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Indicators Of Malnutrition And Efforts to Address it globally And Locally

Our contemporary world faces many challenges that threaten the security and peace of humanity in a way that is perhaps the most dangerous over the past decades, foremost of which is the elimination of malnutrition diseases in all their increasing forms, which constitute a serious threat to human life and health, and hinder his ability to face the burdens of life, and suffer Including different social and economic classes, but the poor, women and children are the most affected groups.

In light of the trends of food systems towards globalization and their lack of important foodstuffs that preserve human health, and amid the spread of poverty rates as a result of the Russian-Ukrainian war and the preceding outbreak of the Corona pandemic, which also coincided with unprecedented disturbances in climatic conditions, the world is moving away from achieving the goal of sustainable development. The aim is to eliminate all forms of hunger, food insecurity and malnutrition by the year 2030, unless efforts are intensified and bolder action is taken by the international community.

the Strategic Forum for Public Policies and Development Studies “Deraya” issues a detailed report on forms of malnutrition, its causes and negative effects, as well as indicators of global malnutrition and international efforts in this regard , Based on the seriousness of the problem of malnutrition and its enormous human and economic cost. The report also sheds light on indicators of the nutritional status of children in Egypt and the Egyptian state’s efforts to eradicate malnutrition diseases.

First: forms of malnutrition

The World Health Organization defines malnutrition as a term referring to a deficiency, excess or imbalance in a person’s energy and/or nutrient intake. The different forms of malnutrition are as follows:

1- Undernutrition: There are four general sub-forms of undernutrition, namely: wasting, stunting, underweight, and lack of vitamins and minerals. Undernutrition leads to rapid vulnerability to disease and exposure to death, especially for children.

2- Malnutrition associated with micronutrient deficiencies: where the body lacks micronutrients represented in vitamins and minerals, which enable the body to produce enzymes, hormones and other substances necessary for proper growth.

3- Overweight and obesity: where a person’s weight is heavy in relation to his height, and abnormal or excessive accumulation of fat can harm health. Overweight and obesity result from an imbalance between energy intake (too much) and energy expenditure (too little).

Second: the causes of malnutrition and its negative effects

The phenomenon of malnutrition arises due to several factors, most notably the high rates of poverty, food insecurity, lack of primary health care programs for both mothers and infants, lack of potable water, and inadequate sanitation systems. Wars and conflicts exacerbate the malnutrition crisis, as the Russian-Ukrainian war disrupted supply and supply chains, followed by food shortages and an increase in the prices of basic commodities, including wheat, edible oils, and fuel. This is in addition to the repercussions of global warming, which is expected to reduce food production by 5.5% by 2050, and cause disruption to supply chains, especially in low-income countries.

Corona leads to high rates of malnutrition

The Corona pandemic exacerbated the levels of malnutrition in the world, as the number of malnourished people increased to approximately 768 million in 2020, which represents 10% of the world’s population. And the Director-General of the World Health Organization had stated in 2020 that an additional 10,000 children may die every month due to malnutrition resulting from the repercussions of the Corona pandemic, indicating his expectations that the number of malnourished children as a result of the Corona pandemic will increase by up to 14%.

In this context, the German Center for Nutrition stated that malnutrition is due to unhealthy nutrition (processed foods and ready-made products), in addition to the incidence of certain diseases such as chronic bowel diseases that prevent the proper absorption of nutrients, as well as excessive smoking, coffee and sweets. He pointed out that sadness and stress may cause malnutrition, as it leads to loss of appetite and causes problems in the stomach and intestines.

Here it should be noted that malnutrition is one of the main risk factors for many diseases, which are known as “diet-related noncommunicable diseases”, which include cardiovascular diseases (such as heart attacks and stroke, and are usually associated with blood pressure), some cancers, and diabetes. diabetes.

Malnutrition leads to anemia, which is caused by iron deficiency and leads to general weakness and exhaustion, as well as protein deficiency diseases, which are diseases specific to infants from the age of 6:12 months, and they occur because children do not get proteins that complement breast milk. This leads to skin infections and an enlarged liver at times, and a lack of calcium and vitamin D leads to rickets in children.

Malnutrition causes 11 million deaths annually

According to a scientific study conducted by an international team of researchers, which was published in the journal “The Lancet”, malnutrition causes about 11 million deaths worldwide annually due to heart disease, stroke and cancer. The researchers also explained that unhealthy nutrition includes, for example, eating too much salt, drinks that contain a lot of sugar, and not enough whole grains, fruits and vegetables.

According to the study, the number of deaths due to a lack of eating fruits amounted to about 2 million cases, and due to an increase in salt, about 3 million cases, while those caused by a lack of eating brown bread (whole grains) amounted to about 3 million deaths, and a lack of eating nuts and seeds resulted in 2 million deaths.

The World Health Organization reports that approximately 45% of deaths of children under the age of five are related to under nutrition. Most of these deaths occur in low- and middle-income countries. She also noted the increasing incidence of overweight and obesity among children in these same countries.

The Food and Agriculture Organization of the United Nations “FAO” confirms that economic and social transformations have contributed to the formation of dangerous diets that have led to a significant increase in weight, obesity and stunting, stressing that children who suffer from undernourishment are more vulnerable than others to infectious diseases, and this also affects their growth. Mental and cognitive, which hinders their academic achievement and their ability to obtain appropriate jobs and earn income in the future. Malnutrition also leads to great risks for the future of mothers and women, as it leads to an endless cycle of malnutrition throughout life.

Third: Global indicators of malnutrition diseases

The 2022 edition of the “State of Food Security and Nutrition in the World” report, which was jointly prepared by the Food and Agriculture Organization, the International Fund for Agricultural Development, the United Nations Children’s Fund (UNICEF), the World Food Program and the World Health Organization, presented the latest developments in the field of malnutrition crisis. The UNICEF Nutrition Strategy for the period 2020-2030, titled “Nutrition for Every Child,” clarified the most prominent global indicators of malnutrition diseases.. The following are numbers and statistics that reflect the size of the problem and its steady increase:

1-   The prevalence of undernourishment increased in 2021 to reach 9.8%, after it was 9.3% in 2020 and 8% in 2019.

2-   The total number of undernourished people in 2021 reached about 768 million. More than half of the 425 million live in Asia and more than a third of the 278 million live in Africa, while Latin America and the Caribbean includes about 8%, with a number of up to 57 million. As the following figure shows:

Figure No. (1) The prevalence of undernourishment and the number of undernourished people globally:

Source: The State of Food Security and Nutrition in the World report.

3- The updated projections for the number of undernourished people indicate that about 670 million people are still undernourished in 2030 – an increase of 78 million compared to a scenario in which the Corona pandemic did not occur.

4- 22% of children under five years of age suffered from stunting, by 149.2 million in 2020, and in general, stunted children reside in low-income countries or lower-middle-income countries.

5- 6.7% of children under five years of age suffered from wasting, at a rate of 45.4 million in 2020, and low- and middle-income countries bear the greatest burden of wasting among children under the age of five, with a total rate of 93% of children suffering from wasting in the world. Children in rural environments and poorer families whose mothers had no formal education were more likely to be stunted and wasted.

6- 5.7% of children under the age of five suffered from overweight, at 38.9 million worldwide, in 2020.

7- Obesity among adults is on the rise, after its rates increased worldwide from 11.8% in 2012 to 13.1% in 2016 – the latest year for which data are available. Obese adults are more likely to live in upper-middle-income or high-income countries..The prevalence of obesity among women is higher than among men. Obese women are more likely to live in urban areas and in wealthier households.

8- Low birth weight was recorded in 14.6% of newborns. . However, data gaps pose a challenge to the global monitoring of this indicator, given that nearly one in three newborns in the world were not weighed at birth, as confirmed by relevant studies.

9- About 3.1 billion people were unable to afford a healthy diet in 2020, an increase of 112 million people compared to 2019, which reflects the effects of inflation in food consumption prices as a result of the economic effects resulting from the Covid-19 pandemic and the measures taken to contain it.

10- An estimated 45 million children under the age of five suffered from wasting, one of the most deadly forms of malnutrition, which increases people’s risk of dying by up to 12 times s development “, 149 million children under 5 years of age also suffered from stunted growth and development due to chronic nutrient deficiencies in nutrients while 39 million children were overweight.

11- Progress has been made in the field of exclusive breastfeeding, as about 44% of infants under the age of six months were exclusively breastfed in 2020, but this percentage is still less than the 50% targeted by 2030.

Fourth: International efforts to solve the problem of malnutrition

1-   The launch of the United Nations Trust Fund “Unit Life”: The fund was launched in June 2021 on the sidelines of the “Generational Equality Forum”, in cooperation between the United Nations Women’s Fund, the United Nations Fund for Capital Developments, the Court of the Crown Prince of Abu Dhabi and the French government, and aims to combat chronic malnutrition In regions of the world through innovative partnerships to finance nutritious food systems, smart climate-sensitive agriculture, and women’s empowerment and education programs.

  2- Establishment of the United Nations Contract For Action on Nutrition: In April 2016, the United Nations General Assembly announced the establishment of the United Nations Decade of Action on Nutrition, to be jointly implemented by the Food Organization and the World Health Organization, with the aim of addressing all forms of malnutrition.

3-   The Convention on the Rights of the Child: The Convention was adopted in November 1989 and ratified by UNICEF member states. The Convention guarantees the right of the child to obtain adequate food, to enjoy the highest achievable standard of health and to take the necessary measures to reduce infant and child mortality.

Fifth: Indicators of the nutritional status of children in Egypt

In August 2022, the Central Agency for Public Mobilization and Statistics issued the results of the Egyptian Family Health Survey 2021, with the aim of providing indicators that clarify the demographic and health status of Egyptians, and contributing to the development of plans and programs that help improve the health situation in Egypt, as well as providing a database that supports the implementation of the principles and objectives of the national project for the development of the Egyptian family and achieving sustainable development plans.

With regard to the nutritional status of children in Egypt, the health survey indicated that there is a clear improvement in indicators of the nutritional status of  children between 2014 and 2021, according to the following statistics:

-The percentage of children with short stature “stunted” decreased from 21% in 2014 to 13% in 2021.

-The percentage of underweight children decreased from 8% in 2014 to 3% in 2021.

-The percentage of underweight children decreased from 6% in 2014 to 4% in 2021.

Figure No. (2) shows the development of the nutritional status of young children from 2014 to 2021

Source: Central Agency for Public Mobilization and Statistics

The results of the survey indicate that there are some differences according to the different geographical regions, as the percentage of short stature in relation to age increases in Al-Waha Al-Qibli countryside to reach 16%, and decreases in urban Lower Egypt to less than 10%.

Figure No. (3) shows the percentage of overweight children by place of residence

Source: Central Agency for Public Mobilization and Statistics

According to this figure, the prevalence of anemia is evident among children in urban areas in Upper Egypt, while it is prevalent among children in rural areas in Upper Egypt.

In a statistical scientific study conducted by the researcher Abd al-Rahman Abu Shouk – a researcher at Harvard Medical School – and implemented by nearly a thousand researchers, and its results were published in the “Nature Medicine” journal, this paper presented numbers and statistics on the double burden of obesity and wasting in low- and middle-income countries, resulting from poor Nutrition in children at the age of five years ago, and dealt in a scientific manner in detail with the diseases of malnutrition in the governorates of the Arab Republic of Egypt, the results of which were as follows:

1-Damietta governorate topped the governorates in which wasting is prevalent, with a rate of 13.1% of children under the age of five.

2- The governorate of Beni Suef came in the last place with 3.4% of the total number of children under the age of five suffering from wasting.

3- Sharkia governorate ranked first in the percentage of overweight children.

Sixth: The efforts of the Egyptian state to eradicate malnutrition diseases

The new republic placed the health of the Egyptian citizen at the top of its priorities and made great efforts to confront malnutrition diseases and took many measures to reduce their repercussions in light of its pursuit of sustainable development, which came as follows:

1- Launching the National Food and Nutrition Strategy 2022-2030: The strategy aims to ensure that all citizens – by 2030 – have access to healthy, safe and sustainable food systems with an integrated, high-quality and comprehensive health care system.

2-  The national campaign to treat malnutrition in schools: The campaign aims at early detection of obesity and anemia in children and attention to the general health of school children at a total cost of about 165 million pounds, according to which about 15 million male and female students in the age group of 6 have already been examined. 12 years in more than 22 thousand schools.

3-  The presidential initiative to detect genetic diseases of newborns: The initiative was launched on July 13, 2021 with the aim of early detection of genetic diseases of newborns and providing free treatment for infected children, in addition to dispensing milk and foodstuffs through centers and clinics distributed in all governorates of the Republic.

4-  School feeding project: The Ministry of Education, in cooperation with a number of ministries and concerned authorities and the World Food Organization “FAO”, launched the school feeding project with the aim of providing daily meals that contain the most important vitamins and minerals that students need at the level of different educational stages.

5-   The national program for “universal salt iodization”: National laws oblige the owners of salt factories to provide it with iodine, according to the national program for “universal salt iodization” according to the 1996 quality standards.

6-   Climate Change and Nutrition Initiative (I-CAN): Launched by the Minister of Health during the activities of the COP27 climate conference, with the aim of supporting the implementation of measures to deal with climate change and mitigate its effects, support systems for transition to sustainable healthy food systems, and reduce the exacerbation of malnutrition cases. The initiative comes in partnership with the World Health Organization, the Food and Agriculture Organization, and a number of partner organizations and stakeholders.

Seventh: Recommendations

Despite the sincere Egyptian efforts to eradicate malnutrition diseases, especially among children, more efforts can be made, most notably the following:

1- Obligating food industry companies to mark the product through the food card, which serves as an “identity card” for the product, provided that it includes the ingredients of the product, its nutritional value and calories.

2- Including  in the school curricula the basics of choosing the appropriate food and integrate nutritional and health concepts in the curricula.

3-Conducting more studies and supporting quantitative and qualitative research to understand the social practices and habits that shape the nutritional status of children and women in particular.

4- Raising the capabilities of health pioneers in the areas of community awareness and providing nutritional advice, especially in rural and Upper Egypt areas.

5- Monitoring data and information that enable tracking of progress towards improving children’s nutrition.

6- Reducing the levels of salt and fat in school meals so that they are at the lowest levels possible.

7- Encouraging absolute breastfeeding, especially in the first 6 months of the child’s life, and helping working mothers to continue breastfeeding.



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