumonia, malaria, and measles, can cause malnutrition. So can some chronic illnesses, especially HIV/AIDS. Malnutrition can also result from abnormal nutrient loss due to

diarrhea Diarrhea, also spelled diarrhoea, is the condition of having at least three loose, liquid, or watery bowel movements each day. It often lasts for a few days and can result in dehydration due to fluid loss. Signs of dehydration often begin wi ...

or chronic small bowel illnesses, like

Crohn's disease Crohn's disease is a type of inflammatory bowel disease (IBD) that may affect any segment of the gastrointestinal tract. Symptoms often include abdominal pain, diarrhea (which may be bloody if inflammation is severe), fever, abdominal distension, ...

or untreated

coeliac disease Coeliac disease (British English) or celiac disease (American English) is a long-term autoimmune disorder, primarily affecting the small intestine, where individuals develop intolerance to gluten, present in foods such as wheat, rye and barl ...

. "Secondary malnutrition" can result from increased energy expenditure. In infants, a lack of breastfeeding may contribute to undernourishment. Anorexia nervosa and

bariatric surgery Bariatric surgery (or weight loss surgery) includes a variety of procedures performed on people who are obese. Long term weight loss through the standard of care procedures ( Roux en-Y bypass, sleeve gastrectomy, and biliopancreatic diversion ...

can also cause malnutrition.

Dietary practices

Undernutrition

Undernutrition due to lack of adequate breastfeeding is associated with the deaths of an estimated one million children annually. Illegal advertising of breast-milk substitutes contributed to malnutrition and continued three decades after its 1981 prohibition under the ''WHO International Code of Marketing Breast Milk Substitutes''. Maternal malnutrition can also factor into the poor health or death of a baby. Over 800,000

neonatal deaths Infant mortality is the death of young children under the age of 1. This death toll is measured by the infant mortality rate (IMR), which is the probability of deaths of children under one year of age per 1000 live births. The under-five morta ...

have occurred because of deficient growth of the fetus in the mother's womb. Deriving too much of one's diet from a single source, such as eating almost exclusively potato, maize or rice, can cause malnutrition. This may either be from a lack of education about proper nutrition, or from only having access to a single food source. It is not just the total amount of calories that matters but specific nutritional deficiencies such as vitamin A deficiency,

iron deficiency Iron deficiency, or sideropenia, is the state in which a body lacks enough iron to supply its needs. Iron is present in all cells in the human body and has several vital functions, such as carrying oxygen to the tissues from the lungs as a key ...

zinc deficiency Zinc deficiency is defined either as insufficient zinc to meet the needs of the body, or as a serum zinc level below the normal range. However, since a decrease in the serum concentration is only detectable after long-term or severe depletion, s ...

can also increase risk of death.UNICEF (2013)
Improving Child Nutrition – The achievable imperative for global progress
UNICEF

Overnutrition

Overnutrition caused by overeating is also a form of malnutrition. In the United States, more than half of all adults are now overweight—a condition that, like hunger, increases susceptibility to disease and disability, reduces worker productivity, and lowers

life expectancy Life expectancy is a statistical measure of the average time an organism is expected to live, based on the year of its birth, current age, and other demographic factors like sex. The most commonly used measure is life expectancy at birth ...

. Overeating is much more common in the United States, since most people have adequate access to food. Many parts of the world have access to a surplus of non-nutritious food. Increased

sedentary lifestyle Sedentary lifestyle is a lifestyle type, in which one is physically inactive and does little or no physical movement and or exercise. A person living a sedentary lifestyle is often sitting or lying down while engaged in an activity like soci ...

s also contribute to overnutrition. Yale University psychologist Kelly Brownell calls this a " toxic food environment," where fat- and sugar-laden foods have taken precedence over healthy nutritious foods. In these developed countries, overnutrition can be prevented by choosing the right kind of food. More fast food is consumed per capita in the United States than in any other country. This mass consumption of fast food results from its affordability and accessibility. Fast food, which is low in cost and nutrition, is high in calories. Due to increasing urbanization and

automation Automation describes a wide range of technologies that reduce human intervention in processes, namely by predetermining decision criteria, subprocess relationships, and related actions, as well as embodying those predeterminations in machines ...

, people are living more sedentary lifestyles. These factors combine to make weight gain difficult to avoid. Overnutrition also occurs in developing countries. It has appeared in parts of developing countries where income is on the rise. It is also a problem in countries where hunger and poverty persist. Economic development, rapid urbanisation and shifting dietary patterns have increased the burden of overnutrition in the cities of low and middle-income countries. In China, consumption of high-fat foods has increased, while consumption of rice and other goods has decreased. Obesity and Diabetes Trend Chart

Overeating leads to many diseases, such as

heart disease Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack). Other CVDs include stroke, h ...

and diabetes, that may be fatal.

Agricultural productivity

Local food shortages can be caused by a lack of

arable land Arable land (from the la, arabilis, "able to be ploughed") is any land capable of being ploughed and used to grow crops.'' Oxford English Dictionary'', "arable, ''adj''. and ''n.''" Oxford University Press (Oxford), 2013. Alternatively, for th ...

, adverse weather, and/or poorer farming skills (like inadequate

crop rotation Crop rotation is the practice of growing a series of different types of crops in the same area across a sequence of growing seasons. It reduces reliance on one set of nutrients, pest and weed pressure, and the probability of developing resistant ...

). They can also occur in areas which lack the technology or resources needed for the higher yields found in modern

agriculture Agriculture or farming is the practice of cultivating plants and livestock. Agriculture was the key development in the rise of sedentary human civilization, whereby farming of domesticated species created food surpluses that enabled people to ...

. These resources include fertilizers, pesticides, irrigation, machinery, and storage facilities. As a result of widespread poverty, farmers and governments cannot provide enough of these resources to improve local yields. Additionally, the World Bank and some wealthy donor countries have pressured developing countries to use

free market In economics, a free market is an economic system in which the prices of goods and services are determined by supply and demand expressed by sellers and buyers. Such markets, as modeled, operate without the intervention of government or any ...

policies. Even as the United States and Europe extensively

subsidized A subsidy or government incentive is a form of financial aid or support extended to an economic sector (business, or individual) generally with the aim of promoting economic and social policy. Although commonly extended from the government, the ter ...

their own farmers, they urged developing countries to cut or eliminate subsidized agricultural inputs, like fertilizer. Without subsidies, few (if any) farmers in developing countries can afford fertilizer at

market prices A price is the (usually not negative) quantity of payment or compensation given by one party to another in return for goods or services. In some situations, the price of production has a different name. If the product is a "good" in the c ...

. This leads to low agricultural production, low

wage A wage is payment made by an employer to an Worker, employee for work (human activity), work done in a specific period of time. Some examples of wage payments include wiktionary:compensatory, compensatory payments such as ''minimum wage'', ''p ...

s, and high, unaffordable food prices. Fertilizer is also increasingly unavailable because Western

environmental groups An environmental organization is an organization coming out of the conservation or environmental movements that seeks to protect, analyse or monitor the environment against misuse or degradation from human forces. In this sense the environmen ...

have fought to end its use due to environmental concerns. The

Green Revolution The Green Revolution, also known as the Third Agricultural Revolution, was a period of technology transfer initiatives that saw greatly increased crop yields and agricultural production. These changes in agriculture began in developed countrie ...

pioneers Norman Borlaug and Keith Rosenberg cited as the obstacle to feeding

Africa Africa is the world's second-largest and second-most populous continent, after Asia in both cases. At about 30.3 million km2 (11.7 million square miles) including adjacent islands, it covers 6% of Earth's total surface area ...

by .

Future threats

In the future, variety of factors could potentially disrupt global food supply and cause widespread malnutrition. Global warming is of importance to food security. Almost all malnourished people (95%) live in the tropics and

subtropics The subtropical zones or subtropics are geographical and climate zones to the north and south of the tropics. Geographically part of the temperate zones of both hemispheres, they cover the middle latitudes from to approximately 35° north a ...

, where the climate is relatively stable. According to the latest Intergovernmental Panel on Climate Change reports, temperature increases in these regions are "very likely." Even small changes in temperatures can make extreme weather conditions occur more frequently. Extreme weather events, like drought, have a major impact on agricultural production, and hence nutrition. For example, the 1998–2001 Central Asian drought killed about 80 percent of livestock in Iran and caused a 50% reduction in wheat and barley crops there. Other central Asian nations experienced similar losses. An increase in extreme weather such as drought in regions such as Sub-Saharan Africa would have even greater consequences in terms of malnutrition. Even without an increase of extreme weather events, a simple increase in temperature reduces the productivity of many crop

species In biology, a species is the basic unit of Taxonomy (biology), classification and a taxonomic rank of an organism, as well as a unit of biodiversity. A species is often defined as the largest group of organisms in which any two individuals of ...

, and decreases food security in these regions. Another threat is

colony collapse disorder Colony collapse disorder (CCD) is an abnormal phenomenon that occurs when the majority of worker bees in a honey bee colony disappear, leaving behind a queen, plenty of food, and a few nurse bees to care for the remaining immature bees. While ...

, a phenomenon where

bee Bees are winged insects closely related to wasps and ants, known for their roles in pollination and, in the case of the best-known bee species, the western honey bee, for producing honey. Bees are a monophyletic lineage within the superfami ...

s die in large numbers. Since many agricultural crops worldwide are pollinated by bees, colony collapse disorder represents a threat to the global food supply.

Prevention

Reducing malnutrition is key part of the United Nations'

Sustainable Development Goal 2 Sustainable Development Goal 2 (SDG 2 or Global Goal 2) aims to achieve "zero hunger". It is one of the 17 Sustainable Development Goals established by the United Nations in 2015. The official wording is: "End hunger, achieve food security and im ...

( SDG2), "Zero Hunger," which aims to reduce malnutrition, undernutrition, and stunted child growth. Managing severe acute undernutrition in a community setting has received significant research attention.

Food security

In the 1950s and 1960s, the

aimed to bring modern Western agricultural techniques (like

nitrogen fertilizers A fertilizer (American English) or fertiliser (British English; see spelling differences) is any material of natural or synthetic origin that is applied to soil or to plant tissues to supply plant nutrients. Fertilizers may be distinct from ...

and pesticides) to

Asia Asia (, ) is one of the world's most notable geographical regions, which is either considered a continent in its own right or a subcontinent of Eurasia, which shares the continental landmass of Afro-Eurasia with Africa. Asia covers an area ...

. Investments in agriculture, such as fund fertilizers and seeds, increased food harvests and thus

food production The food industry is a complex, global network of diverse businesses that supplies most of the food consumed by the world's population. The food industry today has become highly diversified, with manufacturing ranging from small, traditional, ...

. Consequently, food prices and malnutrition decreased (as they had earlier in Western nations). The Green Revolution was possible in Asia because of existing infrastructure and institutions, such as a system of roads and public seed companies that made seeds available. These resources were in short supply in Africa, decreasing the Green Revolution's impact on the continent. For example, almost five million of the 13 million people in Malawi used to need emergency food aid. However, in the early 2000s, the Malawian government changed its agricultural policies, and implemented subsidies for fertilizer and seed introduced against World Bank strictures. By 2007, farmers were producing record-breaking corn harvests. Corn production leaped to 3.4 million in 2007 compared to 1.2 million in 2005, making Malawi a major food exporter. Consequently, food prices lowered and wages for farmworkers rose. Such investments in agriculture are still needed in other African countries like the Democratic Republic of the Congo (DRC). Despite the country's great agricultural potential, the prevalence of malnutrition in the DRC is among the highest in the world. Proponents for investing in agriculture include Jeffrey Sachs, who argues that wealthy countries should

in fertilizer and seed for Africa's farmers. Imported Ready to Use Therapeutic Food (RUTF) has been used to treat malnutrition in northern Nigeria. Some Nigerians also use ''soy'' '' kunu,'' a locally sourced and prepared blend consisting of peanut,

millet Millets () are a highly varied group of small-seeded grasses, widely grown around the world as cereal crops or grains for fodder and human food. Most species generally referred to as millets belong to the tribe Paniceae, but some millets also ...

and soybeans. New technology in agricultural production has great potential to combat undernutrition. It makes farming easier, thus improving agricultural yields. By increasing farmers' incomes, this could reduce poverty. It would also open up area which farmers could use to diversify crops for household use. The World Bank claims to be part of the solution to malnutrition, asserting that countries can best break the

cycle of poverty In economics, a cycle of poverty or poverty trap is caused by self-reinforcing mechanisms that cause poverty, once it exists, to persist unless there is outside intervention. It can persist across generations, and when applied to developing cou ...

and malnutrition by building export-led economies, which give them the financial means to buy foodstuffs on the world market.

Economics

Many aid groups have found that giving cash assistance (or cash vouchers) is more effective than donating food. Particularly in areas where food is available but unaffordable, giving cash assistance is a cheaper, faster, and more efficient way to deliver help to the hungry. In 2008, the UN's World Food Program, the biggest non-governmental distributor of food, announced that it would begin distributing cash and vouchers instead of food in some areas, which

Josette Sheeran Josette Sheeran (born 12 June 1954) is an American non-profit executive and diplomat who served in the United States Department of State. Sheeran serves as the seventh president and CEO of Asia Society since June 10, 2013. Sheeran was also the Uni ...

, the WFP's executive director, described as a "revolution" in food aid. The aid agency

Concern Worldwide Concern Worldwide (often referred to as Concern) is Ireland's largest aid and humanitarian agency. Since its foundation 50 years ago it has worked in 50 countries. According to its latest annual report, Concern helped 28.6 million of the world's ...

piloted a method of giving cash assistance using a

mobile phone operator A mobile phone operator, wireless provider, or carrier is a mobile telecommunications company that provides wireless Internet GSM services for mobile device users. The operator gives a SIM card to the customer who inserts it into the mobile devi ...

Safaricom Safaricom PLC is a listed Kenyan mobile network operator headquartered at Safaricom House in Nairobi, Kenya. It is the largest telecommunications provider in Kenya, and one of the most profitable companies in the East and Central Africa region. Th ...

, which runs a money transfer program that allows cash to be sent from one part of a country to another. However, during a drought, delivering food might be the most appropriate way to help people, especially those who live far from markets and thus have limited access to them.

Fred Cuny Frederick C. Cuny (November 14, 1944 – April 15, 1995) was an American humanitarian whose work spanned disaster relief, refugee emergency management, recovery from war and civil conflict as well as disaster and emergency preparedness, mitigation ...

stated that "the chances of saving lives at the outset of a relief operation are greatly reduced when food is imported. By the time it arrives in the country and gets to people, many will have died." U.S. law requires food aid to be purchased at home rather than in the countries where the hungry live; this is inefficient because approximately half of the money spent goes for transport. Cuny further pointed out that "studies of every recent famine have shown that food was available in-country—though not always in the immediate food deficit area" and "even though by local standards the prices are too high for the poor to purchase it, it would usually be cheaper for a donor to buy the hoarded food at the inflated price than to import it from abroad." MontrealSoupKitchen1931

Food banks and

soup kitchen A soup kitchen, food kitchen, or meal center, is a place where food is offered to the hungry usually for free or sometimes at a below-market price (such as via coin donations upon visiting). Frequently located in lower-income neighborhoods, sou ...

s address malnutrition in places where people lack money to buy food. A

basic income Universal basic income (UBI) is a social welfare proposal in which all citizens of a given population regularly receive an unconditional transfer payment, that is, without a means test or need to work. It would be received independently of an ...

has been proposed as a way to ensure that everyone has enough money to buy food and other basic needs. This is a form of social security in which all citizens or residents of a country regularly receive an unconditional sum of money, either from a government or some other public institution, in addition to any income received from elsewhere.

Successful initiatives

Ethiopia pioneered a program that later became part of the World Bank's prescribed method for coping with a food crisis. Through the country's main food assistance program, the Productive Safety Net Program, Ethiopia provided rural residents who were chronically short of food a chance to work for food or cash. Foreign aid organizations like the World Food Program were then able to buy food locally from surplus areas to distribute in areas with a shortage of food. Aid organizations now view the Ethiopian program as a model of how to best help hungry nations. Successful initiatives also include Brazil's recycling program for

organic waste Biodegradable waste includes any organic matter in waste which can be broken down into carbon dioxide, water, methane or simple organic molecules by micro-organisms and other living things by composting, aerobic digestion, anaerobic digesti ...

, which benefits farmers, the urban poor, and the city in general. City residents separate organic waste from their garbage, bag it, and then exchange it for fresh fruit and vegetables from local farmers. This reduces the country's waste while giving the urban poor a steady supply of nutritious food.

World population

Restricting population size is a proposed solution to malnutrition. Thomas Malthus argues that population growth can be controlled by natural disasters and by voluntary limits through "moral restraint." Robert Chapman suggests that government policies are a necessary ingredient for curtailing global population growth. The United Nations recognizes that poverty and malnutrition (as well as the environment) are interdependent and complementary with population growth. According to the World Health Organisation, " Family planning is key to slowing unsustainable population growth and the resulting negative impacts on the economy, environment, and national and regional development efforts". However, more than 200 million women worldwide lack adequate access to family planning services. There are different theories about what causes famine. Some theorists, like the Indian

Amartya Sen, believe that the world has more than enough resources to sustain its population. In this view, malnutrition is caused by unequal distribution of resources and under- or unutilized arable land. For example, Sen argues that "no matter how a famine is caused, methods of breaking it call for a large supply of food in the

public distribution system The Public Distribution System (PDS) is an Indian food security system that was established by the Government of India under the Ministry of Consumer Affairs, Food and Public Distribution to distribute food and non-food items to India's poor a ...

. This applies not only to organizing rationing and control, but also to undertaking work programmes and other methods of increasing purchasing power for those hit by shifts in exchange entitlements in a general inflationary situation."

Food sovereignty

Food sovereignty is one suggested policy framework to resolve access issues. In this framework, people (rather than international market forces) have the right to define their own food, agricultural, livestock, and fishery systems. Food First is one of the primary think tanks working to build support for food sovereignty.

Neoliberals Neoliberalism (also neo-liberalism) is a term used to signify the late 20th century political reappearance of 19th-century ideas associated with free-market capitalism after it fell into decline following the Second World War. A prominent fa ...

advocate for an increasing role of the

Health facilities

Another possible long-term solution to malnutrition is to increase access to health facilities in rural parts of the world. These facilities could monitor undernourished children, act as supplemental food distribution centers, and provide education on dietary needs. Similar facilities have already proven very successful in countries such as Peru and Ghana.

Breastfeeding

In 2016, estimates suggested that more widespread breastfeeding could prevent about 823,000 deaths annually of children under age 5. In addition to reducing infant deaths,

breast milk Breast milk (sometimes spelled as breastmilk) or mother's milk is milk produced by mammary glands located in the breast of a human female. Breast milk is the primary source of nutrition for newborns, containing fat, protein, carbohydrates ( lact ...

provides an important source of micronutrients - which are clinically proven to bolster children's immune systems - and provides long-term defenses against non-communicable and

allergic Allergies, also known as allergic diseases, refer a number of conditions caused by the hypersensitivity of the immune system to typically harmless substances in the environment. These diseases include hay fever, food allergies, atopic dermati ...

diseases. Breastfeeding improves cognitive abilities in children, and correlates strongly with individual educational achievements. As previously noted, lack of proper breastfeeding is a major factor in

child mortality Child mortality is the mortality of children under the age of five. The child mortality rate, also under-five mortality rate, refers to the probability of dying between birth and exactly five years of age expressed per 1,000 live births. It en ...

rates, and is a primary determinant of disease development for children. The medical community recommends exclusively breastfeeding infants for 6 months, with nutritional whole food supplementation and continued breastfeeding up to 2 years or older for overall optimal health outcomes. Exclusive breastfeeding is defined as giving an infant only breast milk for six months as a source of food and nutrition. This means no other liquids, including water or semi-solid foods.

Barriers to breastfeeding

Breastfeeding is noted as one of the most

cost-effective Cost-effectiveness analysis (CEA) is a form of economic analysis that compares the relative costs and outcomes (effects) of different courses of action. Cost-effectiveness analysis is distinct from cost–benefit analysis, which assigns a moneta ...

medical interventions benefiting child health. While there are considerable differences among developed and

, there are universal determinants of whether a mother breastfeeds or uses formula; these include income, employment, social norms, and access to healthcare. Many newly made mothers face financial barriers; community-based healthcare workers have helped to alleviate these barriers, while also providing a viable alternative to traditional and expensive hospital-based medical care. Recent studies, based upon surveys conducted from 1995 to 2010, show that exclusive breastfeeding rates have risen globally, from 33% to 39%. Despite the growth rates, medical professionals acknowledge the need for improvement given the importance of exclusive breastfeeding.

21st century global initiatives

Starting around 2009, there was renewed international media and political attention focused on malnutrition. This resulted in part from spikes in food prices and the

2008 financial crisis 8 (eight) is the natural number following 7 and preceding 9. In mathematics 8 is: * a composite number, its proper divisors being , , and . It is twice 4 or four times 2. * a power of two, being 2 (two cubed), and is the first number of ...

. Additionally, there was an emerging consensus that combating malnutrition is one of the most cost-effective ways to contribute to development. This led to the 2010 launch of the UN's ''Scaling up Nutrition'' movement (SUN). In April 2012, a number of countries signed the Food Assistance Convention, the world's first legally binding international agreement on food aid. The following month, the

Copenhagen Consensus Copenhagen Consensus is a project that seeks to establish priorities for advancing global welfare using methodologies based on the theory of welfare economics, using cost–benefit analysis. It was conceived and organized around 2004 by Bjørn Lom ...

recommended that politicians and private sector

philanthropists Philanthropy is a form of altruism that consists of "private initiatives, for the public good, focusing on quality of life". Philanthropy contrasts with business initiatives, which are private initiatives for private good, focusing on material ...

should prioritize interventions against hunger and malnutrition in order to maximize the effectiveness of aid spending. The Consensus recommended prioritizing these interventions ahead of any others, including the fights against malaria and

AIDS Human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV), a retrovirus. Following initial infection an individual ma ...

. In June 2015, the European Union and the

Bill & Melinda Gates Foundation The Bill & Melinda Gates Foundation (BMGF), a merging of the William H. Gates Foundation and the Gates Learning Foundation, is an American private foundation founded by Bill Gates and Melinda French Gates. Based in Seattle, Washington, it was l ...

launched a partnership to combat undernutrition, especially in children. The program was first implemented in

Burundi Burundi (, ), officially the Republic of Burundi ( rn, Repuburika y’Uburundi ; Swahili: ''Jamuhuri ya Burundi''; French: ''République du Burundi'' ), is a landlocked country in the Great Rift Valley at the junction between the African Gr ...

, Ethiopia, Kenya, Laos and Niger. It aimed to help these countries improve information and analysis about nutrition, enabling them to develop effective national nutrition policies. Also in 2015, the UN's Food and Agriculture Organization created a partnership aimed at ending hunger in Africa by 2025. The African Union's Comprehensive Africa Agriculture Development Programme (CAADP) provided the framework for the partnership. It includes a variety of interventions, including support for improved food production, a strengthening of social protection, and integration of the

into national legislation. The EndingHunger campaign is an online communication campaign whose goal is to raise awareness about hunger. The campaign has created

viral video A viral video is a video that becomes popular through a viral process of Internet sharing, typically through video sharing websites such as YouTube as well as social media and email.Lu Jiang, Yajie Miao, Yi Yang, ZhenZhong Lan, Alexander H ...

s depicting

celebrities Celebrity is a condition of fame and broad public recognition of a person or group as a result of the attention given to them by mass media. An individual may attain a celebrity status from having great wealth, their participation in sports ...

voicing their anger about the large number of hungry people in the world. After the Millennium Development Goals expired in 2015, the Sustainable Development Goals became the main global policy focus to reduce hunger and poverty. In particular, Goal 2: Zero Hunger sets globally agreed-upon targets to wipe out hunger, end all forms of malnutrition, and make agriculture sustainable. The partnership Compact2025 develops and disseminates evidence-based advice to politicians and other decision-makers, with the goal of ending hunger and undernutrition by 2025. The

International Food Policy Research Institute The International Food Policy Research Institute (IFPRI) is an international agricultural research center founded in the early 1970s to improve the understanding of national agricultural and food policies to promote the adoption of innovations ...

(IFPRI) led the partnership, with the involvement of UN organisations, non-governmental organizations (NGOs), and

private foundation A private foundation is a tax-exempt organization not relying on broad public support and generally claiming to serve humanitarian purposes. The Bill & Melinda Gates Foundation is the largest private foundation in the U.S. with over $38 billion i ...

Treatment

VOA Heinlein - Somali refugees September 2011 - 09

Improving nutrition

Efforts to improve nutrition are some of the common forms of development aid. Interventions often promote breastfeeding in order to reduce

rates Rate or rates may refer to: Finance * Rates (tax), a type of taxation system in the United Kingdom used to fund local government * Exchange rate, rate at which one currency will be exchanged for another Mathematics and science * Rate (mathema ...

of malnutrition and death in children. Some of these interventions have been successful. For example, interventions with commodities such as ready to use therapeutic foods, micronutrient intervention and vitamin supplementation were identified to significantly improve nutrition, reduce stunting and prevent diseases in communities with severe acute malnutrition. In young children, outcomes improve when children between six months and two years of age receive complementary food (in addition to breast milk). There is also good evidence that supports giving supplemental micronutrients to pregnant women and young children in the developing world. Sending food and money is a common form of development aid, aimed at feeding hungry people. Some strategies help people buy food within local markets. Simply feeding students at school is insufficient. Longer-term measures include improving agricultural practices, reducing poverty, and improving sanitation.

Identifying malnourishment

Measuring children is crucial to identifying malnourishment. In 2000, the United States

Centers for Disease Control and Prevention The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georg ...

(CDC) established the International Micronutrient Malnutrition Prevention and Control (IMMPaCt) program. It tested children for malnutrition by conducting a three-dimensional scan, using an iPad or a

tablet Tablet may refer to: Medicine * Tablet (pharmacy), a mixture of pharmacological substances pressed into a small cake or bar, colloquially called a "pill" Computing * Tablet computer, a mobile computer that is primarily operated by touching the ...

. Its objective was to help doctors provide more efficient treatments. There may be some chance of error when using this method. A systematic review of 42 studies found that many approaches to mitigating acute malnutrition are equally effective; thus, intervention decisions can be based on cost-related factors. Overall, evidence for the effectiveness of acute malnutrition interventions is not robust. The limited evidence related to cost indicates that community and outpatient management of children with uncomplicated malnutrition may be the most cost-effective strategy.

Medical management

It is often possible to manage severe malnutrition within a person's home, using ready-to-use therapeutic foods. In people with severe malnutrition complicated by other health problems, treatment in a hospital setting is recommended. In-hospital treatment often involves managing low blood sugar, maintaining adequate

body temperature Thermoregulation is the ability of an organism to keep its body temperature within certain boundaries, even when the surrounding temperature is very different. A thermoconforming organism, by contrast, simply adopts the surrounding temperature ...

, addressing dehydration, and gradual feeding. Routine

antibiotic An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting bacterial infections, and antibiotic medications are widely used in the treatment and prevention ...

s are usually recommended because malnutrition weakens the immune system, causing a high risk of infection. Additionally,

broad spectrum antibiotic A broad-spectrum antibiotic is an antibiotic that acts on the two major bacterial groups, Gram-positive and Gram-negative, or any antibiotic that acts against a wide range of disease-causing bacteria. These medications are used when a bacterial inf ...

s are recommended in all severely undernourished children with diarrhea requiring admission to hospital. A severely malnourished child who appears to have dehydration, but has not had diarrhea, should be treated as if they have an infection. Among malnourished people who are hospitalized, nutritional support improves protein intake, calorie intake, and weight.

Bangladeshi model

In response to child malnutrition, the

Bangladeshi government The Cabinet of Bangladesh ( bn, বাংলাদেশের মন্ত্রিসভা) is the chief executive body of the People's Republic of Bangladesh. The cabinet is the collective decision-making body of the entire government unde ...

recommends ten steps for treating severe malnutrition: # Prevent or treat dehydration # Prevent or treat low blood sugar # Prevent or treat low body temperature # Prevent or treat infection; # Correct electrolyte imbalances # Correct micronutrient deficiencies # Start feeding cautiously # Achieve catch-up growth # Provide psychological support # Prepare for discharge and follow-up after recovery

Therapeutic foods

Due in part to limited research on supplementary feeding, there is little evidence that this strategy is beneficial. A 2015 systematic review of 32 studies found that there are limited benefits when children under 5 receive supplementary feeding, especially among younger, poorer, and more undernourished children. However, specially formulated foods do appear to be useful in treating moderate acute malnutrition in the developing world. These foods may have additional benefits in humanitarian emergencies, since they can be stored for years, can be eaten directly from the packet, and do not have to be mixed with clean water or refrigerated. In young children with severe acute malnutrition, it is unclear if ready-to-use therapeutic food differs from a normal diet. Severely malnourished individuals can experience

refeeding syndrome Refeeding syndrome is a metabolic disturbance that occurs as a result of reinstitution of nutrition in people and animals who are starved, severely malnourished, or metabolically stressed because of severe illness. When too much food or liquid nu ...

if fed too quickly. Refeeding syndrome can result regardless of whether food is taken orally or

parenterally A route of administration in pharmacology and toxicology is the way by which a drug, fluid, poison, or other substance is taken into the body. Routes of administration are generally classified by the location at which the substance is applied. ...

. It can present several days after eating with potentially fatal heart failure, dysrhythmias, and confusion. Some manufacturers have

fortified A fortification is a military construction or building designed for the defense of territories in warfare, and is also used to establish rule in a region during peacetime. The term is derived from Latin ''fortis'' ("strong") and ''facere' ...

everyday foods with micronutrients before selling them to consumers. For example, flour has been fortified with iron, zinc, folic acid, and other B vitamins like thiamine, riboflavin, niacin and vitamin

B12 Vitamin B12, also known as cobalamin, is a water-soluble vitamin involved in metabolism. It is one of eight B vitamins. It is required by animals, which use it as a cofactor in DNA synthesis, in both fatty acid and amino acid metabolism. It ...

. Baladi bread ( Egyptian flatbread) is made with fortified wheat flour. Other fortified products include fish sauce in Vietnam and

iodized salt Iodised salt ( also spelled iodized salt) is table salt mixed with a minute amount of various salts of the element iodine. The ingestion of iodine prevents iodine deficiency. Worldwide, iodine deficiency affects about two billion people and is ...

Micronutrient supplementation

According to the World Bank, treating malnutrition - mostly by fortifying foods with micronutrients - improves lives more quickly than other forms of aid, and at a lower cost. After reviewing a variety of development proposals, The

, a group of economists who reviewed a variety of development proposals, ranked micronutrient supplementation as its number-one treatment strategy. In malnourished people with

, zinc supplementation is recommended following an initial four-hour rehydration period. Daily zinc supplementation can help reduce the severity and duration of the diarrhea. Additionally, continuing daily zinc supplementation for ten to fourteen days makes diarrhea less likely to recur in the next two to three months.The Treatment of Diarrhoea: A manual for physicians and other senior health workers
World Health Organization, 2005. See especially Ch. 4 "Management of Acute Diarrhoea (Without Blood)" and Ch. 8 "Management of Diarrhoea With Severe Malnutrition." Malnourished children also need both potassium and magnesium.National Guidelines for the Management of Severely Malnourished Children in Bangladesh
, Institute of Public Health Nutrition, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People's Republic of Bangladesh, May 2008, page 18 (19 in PDF) and following pages. Within two to three hours of starting rehydration, children should be encouraged to take food, particularly foods rich in potassium like bananas, green

coconut water Coconut water (also coconut juice) is the clear liquid inside coconuts (fruits of the coconut palm). In early development, it serves as a suspension for the endosperm of the coconut during the nuclear phase of development. As growth continue ...

, and unsweetened fresh fruit juice. Along with continued eating, many homemade products can also help restore normal electrolyte levels. For example, early during the course of a child's diarrhea, it can be beneficial to provide cereal water (salted or unsalted) or vegetable broth (salted or unsalted). If available, vitamin A, potassium, magnesium, and zinc supplements should be added, along with other vitamins and minerals. Giving base (as in

Ringer's lactate Ringer's lactate solution (RL), also known as sodium lactate solution, Lactated Ringer’s, and Hartmann's solution, is a mixture of sodium chloride, sodium lactate, potassium chloride, and calcium chloride in water. It is used for replacing f ...

) to treat

acidosis Acidosis is a process causing increased acidity in the blood and other body tissues (i.e., an increase in hydrogen ion concentration). If not further qualified, it usually refers to acidity of the blood plasma. The term ''acidemia'' describes ...

without simultaneously supplementing potassium worsens

low blood potassium Hypokalemia is a low level of potassium (K+) in the blood serum. Mild low potassium does not typically cause symptoms. Symptoms may include feeling tired, leg cramps, weakness, and constipation. Low potassium also increases the risk of an abno ...

Treating diarrhea

Preventing dehydration

Food and drink can help prevent dehydration in malnourished people with diarrhea. Eating (or breastfeeding, among infants) should resume as soon as possible. Sugary beverages like soft drinks, fruit juices, and sweetened teas are not recommended as they may worsen diarrhea. Malnourished people with diarrhea (especially children) should be encouraged to drink fluids; the best choices are fluids with modest amounts of sugar and salt, like vegetable broth or salted

rice water Rice water is a suspension of starch obtained by draining boiled rice or by boiling rice until it completely dissolves into the water. It may be used as a weak gruel for invalids. It is especially effective in the treatment of diarrhea such as ...

. If clean water is available, they should be encouraged to drink that too. Malnourished people should be allowed to drink as much as they want, unless signs of swelling emerge. Babies can be given small amounts of fluids via an eyedropper or a syringe without the needle. Children under two should receive a teaspoon of fluid every one to two minutes; older children and adults should take frequent sips of fluids directly from a cup. After the first two hours, fluids and foods should be alternated, rehydration should be continued at the same rate or more slowly, depending on how much fluid the child wants and whether they are having ongoing diarrhea. Alternating between rehydration and food at this point is After the first two hours of rehydration it is recommended that to alternate between rehydration and food. If vomiting occurs, fluids can be paused for 5–10 minutes and then restarted more slowly. Vomiting rarely prevents rehydration, since fluids are still absorbed and vomiting is usually short-term.

Oral rehydration therapy

If prevention has failed and dehydration develops, the preferred treatment is rehydration through

oral rehydration therapy Oral rehydration therapy (ORT) is a type of fluid replacement used to prevent and treat dehydration, especially due to diarrhea. It involves drinking water with modest amounts of sugar and salts, specifically sodium and potassium. Oral rehydrat ...

(ORT). In severely undernourished children with diarrhea, rehydration should be done slowly, according to the World Health Organization. Oral rehydration solutions consist of clean water mixed with small amounts of sugars and salts. These solutions help restore normal electrolyte levels, provide a source of carbohydrates, and help with fluid replacement. Reduced- osmolarity ORS is the current standard of care for oral rehydration therapy, with reasonably wide availability. Introduced in 2003 by WHO and UNICEF, reduced-osmolarity solutions contain lower concentrations of sodium and glucose than original ORS preparations. Reduced-osmolarity ORS has the added benefit of reducing stool volume and vomiting while simultaneously preventing dehydration. Packets of reduced-osmolarity ORS include glucose, table salt,

potassium chloride Potassium chloride (KCl, or potassium salt) is a metal halide salt composed of potassium and chlorine. It is odorless and has a white or colorless vitreous crystal appearance. The solid dissolves readily in water, and its solutions have a sa ...

, and

trisodium citrate Trisodium citrate has the chemical formula of Na3C6H5O7. It is sometimes referred to simply as "sodium citrate", though sodium citrate can refer to any of the three sodium salts of citric acid. It possesses a saline, mildly tart flavor, and is a ...

. For general use, each packet should be mixed with a liter of water. However, for malnourished children, experts recommend adding a packet of ORS to two liters of water, along with an extra 50 grams of sucrose and some stock potassium solution. People who have no access to commercially available ORS can make a homemade version using water, sugar, and table salt. Experts agree that homemade ORS preparations should include one

liter The litre (international spelling) or liter (American English spelling) (SI symbols L and l, other symbol used: ℓ) is a metric unit of volume. It is equal to 1 cubic decimetre (dm3), 1000 cubic centimetres (cm3) or 0.001 cubic metre (m3) ...

(34 oz.) of clean water and 6 teaspoons of sugar; however, they disagree about whether they should contain half a teaspoon of table salt or a full teaspoon. Most sources recommend using half a teaspoon of salt per liter of water.Family Practice Notebook
Oral Rehydration Solution, Scott Moses, MD, February 1, 2014. However, people with malnutrition have an excess of body sodium. To avoid worsening this symptom, ORS for people with severe undernutrition should contain half the usual amount of sodium and more potassium. Patients who do not drink may require fluids by

nasogastric tube Nasogastric intubation is a medical process involving the insertion of a plastic tube (nasogastric tube or NG tube) through the nose, down the oesophagus, and down into the stomach. Orogastric intubation is a similar process involving the inserti ...

. Intravenous fluids are recommended only in those who have significant dehydration due to their potential complications, including

congestive heart failure Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome, a group of signs and symptoms caused by an impairment of the heart's blood pumping function. Symptoms typically include shortness of breath, excessive fatigue, an ...

Low blood sugar

Hypoglycemia Hypoglycemia, also called low blood sugar, is a fall in blood sugar to levels below normal, typically below 70 mg/dL (3.9 mmol/L). Whipple's triad is used to properly identify hypoglycemic episodes. It is defined as blood glucose belo ...

, whether known or suspected, can be treated with a mixture of sugar and water. If the patient is conscious, the initial dose of sugar and water can be given by mouth. Otherwise, they should receive glucose by intravenous or

. If seizures occur (and continue after glucose is given), rectal diazepam may be helpful. Blood sugar levels should be re-checked on two hour intervals.

Hypothermia

Hypothermia (dangerously low

core body temperature Normal human body-temperature (normothermia, euthermia) is the typical temperature range found in humans. The normal human body temperature range is typically stated as . Human body temperature varies. It depends on sex, age, time of day, exert ...

) can occur in malnutrition, particularly in children. Mild hypothermia causes confusion trembling, and clumsiness; more severe cases can be fatal. Keeping malnourished children warm can prevent or treat hypothermia. Covering the child (including their head) in blankets is one method. Another method is to warm the child through direct skin-to-skin contact with their mother or father, then covering both parent and child. Warming methods are usually most important at night. Prolonged bathing or prolonged medical exams can further lower body temperature and are not recommended for malnourished children at high risk of hypothermia.

Epidemiology

Nutritional deficiencies world map - DALY - WHO2004

The figures provided in this section on epidemiology all refer to ''undernutrition'' even if the term malnutrition is used which, by definition, could also apply to too much nutrition. The

Global Hunger Index The Global Hunger Index (GHI) is a tool that attempts to measure and track hunger globally as well as by region and by country, prepared by European NGOs of Concern Worldwide and Welthungerhilfe. The GHI is calculated annually, and its results ...

(GHI) is a multidimensional statistical tool used to describe the state of countries' hunger situation. The GHI measures progress and failures in the global fight against hunger. The GHI is updated once a year. The data from the 2015 report shows that Hunger levels have dropped 27% since 2000. Fifty two countries remain at serious or alarming levels. In addition to the latest statistics on Hunger and Food Security, the GHI also features different special topics each year. The 2015 report include an article on conflict and food security.

People affected

The United Nations estimated that there were 821 million undernourished people in the world in 2017. This is using the UN's definition of 'undernourishment', where it refers to insufficient consumption of raw calories, and so does not necessarily include people who lack micro nutrients. The undernourishment occurred despite the world's farmers producing enough food to feed around 12 billion people—almost double the current world population. Malnutrition, as of 2010, was the cause of 1.4% of all

disability adjusted life years The disability-adjusted life year (DALY) is a measure of overall disease burden, expressed as the number of years lost due to ill-health, disability or early death. It was developed in the 1990s as a way of comparing the overall health and life e ...

Mortality

Nutritional deficiencies world map-Deaths per million persons-WHO2012

Mortality due to malnutrition accounted for 58 percent of the total mortality in 2006: "In the world, approximately 62 million people, all causes of death combined, die each year. One in twelve people worldwide is malnourished and according to the

Save the Children The Save the Children Fund, commonly known as Save the Children, is an international non-governmental organization established in the United Kingdom in 1919 to improve the lives of children through better education, health care, and economic ...

2012 report, one in four of the world's children are chronically malnourished. In 2006, more than 36 million died of hunger or diseases due to deficiencies in micronutrients". In 2010 protein-energy malnutrition resulted in 600,000 deaths down from 883,000 deaths in 1990. Other nutritional deficiencies, which include

and

iron deficiency anemia Iron-deficiency anemia is anemia caused by a lack of iron. Anemia is defined as a decrease in the number of red blood cells or the amount of hemoglobin in the blood. When onset is slow, symptoms are often vague such as feeling tired, weak, shor ...

, result in another 84,000 deaths. In 2010 malnutrition caused about 1.5 million deaths in women and children. According to the World Health Organization, malnutrition is the biggest contributor to

, present in half of all cases. Six million children die of hunger every year.

Underweight An underweight person is a person whose body weight is considered too low to be healthy. A person who is underweight is malnourished. Assessment The body mass index, a ratio of a person's weight to their height, has traditionally been used t ...

births and intrauterine growth restrictions cause 2.2 million child deaths a year. Poor or non-existent breastfeeding causes another 1.4 million. Other deficiencies, such as lack of vitamin A or zinc, for example, account for 1 million. Malnutrition in the first two years is irreversible. Malnourished children grow up with worse health and lower education achievement. Their own children tend to be smaller. Malnutrition was previously seen as something that exacerbates the problems of diseases such as measles, pneumonia and diarrhea, but malnutrition actually causes diseases, and can be fatal in its own right.

History

Hunger has been a perennial human problem. However, until the early 20th century, there was relatively little awareness of the qualitative aspects of malnutrition. Throughout history, various peoples have known the importance of eating certain foods to prevent symptoms now associated with malnutrition. Yet such knowledge appears to have been repeatedly lost and then re-discovered. For example, the ancient Egyptians reportedly knew the symptoms of scurvy. Much later, in the

14th century As a means of recording the passage of time, the 14th century was a century lasting from 1 January 1301 ( MCCCI), to 31 December 1400 ( MCD). It is estimated that the century witnessed the death of more than 45 million lives from political and na ...

Crusaders The Crusades were a series of religious wars initiated, supported, and sometimes directed by the Latin Church in the medieval period. The best known of these Crusades are those to the Holy Land in the period between 1095 and 1291 that were in ...

sometimes used anti-scurvy measures - for example, ensuring that

citrus fruits ''Citrus'' is a genus of flowering trees and shrubs in the rue family, Rutaceae. Plants in the genus produce citrus fruits, including important crops such as oranges, lemons, grapefruits, pomelos, and limes. The genus ''Citrus'' is native to ...

were planted on Mediterranean islands, for use on sea journeys. However, for several centuries, Europeans appear to have forgotten the importance of these measures. They rediscovered this knowledge in the

18th century The 18th century lasted from January 1, 1701 ( MDCCI) to December 31, 1800 ( MDCCC). During the 18th century, elements of Enlightenment thinking culminated in the American, French, and Haitian Revolutions. During the century, slave tradi ...

, and by the early 19th century, the

Royal Navy The Royal Navy (RN) is the United Kingdom's naval warfare force. Although warships were used by English and Scottish kings from the early medieval period, the first major maritime engagements were fought in the Hundred Years' War against ...

was issuing frequent rations of lemon juice to every crewman on their ships. This massively reduced scurvy deaths among British sailors, which in turn gave the British a significant advantage in the Napoleonic Wars. Later on in the 19th century, the Royal Navy replaced lemons with limes (unaware at the time that lemons are far more effective at preventing scurvy). According to historian Michael Worboys, malnutrition was essentially discovered, and the science of nutrition established, between World War I and World War II. Advances built on prior works like

Casimir Funk Kazimierz Funk (; February 23, 1884 – November 19, 1967), commonly anglicized as Casimir Funk, was a Polish-American biochemist generally credited with being among the first to formulate (in 1912) the concept of vitamins, which he called "vit ...

's 1912 formulisation of the concept of vitamins. Scientific study of malnutrition increased in the 1920s and 1930s, and grew even more common after World War II. Non-governmental organizations and United Nations agencies began to devote considerable energy to alleviating malnutrition around the world. The exact methods and priorities for doing this tended to fluctuate over the years, with varying levels of focus on different types of malnutrition like Kwashiorkor or Marasmus; varying levels of concern on protein deficiency compared to vitamins, minerals and lack of raw calories; and varying priorities given to the problem of malnutrition in general compared to other health and development concerns. The

green Revolution The Green Revolution, also known as the Third Agricultural Revolution, was a period of technology transfer initiatives that saw greatly increased crop yields and agricultural production. These changes in agriculture began in developed countrie ...

of the 1950s and 1960s saw considerable improvement in capability to prevent malnutrition. One of the first official global documents addressing Food security and global malnutrition was the 1948 Universal Declaration of Human Rights(UDHR). Within this document it stated that access to food was part of an adequate right to a standard of living. The

Right to food The right to food, and its variations, is a human right protecting the right of people to feed themselves in dignity, implying that sufficient food is available, that people have the means to access it, and that it adequately meets the individual ...

was asserted in the International Covenant on Economic, Social and Cultural Rights, a

treaty A treaty is a formal, legally binding written agreement between actors in international law. It is usually made by and between sovereign states, but can include international organizations, individuals, business entities, and other legal pers ...

adopted by the United Nations General Assembly on December 16, 1966. The Right to food is a human right for people to feed themselves in dignity, be free from hunger, food insecurity, and malnutrition. As of 2018, the treaty has been signed by 166 countries, by signing states agreed to take steps to the maximum of their available resources to achieve the right to adequate food. However, after the 1966 International Covenant the global concern for the access to sufficient food only became more present, leading to the first ever World Food Conference that was held in 1974 in Rome, Italy. The

Universal Declaration on the Eradication of Hunger and Malnutrition The Universal Declaration on the Eradication of Hunger and Malnutrition was adopted on 16 November 1974, by governments who attended the 1974 World Food Conference that was convened under General Assembly resolution 3180 (XXVIII) of 17 December ...

was a UN resolution adopted November 16, 1974 by all 135 countries that attended the 1974 World Food Conference. This non-legally binding document set forth certain aspirations for countries to follow to sufficiently take action on the global food problem. Ultimately this document outline and provided guidance as to how the international community as one could work towards fighting and solving the growing global issue of malnutrition and hunger. Adoption of the right to food was included in the Additional Protocol to the American Convention on Human Rights in the area of Economic, Social, and Cultural Rights, this 1978 document was adopted by many countries in the Americas, the purpose of the document is, "to consolidate in this hemisphere, within the framework of democratic institutions, a system of personal liberty and social justice based on respect for the essential rights of man." A later document in the timeline of global inititaves for malnutrition was the 1996

Rome Declaration on World Food Security The Rome Declaration on World Food Security is a document adopted at the 1996 World Food Summit took place in Rome, Italy between 13 and 17 November 1996. The summit was organised by the Food and Agriculture Organization of the United Nations (F ...

, organized by the Food and Agriculture Organization. This document reaffirmed the right to have access to safe and nutritious food by everyone, also considering that everyone gets sufficient food, and set the goals for all nations to improve their commitment to food security by halving their amount of undernourished people by 2015. In 2004 the Food and Agriculture Organization adopted the Right to Food Guidelines, which offered states a framework of how to increase the right to food on a national basis.

Special populations

Undernutrition is an important determinant of maternal and child health, accounting for more than a third of child deaths and more than 10 percent of the total global

disease burden Disease burden is the impact of a health problem as measured by financial cost, mortality, morbidity, or other indicators. It is often quantified in terms of quality-adjusted life years (QALYs) or disability-adjusted life years (DALYs). Both ...

according to 2008 studies.

Children

Undernutrition adversely affects the cognitive development of children, contributing to poor earning capacity and poverty in adulthood. The development of childhood undernutrition coincides with the introduction of complementary weaning foods which are usually nutrient deficient. The World Health Organization estimates that malnutrition accounts for 54 percent of child mortality worldwide, about 1 million children. There is a strong association between undernutrition and child mortality. Another estimate also by WHO states that childhood underweight is the cause for about 35% of all deaths of children under the age of five years worldwide.Prüss-Üstün, A., Bos, R., Gore, F., Bartram, J. (2008)
Safer water, better health – Costs, benefits and sustainability of interventions to protect and promote health
World Health Organization (WHO), Geneva, Switzerland Over 90% of the stunted children below five years of age live in sub-Saharan Africa and South Central Asia. Although access to adequate food and improving nutritional intake is an obvious solution to tackling undernutrition in children, the progress in reducing children undernutrition is disappointing.

Women

Researchers from the Centre for World Food Studies in 2003 found that the gap between levels of undernutrition in men and women is generally small, but that the gap varies from region to region and from country to country. These small-scale studies showed that female undernutrition prevalence rates exceeded male undernutrition prevalence rates in South/Southeast Asia and Latin America and were lower in Sub-Saharan Africa. Datasets for Ethiopia and Zimbabwe reported undernutrition rates between 1.5 and 2 times higher in men than in women; however, in India and Pakistan, datasets rates of undernutrition were 1.5–2 times higher in women than in men. Intra-country variation also occurs, with frequent high gaps between regional undernutrition rates. Gender inequality in nutrition in some countries such as India is present in all stages of life. Studies on nutrition concerning gender bias within households look at patterns of food allocation, and one study from 2003 suggested that women often receive a lower share of food requirements than men. Gender discrimination, gender roles, and social norms affecting women can lead to early marriage and childbearing, close birth spacing, and undernutrition, all of which contribute to malnourished mothers. Within the household, there may be differences in levels of malnutrition between men and women, and these differences have been shown to vary significantly from one region to another, with problem areas showing relative deprivation of women. Samples of 1000 women in India in 2008 demonstrated that malnutrition in women is associated with poverty, lack of development and awareness, and illiteracy. The same study showed that gender discrimination in households can prevent a woman's access to sufficient food and healthcare. How socialization affects the health of women in Bangladesh, Najma Rivzi explains in an article about a research program on this topic. In some cases, such as in parts of Kenya in 2006, rates of malnutrition in pregnant women were even higher than rates in children. Women in some societies are traditionally given less food than men since men are perceived to have heavier workloads. Household chores and agricultural tasks can in fact be very arduous and require additional energy and nutrients; however, physical activity, which largely determines energy requirements, is difficult to estimate.

Physiology

Women have unique nutritional requirements, and in some cases need more nutrients than men; for example, women need twice as much calcium as men.

Pregnancy and breastfeeding

During pregnancy and breastfeeding, women must ingest enough nutrients for themselves and their child, so they need significantly more protein and calories during these periods, as well as more vitamins and minerals (especially iron, iodine, calcium, folic acid, and vitamins A, C, and K). In 2001 the FAO of the UN reported that iron deficiency affected 43 percent of women in

and increased the risk of death during childbirth. A 2008 review of interventions estimated that universal supplementation with calcium, iron, and folic acid during pregnancy could prevent 105,000 maternal deaths (23.6 percent of all maternal deaths). Malnutrition has been found to affect three quarters of UK women aged 16–49 indicated by them having less folic acid than the WHO recommended levels. Frequent pregnancies with short intervals between them and long periods of breastfeeding add an additional nutritional burden.

Educating children

Action for healthy kids Action for Healthy Kids is a nationwide grassroots network mobilizing school professionals, families and communities to take actions that support the health of the whole child. Founded in 2002, the organization is committed to addressing the root ...

" has created several methods to teach children about nutrition. They introduce 2 different topics, self-awareness which teaches children about taking care of their own health and social awareness, which is how culinary arts vary from culture to culture. As well as its importance when it comes to nutrition. They include eBooks, tips, cooking clubs. including facts about vegetables and fruits. Team Nutrition has created " MyPlate eBooks" this includes 8 different eBooks to download for free. These eBooks contain drawings to color, audio narration, and a large number of characters to make nutrition lessons entertaining for children. According to the FAO, women are often responsible for preparing food and have the chance to educate their children about beneficial food and health habits, giving mothers another chance to improve the nutrition of their children.

Elderly

Malnutrition and being underweight are more common in the elderly than in adults of other ages. If elderly people are healthy and active, the aging process alone does not usually cause malnutrition. However, changes in body composition, organ functions, adequate energy intake and ability to eat or access food are associated with aging, and may contribute to malnutrition. Sadness or depression can play a role, causing changes in appetite, digestion, energy level, weight, and well-being. A study on the relationship between malnutrition and other conditions in the elderly found that malnutrition in the elderly can result from gastrointestinal and endocrine system disorders, loss of taste and smell, decreased appetite and inadequate dietary intake. Poor dental health, ill-fitting dentures, or chewing and swallowing problems can make eating difficult. As a result of these factors, malnutrition is seen to develop more easily in the elderly. Rates of malnutrition tend to increase with age with less than 10 percent of the "young" elderly (up to age 75) malnourished, while 30 to 65 percent of the elderly in home care, long-term care facilities, or acute hospitals are malnourished. Many elderly people require assistance in eating, which may contribute to malnutrition. However, the mortality rate due to undernourishment may be reduced. Because of this, one of the main requirements of elderly care is to provide an adequate diet and all essential nutrients. Providing the different nutrients such as protein and energy keeps even small but consistent weight gain. Hospital admissions for malnutrition in the United Kingdom have been related to insufficient social care, where vulnerable people at home or in care homes are not helped to eat. In Australia malnutrition or risk of malnutrition occurs in 80 percent of elderly people presented to hospitals for admission. Malnutrition and weight loss can contribute to sarcopenia with loss of lean body mass and muscle function. Abdominal obesity or weight loss coupled with sarcopenia lead to immobility, skeletal disorders, insulin resistance, hypertension, atherosclerosis, and metabolic disorders. A paper from the ''Journal of the American Dietetic Association'' noted that routine nutrition screenings represent one way to detect and therefore decrease the prevalence of malnutrition in the elderly.

References

External links

*
Action Against Hunger , ACF-USA

Action Against Hunger , ACF-UK

Hunger Relief International , HRI

Hunger Relief research on IssueLab

The Global Food Security and Nutrition Forum (FSN Forum)

Ten Things you can do to Fight World Hunger
''The Nation'', May 13, 2009
United Nation 2007 report

World Food Programme , WFP

UN

WFP
{{Authority control Global issues Wikipedia medicine articles ready to translate Wikipedia infectious disease articles ready to translate Health effects of food and nutrition Limbic system Motivation Neuropsychology Eating behaviors Hazards of outdoor recreation

Prevalence

In children

In adults

Recent increase

Definitions

Undernutrition

Micronutrient malnutrition

Protein-energy malnutrition

Overnutrition

Classifying malnutrition

Definition by Gomez & Galvan

Definition by Waterlow

Effects

Signs

Cognitive development

Causes & risk factors

Social and political

Diseases & conditions

Dietary practices

Undernutrition

Overnutrition

Agricultural productivity

Future threats

Prevention

Food security

Economics

Successful initiatives

World population

Food sovereignty

Health facilities

Breastfeeding

Barriers to breastfeeding

21st century global initiatives

Treatment

Improving nutrition

Identifying malnourishment

Medical management

Bangladeshi model

Therapeutic foods

Micronutrient supplementation

Treating diarrhea

Preventing dehydration

Oral rehydration therapy

Low blood sugar

Hypothermia

Epidemiology

People affected

Mortality

History

Special populations

Children

Women

Physiology

Pregnancy and breastfeeding

Educating children

Elderly

See also

References

External links