The State of the World's Children 1998: Features

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Malnutrition in industrialized countries

Supermarkets stock fresh fruit and vegetables in the middle of winter. Meats and canned and processed goods of all sorts line the aisles. Food is abundant and readily available in most industrialized countries. As a result, the general feeling is that whatever problems industrialized countries may have, malnutrition is surely not one of them.

Yet, readily available and sufficient food does not automatically bring about good nutrition. On the contrary, obesity is one major nutrition-related problem in the United States. According to the most recent government statistics, over half the American population today is obese, and of children between the ages of 6 and 17, nearly one fourth are obese.

Obesity carries with it increased general health risks, including a higher incidence of cardiovascular disease, hypertension, non-insulin dependent diabetes, certain kinds of cancer, gall bladder disease, menstrual abnormalities and complications of arthritis and gout.

Obese children face traumatic social and psychological difficulties and increased risk for high blood pressure, high blood cholesterol, abnormal glucose tolerance and possible orthopaedic problems, such as difficulty with walking. Obese children tend to become obese adolescents, who tend to become obese adults.

A number of factors bring about this disorder and can interact with one another. Besides nutrition, both genetic make-up and cultural behaviour patterns can predispose a person to obesity. Endocrinological and metabolical factors are also involved.

A long-time researcher in the field, Dr. William H. Dietz, noting the increased frequency with which, paradoxically, both hunger and obesity occur in poorer populations in the United States, has suggested that one cause of obesity might well be hunger.

Without question, the poor in the United States do suffer 'episodic food insufficiency'. One recent study concluded that there are more than 13 million poor children under the age of 12 in the United States who are hungry, or at risk of being hungry, during some part of one or more months of the year.

Clear signs of nutrient deficiencies have also emerged, according to one recent study, among one- to five-year-olds in poor families as well as in those better off. Defining deficiency as receiving less than 70 per cent of the recommended daily allowance of the 16 standard nutrients measured in the survey, the study found that 6 per cent of one- to five-year-olds from families not considered poor did not receive enough food energy, folate or vitamin C. Over 15 per cent did not receive enough calcium and nearly 20 per cent not enough vitamin E. Fully one quarter did not get enough iron, and over a third failed to receive enough zinc.

For poor children, the findings were even more disheartening: Substantially higher proportions were deficient in 14 of the 16 nutrients. For example, in 40 per cent of poor children iron intake was inadequate, and 18 per cent received inadequate vitamin C.

The very abundance and availability of the wrong kinds of food, eaten with little moderation or balance, is another culprit. Nutritionally deficient foods such as soft drinks, chips, candy and fast foods tend to crowd out nutritionally beneficial ones.

And the increasingly sedentary pattern of life in the modern industrialized world is yet another suspect. A study published last year found that 10- to 15-year-olds who watched more than five hours of television a day were 4.6 times more likely to be overweight than youngsters who watched two hours or less.

Other industrialized countries show similar patterns, particularly among less well-off groups. One British study describes the diet of lower socio-economic groups as providing simply "cheap energy," comprising mainly foods such as full cream milk, fat, sugars, jams, potatoes, cereals and meat products. The diet includes few vegetables, fruit or wholewheat bread and is low in essential nutrients: calcium, iron, magnesium, vitamin C and folate. The study also shows a correlation between the diet and poor health.

In France, recent reports say that the poorest people spend over one fourth of their income on food, yet what they buy is similar to the inadequate diet of the British poor: bread and other starches, coffee, milk, sugar, processed meats and hardly any fruit or vegetables. Not surprisingly, a field study of one of the poorer suburbs of Paris found that the children who lived there were at risk nutritionally. Significantly, a study of newborns in France found that fully 63 per cent showed iron deficiency and 55 per cent suffered from anaemia.

Ways need to be found to change these nutritional patterns since plentiful food alone is clearly not a solution. Taking care — in what is eaten and when — is as necessary a step in industrialized countries as it is in the developing world.

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