Malnutrition has been dubbed the world's "silent emergency", a condition leading to death and disability on a vast scale, particularly among children and women of child-bearing age. Malnutrition not only kills, it destroys lives by compromising health, learning, productivity, curiosity, incentive and hope. Malnutrition engenders social and economic costs that cripple the development of individuals, communities and nations.

Large segments of the world's people, mostly poor and concentrated in developing nations are malnourished in calories, protein and/or micronutrients. Micronutrients are the vitamins and minerals that the body critically needs -- albeit in minute amounts -- for health, well-being and a whole range of essential physiological functions. Among the populations most vulnerable to malnutrition, including micronutrient deficiencies, are infants, pre-school children and breastfeeding mothers, all of whose nutritional demands are elevated.

Malnutrition readily crosses generations. Malnourished women are more likely to die in childbirth, or to suffer debilitating complications of pregnancy and childbirth. The infants of malnourished women begin their own lives malnourished, and face increased risk of early death, childhood disease and life-long impairments. Research has established clear links between malnutrition in early life and the subsequent development of chronic conditions later in life.

Malnutrition can take a variety of forms that often appear in combination. It is not only a silent emergency, it can be a largely invisible one as well. Three quarters of the world's children who die of causes related to malnutrition betray no outward signs of problems to a casual observer. These "mildly to moderately" malnourished youngsters simply fall victim to the complications attendant on inadequate diets--compromised immune systems, chronic disease, or the dehydration associated with persistent diarrheas often aggravated by malnutrition. An even mildly underweight child faces increased risk of death and disease, as does a child of normal weight who suffers the "hidden hunger" of micronutrient deficiency.

Extent of the Problem

How rampant is malnutrition?

More than 800 million people in the world are malnourished--the vast majority from the developing world and almost a quarter of them children. Nearly 12 million children under five die each year in developing countries mainly from preventable causes. Over half of these deaths are either directly or indirectly attributable to malnutrition.

A third of children under five years of age suffer from chronic malnutrition; fully half of South Asia's children are malnourished. Worldwide about 183 million children weigh less than they should for their age; some 67 million children are below the weight they should be for their height (wasted); and 226 million are stunted.

Some regions' children are particularly vulnerable. Half of all children in South Asia are underweight. In Subsaharan Africa, where one of every three children is underweight, the nutritional status of children is worsening.

Underweight and wasting are only the most obvious forms of malnutrition. The hidden hunger of micronutrient deficiencies affect approximately 2 billion people worldwide.

250 million preschool children are clinically deficient in vitamin A, which is essential to the function of the immune system.

Iron deficiency and the debilitating effects of anemia afflict 3.5 million people of all ages worldwide; as many as one in five deaths in women giving birth are due to anemia.

Iodine must be obtained from the environment, but it has been depleted from the soil and water in many regions of the world. It is estimated that over 1.5 persons in the world live in regions of environmental iodine deficiency and are at risk of iodine deficiency disease.

Many of the world's women of reproductive age do not ingest adequate levels of folic acid, a micronutrient essential to normal fetal development of the brain and spinal cord in the early stages of pregnancy.

Consequences for People

What are the human consequences of malnutrition?

In children, calorie/protein deficient diets result in underweight, wasting, lowered resistance to infection, stunted growth, and impaired cognitive development and learning. The body compensates for lack of food by retarded physical and intellectual growth.

Micronutrient deficiencies put people--particularly women and children--at increased risk of early mortality, disease, and disability.

Vitamin A deficiency, if severe, can cause blindness. Even before blindness occurs, a vitamin A deficient child faces a 25% risk of dying from ailments such as measles and diarrhea, which together kill over three million children annually. Vitamin A deficiency is also a cause of maternal mortality, especially in impoverished regions.

Anemia is a factor in pregnancy and childbirth complications that take the lives of some 585,000 women each year. It also contributes to 20 percent or more of post-partum maternal deaths in Africa and Asia. In infancy and early childhood iron deficiency anemia can delay psychomotor development, interfere with learning and lower IQ by close to ten percent--a tragic depletion of human intelligence.

Iodine deficiency disorder, which exists in most parts of the world, may result in goiter, reduced mental function, increased rates of stillbirths and abortions and infant deaths.

Folic acid deficiencies increase the risk of spina bifida and other tragic birth defects related to abnormal development of the brain and spinal cord.

Consequences for Development

Malnourished children who survive childhood thus face diminished futures as adults with compromised abilities, productivity and health. This loss of human potential is all the more tragic in societies with little economic capacity for therapeutic and rehabilitative measures, and has the unfortunate effect of worsening their economic plights.

By one reckoning the worldwide loss of social productivity associated with four overlapping types of malnutrition--nutritional stunting and wasting, iodine deficiency disorders and deficiencies of iron and vitamin A--amounted to almost 46 million years of productive, disability-free life.

Poverty, limited education, disease and poor access to quality foods and to health services are major contributors to adult and childhood malnutrition. Its underlying causes also include the low status of women in many countries, poor pre-natal care and high population densities. Malnutrition can, in turn, exacerbate some of these very problems, perpetuating poverty, compromising childhood education and straining the capacity of health services to cope with the illnesses and other problems of malnourished populations. The complex origins and reciprocal effects of this silent emergency call for activity on a number of fronts. Through its innovative, food technology-based programs SUSTAIN has been an active player in the multifaceted fight against global malnutrition.

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