Maternal and child undernutrition and overweight in low-income and middle-income countries.

TitleMaternal and child undernutrition and overweight in low-income and middle-income countries.
Publication TypeJournal Article
Year of Publication2013
AuthorsBlack RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, Ezzati M, Grantham-McGregor S, Katz J, Martorell R, Uauy R
Corporate AuthorsMaternal and Child Nutrition Study Group
JournalLancet
Volume382
Issue9890
Pagination427-51
Date Published2013 Aug 3
ISSN1474-547X
KeywordsAdolescent, Adult, Anemia, Iron-Deficiency, Avitaminosis, Body Mass Index, Calcium, Child, Child, Preschool, Female, Fetal Growth Retardation, Growth Disorders, Humans, Income, Infant, Newborn, Infant, Small for Gestational Age, Infection, Iodine, Iron, Male, Malnutrition, Middle Aged, Obesity, Overweight, Pregnancy, Pregnancy Complications, Prevalence, Pteroylpolyglutamic Acids, Risk Factors, Rural Health, Socioeconomic Factors, Urban Health, World Health, Young Adult, Zinc
Abstract

Maternal and child malnutrition in low-income and middle-income countries encompasses both undernutrition and a growing problem with overweight and obesity. Low body-mass index, indicative of maternal undernutrition, has declined somewhat in the past two decades but continues to be prevalent in Asia and Africa. Prevalence of maternal overweight has had a steady increase since 1980 and exceeds that of underweight in all regions. Prevalence of stunting of linear growth of children younger than 5 years has decreased during the past two decades, but is higher in south Asia and sub-Saharan Africa than elsewhere and globally affected at least 165 million children in 2011; wasting affected at least 52 million children. Deficiencies of vitamin A and zinc result in deaths; deficiencies of iodine and iron, together with stunting, can contribute to children not reaching their developmental potential. Maternal undernutrition contributes to fetal growth restriction, which increases the risk of neonatal deaths and, for survivors, of stunting by 2 years of age. Suboptimum breastfeeding results in an increased risk for mortality in the first 2 years of life. We estimate that undernutrition in the aggregate--including fetal growth restriction, stunting, wasting, and deficiencies of vitamin A and zinc along with suboptimum breastfeeding--is a cause of 3·1 million child deaths annually or 45% of all child deaths in 2011. Maternal overweight and obesity result in increased maternal morbidity and infant mortality. Childhood overweight is becoming an increasingly important contributor to adult obesity, diabetes, and non-communicable diseases. The high present and future disease burden caused by malnutrition in women of reproductive age, pregnancy, and children in the first 2 years of life should lead to interventions focused on these groups.

DOI10.1016/S0140-6736(13)60937-X
Alternate JournalLancet
PubMed ID23746772