The State of the World's Children 1998: Focus on Nutrition

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The Power of Good Nutrition

The devastation of malnutrition is hard to overstate, but so is the countervailing power of nutrition. Not only is good nutrition the key to the healthy development of individuals, families and societies, but there is also growing reason to believe that improving the nutrition of women and children will contribute to overcoming some of the greatest health challenges facing the world, including the burden of chronic and degenerative disease, maternal mortality, malaria and AIDS.

The most obvious proof of the power of good nutrition can be seen in the taller, stronger, healthier children of many countries, separated by only a generation from their shorter, less robust parents, and by the better diets and more healthful, nurturing environments they enjoy.

Stronger children grow into stronger, more productive adults. Well-nourished girls grow into women who face fewer risks during pregnancy and childbearing, and whose children set out on firmer developmental paths, physically and mentally. And history shows that societies that meet women's and children's nutritional needs also lift their capacities for greater social and economic progress (Fig. 3).

Approximately half of the economic growth achieved by the United Kingdom and a number of Western European countries between 1790 and 1980, for example, has been attributed to better nutrition and improved health and sanitation conditions, social investments made as much as a century earlier.16

Even in countries or regions where poverty is entrenched, the health and development of children and women can be greatly protected or improved (Fig 4). In parts of Brazil, for example, the percentage of underweight children plummeted from 17 per cent in 1973 to just under 6 per cent in 1996, at a time when poverty rates almost doubled.

Much has already been achieved. For example, 12 million children every year are being spared irreversible mental impairment from iodine deficiency because of iodized salt. And more than 60 per cent of young children around the world are receiving vitamin A supplements.

Some effects of even severe malnu trition on a child's mental development can be at least partially reversed. The intelligence of severely malnourished children was found to improve markedly, for example, when health care, adequate food and stimulation were provided continually.17

And there is increasing evidence that good nutrition helps the body resist infection; that when infection occurs, nutrition relieves its severity and seriousness; and that it speeds recovery.

Thirty years ago, most people could readily accept the notion that a 'good diet' was beneficial to overall health. But the idea that specific nutrients could help fend off -- or, even more outlandishly, help treat -- specific diseases smacked of 'fringe science'.

Today, through clinical trials and studies, the fringe is edging closer to the mainstream, as nutrition scientists as well as immunologists, paediatricians and gerontologists test the implica tions for public policy of large-scale interventions to improve nutrition and its effects on an array of critical physiological processes.

Malnutrition, reflected in the poor growth of children and adolescents and the high prevalence of low-birthweight babies, already has well-known effects on a child's capacity to resist illness. It is thus reasonable to argue that in the global fight to reduce childhood death and illness, initiatives to improve nutrition may be as powerful and important as, for example, immunization programmes.

There are now numerous scientific studies that suggest, but do not yet prove, that vitamin A deficiency in a mother infected with the human immunodeficiency virus (HIV) may increase her risk of transmitting the virus to her infant.

Early in the next millennium, it is thought that between 4 million and 5 million children will be infected with HIV. The majority, mostly in sub-Saharan Africa, will acquire the infection directly from their mothers. Although it will take another year or two to be absolutely sure, improving the vitamin A status of populations where both HIV infection and vitamin A deficiency are common may make some contribution to reducing the transmission of the virus.

Figure 3. From good nutrition to greater productivity and beyond

Good early nutriton is most likely to result where there is economic growth, especially equitable growth; when social services become affordable and accessibile; and when adequate investment is made in human resources, including the empowerment of women. Good nutrition in turn contributes to greater productivity and thus to economic growth.

Note: Adapted from Stuart Gillespie, John Mason and Reynaldo Martorell, How nutrition improves, ACC/SCN, Geneva 1996.

Figure 4. Poverty and malnutrition in Latin America and the Caribbean

Malnutrition in Latin America decreased from an estimated 21% in 1970 to 7.2% in 1997, while the rate of poverty, measured by income level only slightly over the last three decades, dropping from 45% in 1970 to 44% in 1997. These trends show that the reduction of malnutritionis not solely dependant on increases in income. In Latin America, the gains in reducing malnutrition are attributed at the underlying level to good care practicesand access to basic health services, including familyplanning, and water/sanitation services; and at the basic level to women's empowerment in terms of their education and the cash resources they control.

Source: Aaron Lchtig, 'Child Undernutrition in Latin America and the Caribbean; Trends, reasons and lessons', presented to the Workshop on the Changing Conditions of the Child in Latin America and the Caribbean, University of Notre Dame, South Bend (USA) 26 September 1997, based on ACC/SCN, Update of the nutrition situation 1996, Summary of results for the Third Report on the World Nutrition Situation, ACC/SCN Geneva, Social Panorama of Latin America 1996, Santiago Chile.

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