Agriculture Reference
In-Depth Information
imbalances, not just deficiencies in energy, protein, and/or other micronutrients.
Malnutrition thus applies to intake that is greater than physiological needs for good
health and performance, not just deficiencies. The most obvious manifestation of these
excesses is the global epidemic of overweight and obesity. The same anthropomet-
ric indicators such as weight-for-height and body mass index that are used to define
wasting and acute undernutrition are employed as indicators of overweight and obe-
sity. Specifically, a BMI in excess of 25 is an indicator of overweight, and a BMI over 30
defines obesity.
Although the focus of this chapter is on malnutrition, this should be distinguished
from another concept, that of food security. Although there are myriad definitions
found in the literature, one that perhaps comes closest to a consensus is from the Food
and Agriculture Organization, which states, “Food security [is] a situation that exists
when all people, at all times, have physical, social and economic access to sufficient, safe
and nutritious food that meets their dietary needs and food preferences for an active
and healthy life” (FAO 2002). As will be discussed next, the use of these terms synony-
mously with malnutrition can indeed be misleading, as the underlying notion of access
to food is only one input into the production of good nutritional outcomes.
Dimensions of Malnutrition
The stark reality of the global scale of undernutrition is illustrated in Table 16.1. The
prevalence of underweight remains at around 40% in the most affected region, South
Asia, despite the success in reducing these levels over the past three decades. Africa's
prevalence of underweight children, 30%, although lower than in South Asia, has, in
fact, not declined over the same period. Owing to population growth, the number of
undernourished children in Africa is on the rise.
The figures on the prevalence of micronutrient deficiencies are equally staggering.
For example, nearly 25% of the general population suffers from anemia, which corre-
sponds to over 1.6 billion people. The highest rates are found among preschool age chil-
dren where the share of those with anemia are 47.4%, a number that is nearly as high for
pregnant women globally. In fact, the prevalence rate is 57.1% among pregnant women in
Africa and nearly 50% in Southeast Asia. There are additionally 468 million nonpregnant
women globally who suffer from anemia (de Benoist et al. 2008). The number of indi-
viduals in the general population who are estimated to have insufficient iodine intake
is two billion. And over one-third of school age children suffer from low iodine intake.
The hardest hit region is South East Asia where around 100 million children have iodine
intakes below what is required (de Benoist et  al. 2004). In the case of vitamin A, the
World Health Organization indicates that deficiencies are a significant health problem in
60 countries, with one-third of the preschool-aged population at risk of vitamin A defi-
ciency. Among the serious manifestations of vitamin A  deiciency is night blindness,
which affects 5.2 million preschool-aged children and 9.8 million pregnant women.1
 
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