Poor diets damaging children’s health worldwide, warns UNICEF

1 in 3 children under five is malnourished; 2 in 3 children under two live on poor diets

MOZAMBIQUE – An alarmingly high number of children are suffering the consequences of poor diets and a food system that is failing them, UNICEF warned in a new report on children, food and nutrition, released on Tuesday.

The State of the World’s Children 2019: Children, food and nutrition finds that at least 1 in 3 children under five – or over 200 million – is either undernourished or overweight. Almost 2 in 3 children between six months and two years of age are not fed food that supports their rapidly growing bodies and brains. This puts them at risk of poor brain development, weak learning, low immunity, increased infections and, in many cases, death.

“Despite all the technological, cultural and social advances of the last few decades, we have lost sight of this most basic fact: If children eat poorly, they live poorly,” said Henrietta Fore, UNICEF Executive Director. “Millions of children subsist on an unhealthy diet because they simply do not have a better choice. The way we understand and respond to malnutrition needs to change: It is not just about getting children enough to eat; it is above all about getting them the right food to eat. That is our common challenge today.”

The report provides the most comprehensive assessment yet of 21^st century child malnutrition in all its forms. It describes a triple burden of malnutrition: Undernutrition, hidden hunger caused by a lack of essential nutrients, and overweight among children under the age of five, noting that around the world:

• 149 million children are stunted, or too short for their age,
• 50 million children are wasted, or too thin for their height,
• 340 million children – or 1 in 2 – suffer from deficiencies in essential vitamins and nutrients such as vitamin A and iron,
• 40 million children are overweight or obese.

In Mozambique, the level of moderate to severe stunting stands at 43 per cent nationwide, with malnutrition levels dropping to ‘serious’ in parts of Cabo Delgado and Zambezia. However, across the country, particularly in rural, hard to reach areas, some communities are steps away from critical conditions, should a further disaster hit them. Also, for the first time in years, Mozambique has reported cases of Pellagra – a disease linked to vitamin B3 deficiency, which results from limited food diversity. More than 800 cases have been reported already.

The report warns that poor eating and feeding practices start from the earliest days of a child’s life. Though breastfeeding can save lives, for example, only 42 per cent of children under six months of age are exclusively breastfed and an increasing number of children are fed infant formula. Sales of milk-based formula grew by 72 per cent between 2008 and 2013 in upper middle-income countries such as Brazil, China and Turkey, largely due to inappropriate marketing and weak policies and programmes to protect, promote and support breastfeeding.

As children begin transitioning to soft or solid foods around the six-month mark, too many are introduced to the wrong kind of diet, according to the report. Worldwide, close to 45 per cent of children between six months and two years of age are not fed any fruits or vegetables. Nearly 60 per cent do not eat any eggs, dairy, fish or meat.

As children grow older, their exposure to unhealthy food becomes alarming, driven largely by inappropriate marketing and advertising, the abundance of ultra-processed foods in cities but also in remote areas, and increasing access to fast food and highly sweetened beverages.

For example, the report shows that 42 per cent of school-going adolescents in low- and middle-income countries consume carbonated sugary soft drinks at least once a day and 46 per cent eat fast food at least once a week. Those rates go up to 62 per cent and 49 per cent, respectively, for adolescents in high-income countries.

As a result, overweight and obesity levels in childhood and adolescence are increasing worldwide. From 2000 to 2016, the proportion of overweight children between 5 and 19 years of age doubled from 1 in 10 to almost 1 in 5. Ten times more girls and 12 times more boys in this age group suffer from obesity today than in 1975.

The greatest burden of malnutrition in all its forms is shouldered by children and adolescents from the poorest and most marginalized communities, the report notes. Only 1 in 5 children aged six months to two years from the poorest households eats a sufficiently diverse diet for healthy growth. Even in high-income countries such as the UK, the prevalence of overweight is more than twice as high in the poorest areas as in the richest areas.

The report also notes that climate-related disasters cause severe food crises. Drought, for example, is responsible for 80 per cent of damage and losses in agriculture, dramatically altering what food is available to children and families, as well as the quality and price of that food. Food security has worsened in Mozambique in 2019, affecting the price of staple foods. According to the Food and Agricultural Organization (FAO), the price of maize has risen and remains higher compared to this time last year in the cyclone affected provinces of Cabo Delgado, Manica and Nampula.

Furthermore, climatic events such as cyclones, floods and droughts are already common to Mozambique. Concerns over climate change suggest that record strength cyclones such as Idai and Kenneth, which devastated parts of central and northern Mozambique earlier this year, could become the norm. This would have a continued and detrimental effect on vulnerable families and their ability to provide for themselves.

To address this growing malnutrition crisis in all its forms, UNICEF is issuing an urgent appeal to governments, the private sector, donors, parents, families and businesses to help children grow healthy by:

1. Mobilizing supportive systems – health, water and sanitation, education and social protection – to scale up nutrition results for all children.
2. Collecting, analyzing and using good-quality data and evidence to guide action and track progress.
3. Empowering families, children and young people to demand nutritious food, including by improving nutrition education and using proven legislation – such as sugar taxes – to reduce demand for unhealthy foods.
4. Driving food suppliers to do the right thing for children, by incentivizing the provision of healthy, convenient and affordable foods. 
5. Building healthy food environments for children and adolescents by using proven approaches, such as accurate and easy-to-understand labelling and stronger controls on the marketing of unhealthy foods.

“We are losing ground in the fight for healthy diets,” said Fore. “This is not a battle we can win on our own. We need governments, the private sector and civil society to prioritize child nutrition and work together to address the causes of unhealthy eating in all its forms.”

The case for good nutrition is not confined to promoting better health and development for children. Malnutrition, according to national evidence, constrains Mozambican economic development by undermining the potential of people to contribute to the country’s productivity, as well as contributing to a loss in productivity through illness and absence from the workplace.

Although progress has been made in reducing under-five mortality; malnutrition rates remain high. Chronic malnutrition is still Mozambique’s most significant nutrition problem. To tackle this crisis, UNICEF and partners support coordinated actions across sectors – health, water, agriculture, education, social action, and also the private sector- to create a better food and nutrition environment for all children and families. Since January 2019, UNICEF has supported the Ministry of Health to train over 1,000 community health workers (APEs) to deliver life-saving health and nutrition services to rural communities, including counselling on breastfeeding, young child feeding, and hygiene promotion. This brings the total number of APEs in Mozambique to some 6,400, with plans to further expand the programme to more remote and vulnerable communities.