Regional Trends in Malnutrition:

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Regional Trends in Malnutrition the evolution of
the global nutrition situation Results for the
UN SCN 6th Report on the World Nutrition
Situation High Level Meeting on Nutrition, 23-24
November 2009, Brussels J Mason and R
Shrimpton Based on the work of Lisa Saldanha,
Bibi Al-Ibrahim, Emily Cercone, Linda
Heron, Katie Robinette, and Amit Wadhwa in the
Department of International Health and
Development, Tulane University School of Public
Health and Tropical Medicine.
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Changes in regional estimates of low birth weight
and underweight children,1980s to 2000s, the
length of the lines indicates extent of
improvement over the approximately 20 year
period.
Underweight prevalences and low birth weight move
together towards 0
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Change in regional estimates of low birth weight
and underweight women (unweighted estimates with
available data) 1980s to 2000s, showing incidence
of low birth weight tends to move with prevalence
of low BMI in women.
Low birth weight and low BMI in women move
together towards low levels of each
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Summary of numbers of countries with child
underweight changes improving, none, or
deteriorating, from repeated national surveys
with latest result gt2000.
Uwt Total Improve-ment No Change Deterior-ation MDGs On track?
Africa Number 42 18 10 14 14
100 43 24 33 38
Asia Number 25 14 10 1 11
100 56 40 4 48
SC Amer/Carib Number 19 6 11 2 5
100 32 58 11 71

Total 86 38 31 17 30
100 44 36 20 45
MDG rate
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Figure U2. Associations between underweight and
stunting, from survey results 1990-2007, by
region.
Stunting and underweight move together in Africa
and Asia, but not in poor S. and C American
countries where stunting is much higher.
Africa
Regression results for 3 regions
together. Stunting 20.502 (0.894 uwt)
5.495 (dummy for Asia) 14.261 (dummy for SC
Amer/Caribb) 1.036 (interaction dummy for SC
Amer/Caribb uwt). All coefficients significant
p0.000 interaction for Asia NS when in model.
N232, adj R squ 0.764.
CS Amer Caribb
Asia
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Figure VA1. Trends in VAD (prevalence of serum
retinol lt 20 mcg/dl in children lt 5yrs)
Shouldnt these rates be faster with high
coverage of VAC distribution? (Do VACs affect
VAD?)
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Figure An1. Trends in anemia in non-pregnant
women by region
This seems the most intractable problem a
breakthrough is needed. (Fortify rice
successfully?)

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Figure I3. Predicted numbers of people
(developing countries) with goitre if there were
no iodized salt, compared with current estimate
(with 68 iodized salt coverage).

An estimated 2 billion people would have goitre
if there were no iodized salt, compared with an
estimated 0.7 billion with the current coverage
of about 70.
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Underweight prevalences from repeated national
surveys (Selected transitioning countries) (WHO
standards)
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Underweight prevalences from repeated national
surveys (Africa) (WHO standards)
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Underweight prevalences from repeated national
surveys E Africa (WHO standards)
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Rates of change in child underweight prevalences
(ppts/yr) during rapidly improving phases in
selected countries, and programmes operating at
those times
Country Period Rate of Improvement Ppts/yr Programme
Bangladesh 1990-2004 1.4 BNIP etc
Indonesia 1987-2002 1.0 UPGK etc
Thailand 1982-1990 2.6 National
1982-2006 1.1 National
Vietnam 1994-2005 1.7 National
Tanzania 1986-2003 0.8 Iringa
1990s 1 approx CSD
Costa Rica 1979-89 1-1.5 Social Plan
Jamaica 1985-89 1.9 CH Aides
Sources 6th Report DCP2, Ch 56
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The double burden of malnutrition Underweight vs
obesity in women in 36 high-stunting burden
countries
Of these 36 countries, data on both underweight
and obesity prevalence among adult females were
available only for 24 countries    
Source WHO Global Database on Child Growth and
Malnutrition
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