Undernutrition in mothers and children is the cause of
more than 35 percent of all child deaths
and 11 percent of the global disease burden, according to a
study led by researchers at the Johns
Hopkins Bloomberg School of Public Health. The study is
the first in a series of five studies, published
Jan. 16 in the medical journal The Lancet, analyzing
the global impact of maternal and child
undernutrition. The research series highlights the critical
role of early nutrition in the health and
development of children and the economic growth of
nations.
"More than 3.5 million mothers and children under 5
die unnecessarily each year in poor
countries due to the underlying cause of undernutrition,
and millions more are permanently disabled by
the physical and mental effects of a poor dietary intake in
the earliest months of life," said Robert
Black, lead author of the series and chair of the Department of International
Health at the
Bloomberg School. "This series provides a new evidence base
for expanded nutrition-related programs
and interventions, which, if implemented at scale, would
prevent many of these deaths and
disabilities."
In the initial study, Black; co-author Zulfiqar
Bhutta, of the Department of Pediatrics and Child
Health at Aga Khan University in Pakistan; and other
colleagues show that stunting, severe wasting and
intrauterine growth restriction together contributed to 2.2
million deaths annually. For children under
5 years old, these symptoms of undernutrition also account
for 91 million disability-adjusted life
years, or DALYs, which is an estimate of years of life lost
due to premature deaths and years of life
lived with disabilities.
Conditions such as stunting, severe wasting and
intrauterine growth restriction in the first two
years of life are known to cause irreparable harm by
impeding physical development and cognitive
growth, which can limit economic potential. Lower income,
poor health and reduced access to proper
nutrition then continue to affect the health of children
born into future generations, establishing a
repetitive cycle.
The study also determined that deficiencies in vitamin
A and zinc had the highest disease
burden and contributed to 0.6 million and 0.4 million
deaths, respectively. Combined they accounted
for 9 percent of the global childhood DALYs. Suboptimum
breast-feeding accounted for 1.4 million
child deaths and 44 million DALYs in children under 5.
"By the time children reach their second birthday, if
undernourished, they could suffer
irreversible physical and cognitive damage, impacting their
future health, economic well-being and
welfare. These effects continue into adulthood and are
passed on to the next generation as
undernourished girls and women have children of their own,"
Black said. "There are effective
interventions to reduce stunting, micronutrient
deficiencies and child deaths. However, a global effort
with greater cooperation is needed to reduce
undernutrition."
Other papers in the five-part Lancet series review and
analyze the effectiveness and potential
impact of nutrition-related interventions and policy
options in developing countries and recommend
actions to accelerate efforts to improve maternal and child
undernutrition. Recommendations include a
new global governance structure, a more effective United
Nations, fewer parallel organizations but
also fewer mandate gaps, and more investment in capacity
strengthening in high-burden countries.
A panel of leading international public health experts
announced the research findings Jan. 16
at events in Washington, D.C., and in London. The full
articles plus accompanying materials are available
online at
www.globalnutritionseries.org.
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