The Poor, Malnutrition, Biofortification, and Biotechnology - The Oxford Topic of Food, Politics, and Society - page 150

Based on this concept, the WHO calculated the “global” burden of disease and attrib-
uted it to leading risk factors (WHO 2002). As can be seen from Figure 6.2, the biggest
single risk factor contributing to the global burden of disease is underweight—almost
one-tenth of the global potential for good health is lost due to this cause. However, add-
ing up the three major micronutrient deficiencies represents the third most important
risk factor. On the one hand, this shows that vitamin and mineral deficiencies are indeed
a serious problem for public health, while on the other hand, it shows that not all forms
of malnutrition are equally severe. For instance, many more people suffer from iodine
deficiency than are undernourished, but the aggregated health consequences are more
severe for underweight.
Apart from this quantification of the amount of ill health caused by micronutrient
deficiencies, the economic loss these deficiencies impose on society has been estimated.
In 1994 the World Bank suggested that iron, iodine, and vitamin A deficiencies could
reduce the gross domestic product (GDP) in developing countries by as much as 5 per-
cent. Subsequent estimates also placed the possible losses of GDP due to micronutri-
ent deficiencies in different developing countries into the range of 2-4 percent (Horton
and Ross 2003; Micronutrient Initiative 2004; Stein and Qaim 2007), with lower esti-
mates still amounting to an annual loss of at least US$5 billion in China and India alone
(Micronutrient Initiative 2009). On the other hand, in the long run, better nutrition can
have a much larger impact; for instance, a historic analysis by Fogel (2004) shows that 30
percent of the growth of British per-capita income over the last 200 years can be attrib-
uted to improved nutrition.

Underweight
Unsafe sex
Blood pressure
Tobacco
Alcohol
WASH
Cholesterol
Indoor smoke
Iron de•ciency
Overweight
Zinc de•ciency
Low fruit & veggie intake
Vitamin A de•ciency
Physical inactivity
Risk factors for injury
Iron, zinc & VA de•ciency

9.5%

6.3%

4.4%
4.1%
4.0%
3.7%

2.8%
2.6%
2.4%
2.3%
1.9%
1.8%
1.8%
1.3%
0.9%

6.1%

Figure 6.2 Global distribution of burden of disease of 15 leading risk factors.
Notes: WASH stands for “Unsafe water, sanitation & hygiene.” Apart from the risk factors explicitly linked to
malnutrition, “Cholesterol” and “Low fruit & vegetable intake” are also related to poor nutrition.
Source: WHO (2002).