Maternal and child undernutrition: global and regional exposures and health consequences

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This is the first paper of the Lancet special series on Maternal and Child Undernutrition and focuses on the magnitude of the problem and the short term consequences of undernutrition in low and middle income countries. The paper uses new analyses of existing data to estimate the effects of the risks related to measures of undernutrition, as well as to suboptimum breastfeeding practices on mortality and disease.

The authors estimated that stunting, severe wasting, and intrauterine growth restriction together were responsible for 2·2 million deaths and 21 per cent of Disability-Adjusted Life-Years (DALYs) for children younger than five years.  One DALY can be thought of as one lost year of “healthy” life. The sum of these DALYs across the population, or the burden of disease, can be thought of as a measurement of the gap between current health status and an ideal health situation where the entire population lives to an advanced age, free of disease and disability.

Deficiencies of vitamin A and zinc were estimated to be responsible for 0·6 million and 0·4 million deaths, respectively, and a combined 9 per cent of global childhood DALYs. Iron and iodine deficiencies resulted in few child deaths, and combined were responsible for about 0·2 per cent of global childhood DALYs. Iron deficiency as a risk factor for maternal mortality added 115 000 deaths and 0·4 per cent of global total DALYs.

Suboptimum breastfeeding was estimated to be responsible for 1·4 million child deaths and 44 million DALYs (10 per cent of DALYs in children younger than five years). In an analysis that accounted for co-exposure of these nutrition-related factors, they were together responsible for about 35 per cent  of child deaths and 11 per cent of the total global disease burden. The high mortality and disease burden resulting from these nutrition-related factors make a compelling case for the urgent implementation of interventions to reduce their occurrence or ameliorate their consequences.

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