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Malnutrition Responsible for a Third of Child Deaths Worldwide

Report also found it accounted for 11% of international disease burden

THURSDAY, Jan. 17 (HealthDay News) -- A international epidemic of maternal and childhood malnutrition accounts for more than one-third of childhood deaths and 11 percent of the world's disease burden, researchers report.

"The key messages here are that the international nutrition system is fragmented and dysfunctional, and reform is needed," lead researcher Dr. Robert Black, a professor at the Johns Hopkins Bloomberg School of Public Health, said during a news conference Wednesday. "The problems are long standing and embedded in organizational structure, but a concerted effort can provide greater progress and accountability. Progress is possible."

Black was lead author of a special series on maternal and child malnutrition appearing online Jan. 17 in The Lancet.

The issue was hailed by different development agencies at the news conference.

"[The World Bank] does agree with the conclusions in the series. They have huge implications for the architecture of an international nutrition system," said Joy Phumaphi, vice president and network head of human development at the World Bank. "We want to associate ourselves with the report."

According to Kent Hill, assistant administrator for global health at USAID, there are some 852 million chronically hungry people living in the world today, and roughly half are children. Even though many can eat enough to ward off hunger, many still don't get the nutrition necessary for growth and development. Mothers and children are the most vulnerable, Hill added.

The quandary has far-reaching consequences for individuals, societies and economies, the experts said.

"Malnutrition and nutrition as a whole is an economic imperative," Phumaphi said. Nutrition affects productivity as well as cognitive functioning and performance in school. "It also increases health costs and, therefore, has catastrophic implications," she noted.

According to Jayaseelan Naidoo, board chairman of the Global Alliance for Improved Nutrition (GAIN), in the absence of proper nutrition, many people are abandoning therapy for HIV/AIDS because of side effects.

The Lancet series starts off with a paper from the Johns Hopkins School of Public Health in Baltimore and Aga Khan University in Karachi, Pakistan, which finds that one-third of child deaths and 11 percent of the total disease burden globally are a result of maternal and child malnutrition.

Deficiencies in vitamin A and zinc had the greatest effect among the micronutrients studied and caused 0.6 million and 0.4 million deaths, respectively, in 2005. Deficiencies in iodine and iron are of lesser concern because of successful interventions. But suboptimal breast-feeding is estimated to be responsible for 1.4 million child deaths worldwide.

"We concur with the report that the first six months of a child's life should be exclusively focused on breast-feeding," Naidoo said.

The second study reported that poor fetal growth or stunting during a child's first two years of life can lead to shorter adult height, lower school attendance and reduced adult income potential. Better nutrition can remedy much of this.

Other researchers found that implementing existing nutrition-related interventions for mothers and children could prevent one-quarter of all child deaths in the 36 countries with the most severe deficits. Breast-feeding counseling and vitamin A supplementation would provide the greatest boost.

The fourth study found that 80 percent of undernourished children worldwide live in just 20 countries. The final paper reported that the international nutrition system is fragmented and needs reform.

"We need to take this amazing piece of work and translate it into practical, measurable results," Naidoo said.

But in addition, said other experts, the world needs better knowledge.

"As much as we know about food, we know very little about the science of food," said Dr. Tadataka Yamada, president of the Global Health Program at the Bill & Melinda Gates Foundation. "In a sense, nutrition has been a little bit of a fractious community, because the less you know, the more your opinion counts. We need new knowledge in nutrition, and we have to invest in this because that will allow other investments we make in nutrition to be wisely and strategically placed."

More information

Visit the World Health Organization for more on nutrition and malnutrition.

SOURCES: Jan. 16, 2008, teleconference with Robert Black, M.D., professor, Johns Hopkins Bloomberg School of Public Health, Baltimore; Joy Phumaphi, Ph.D., vice president/network head, Human Development, World Bank; Kent Hill, Ph.D., assistant administrator, global health, USAID; Jayaseelan Naidoo, board chairman, Global Alliance for Improved Nutrition (GAIN); Tadataka Yamada, M.D., president, Global Health Program, Bill & Melinda Gates Foundation; Jan. 17, 2008, The Lancet online

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