The Global Nutrition Report 2018 was published recently.
With India facing a major malnutrition crisis, it calls for concerted actions to address the gaps and concerns.
What are the key nutrition indicators?
Stunting, or low height for age, is caused by long-term insufficient nutrient-intake and frequent infections.
Wasting, or low weight for height, is a strong predictor of mortality among children under five.
It is usually the result of acute significant food shortage and/or disease.
Overweight is the condition of having more body fat than is healthy.
What are the highlights of the report?
Globally 150.8 million children under five years are stunted and 50.5 million are wasted.
Stunting - Of the three countries that are home to almost half (47.2%) of all stunted children, two are in Asia.
Of these, with 46.6 million (31%) children who are stunted, India tops the list of countries.
It is followed by Nigeria (13.9 million) and Pakistan (10.7 million).
Wasting - More than half of the world's children impacted by wasting (26.9 million) live in South Asia.
India accounted for 25.5 million children who are wasted, followed by Nigeria (3.4 million) and Indonesia (3.3 million).
Overweight - India also figures among the set of countries that has more than a million overweight children.
The other nations are China, Indonesia, Egypt, US, Brazil and Pakistan.
In four countries, more than a fifth of all children are overweight - Ukraine, Albania, Libya and Montenegro.
Of the around 38 million children globally overweight, some 5.4 million are in South Asia and 4.8 million are in East Asia.
Prevalence of overweight children is the highest in upper-middle income countries and the lowest in low-income countries.
In urban areas, there are 7.1% overweight children on average, whereas in rural areas 6.2% children are overweight.
Overweight is slightly more common among boys (6.9%) than girls (6.1%).
As with obesity, among adults, women are more overweight than among men (39.2% and 38.5% respectively in 2016).
Conversely, diabetes is more common among men than women (9% and 7.9% respectively in 2014).
The health consequences of being overweight and obese contribute to an estimated four million deaths globally.
Malnutrition - Malnutrition is responsible for more ill-health than any other cause.
Of the 141 countries analysed, 88% of countries experience more than one form of malnutrition.
The problem of malnutrition remains severe across all regions but none of the countries are on course to meet all nine global nutrition targets.
Packaged foods - As per the report, only 21% of packaged foods in India are rated as being healthy.
This is based on overall energy, salt, sugar and saturated fat on the negative side, and vegetable, fruit, protein, fibre and calcium as positive factors.
What is the case with malnutrition in India?
Spatial variation - An International Food Policy Research Institute (IFPRI) study found that stunting varied greatly from district to district (nearly 12% to 65%).
Notably, 239 of 604 districts have stunting levels above 40%.
There are high and very high levels of stunting mainly in central and northern India (more than 30% and 40%, respectively).
In contrast, less than 20% is the condition in almost the entire south.
Factors - Factors associated with gender, education, economic status, health, hygiene, and other demographic factors explain the spatial variation.
Factors such as women's low BMI accounted for 19% of the difference between the low versus high-burden districts.
Other influential gender-related factors included maternal education (accounted for 12%), age at time of marriage (7%) and antenatal care (6%).
Children's diets (9%), assets (7%), open defecation (7%) and household size (5%) were also influential.
What should be done?
The district- and region-wise sharp contrast shows the important role played by political commitment and administrative efficiency.
It also reflects the role of literacy and women’s empowerment in ensuring children’s health.
The figures thus call for immediate policy action to reduce inequalities and childhood stunting.
With district-wise data, state governments should address the determining factors for malnutrition.
Food and freedom go together, and the availability of one strongly influences access to the other.
So, social institutions can work to improve nutrition and children’s welfare in free societies.
Governments should acknowledge the linkages and commit themselves to improved nutritional policies.
In states where the Anganwadi Services scheme does not work well, it must be subjected to a rigorous review, and targeted interventions for supplementary nutrition should be made.
