The Triple Burden of Malnutrition

A recently released Comprehensive National Nutrition Survey (CNNS) survey shows that 35% of Indian children under five are stunted, 17% are wasted and 33 per cent are underweight. Only 42% of children (6 to 23 months) are fed at an adequate frequency and only 21% are fed an adequately diverse diet. Timely complementary feeding is initiated for only 53% of infants aged 6-8 months.

At the same time, the survey highlights that overweight and obesity increasingly begin in childhood with a growing threat of non-communicable diseases like diabetes (10%) in school-aged children and adolescents. Urban India is moving into an unhealthy food snacking environment, which is influencing children’s food choices and this is spreading to rural areas.

Food consumption patterns in India reveal that child diets are largely starved of proteins and micronutrients and are influenced by household (adult) food choices. Over the decades, despite growing incomes, protein-based calories remain low and unchanged, and the calorific share of fruits and vegetables has declined.

What is the triple burden of malnutrition?

A new UNICEF report The State of the World’s Children 2019: Children, food and nutrition finds that at least 1 in 3 children under five – or 200 million – is either undernourished or overweight. Almost 2 in 3 children in the world between six months and two years of age are not fed food that supports their rapidly growing bodies and brains. This puts them at risk of poor brain development, weak learning, low immunity, increased infections and, in many cases, death.

The report provides the most comprehensive assessment yet of 21^st century child malnutrition in all its forms. It describes a triple burden of malnutrition: Undernutrition, hidden hunger caused by a lack of essential nutrients, and overweight among children under the age of five, noting that around the world:

a) 149 million children are stunted, or too short for their age,

b) 50 million children are wasted, or too thin for their height,

c) 340 million children – or 1 in 2 – suffer from deficiencies in essential vitamins and nutrients such as vitamin A and iron,

d) 40 million children are overweight or obese.

The greatest burden of malnutrition in all its forms is shouldered by children and adolescents from the poorest and most marginalized communities, the report notes. Only 1 in 5 children aged six months to two years from the poorest households eats a sufficiently diverse diet for healthy growth.

The CNNS survey does show some progress in the reduction of malnutrition. It also reflects effective reach of Government programmes to prevent Vitamin A and iodine deficiency in children aged 1-4 years.

“When healthy options are available and these are affordable and desirable then children and families make better food choices.  As the SOWC report highlights this year, children’s nutrition will improve significantly if there is an increase in the production and processing of healthy foods to deliver nutritious, safe, affordable and sustainable diets for all children,” said Dr. Yasmin Ali Haque, UNICEF Representative in India.

The POSHAN Abhiyaan or the National Nutrition Mission is playing a major role in improving nutrition indicators across India. The Government of India’s Anaemia Mukt Bharat programme to fight anemia prevalence has been recognized as one of the best programmes implemented by Governments across the world to address malnutrition.

The 6X6X6 strategy (six target beneficiary groups, six interventions and six institutional mechanisms) of the programme has been highlighted for using anemia testing and treatment as the entry point to provide information on healthy diets.

The report also notes that climate-related disasters cause severe food crises. Drought, for example, is responsible for 80% of damage and losses in agriculture, dramatically altering what food is available to children and families, as well as the quality and price of that food.

5 point guide to end malnutrition in kids

To address this growing malnutrition crisis in all its forms, UNICEF is issuing an urgent appeal to governments, the private sector, donors, parents, families and businesses to help children grow healthy by:

1. Empowering families, children and young people to demand nutritious food, including by improving nutrition education and using proven legislation – such as sugar taxes – to reduce demand for unhealthy foods.

2. Driving food suppliers to do the right thing for children, by incentivizing the provision of healthy, convenient and affordable foods.

3. Building healthy food environments for children and adolescents by using proven approaches, such as accurate and easy-to-understand labelling and stronger controls on the marketing of unhealthy foods.

4. Mobilizing supportive systems – health, water and sanitation, education and social protection – to scale up nutrition results for all children.

5. Collecting, analyzing and using good-quality data and evidence to guide action and track progress.