Global progress in reducing undernutrition through the life cycle is slow and patchy across regions. Prevalence rates, particularly of low birthweight, stunting, and underweight, remain high across most sub-regions, particularly in Eastern Africa and South Central Asia.
In South Central Asia, about one in five children born this year will be undernourished at birth - the most startling manifestation of the intergenerational transmission of undernutrition. Intrauterine growth retardation is a pivotal indicator of progress in breaking the intergenerational cycle of undernutrition, a prospective marker of a child’s future nutrition and health status as well as a retrospective measure of the nutritional and health status of the mother. Given our increasing knowledge of the implications of being born undernourished for adulthood, it should also be considered a valuable summary indicator of human development.
Overall, more than a third of all children in the developing world remain constrained in their physical growth and cognitive development by undernutrition. The ambitious goal of halving childhood underweight prevalence by the year 2000, set at the 1990 World Summit for Children, will not be achieved by most countries. While the high rates of child undernutrition in South Asia are well known, these continue to drop, albeit not very rapidly. Most disturbing is the fact that two sub-regions - Eastern and Western Africa - are actually showing significant increases in prevalence percentages. On the positive side, two sub-regions - the Caribbean and South America - will manage to reach the World Summit goal.
Data on the nutritional status of individuals at different stages of the life cycle are slowly becoming available but remain limited. The emergent situation of coexisting undernutrition and overnutrition among adults is notable, as is the extreme paucity of data on older adults, a group that will continue to grow proportionately in developing-country populations. This chapter has described the nature, levels, causes, and consequences of malnutrition - proxied by anthropometry - as it persists through the life cycle. Basic prevalence data are still needed in many countries.
Although this chapter argues for a particular focus on preventing foetal and early childhood malnutrition, the life cycle dynamics of cause and consequence demand a holistic inclusive approach. Adequate nutrition is a human right for all people, and intervening at each point in the life cycle will accelerate and consolidate positive change. The next chapter provides an update on the global, regional, and sub-regional situation regarding micronutrient deficiencies and programmes for their prevention and control.
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