Under- and overnutrition: a global perspective.

The world is now confronted with a set of medical problems of nutritional origin with which it has never previously had to contend, i.e. both undernutrition of various types and a huge and rapidly escalating burden of diseases crudely classified as relating to overnutrition. The problems of malnutrition, particularly affecting young children, were highlighted in the developing world in the 1950s by a remarkable series of studies emanating from first-class nutrition research centers in Africa, Asia and Latin America, e.g. in Chile, India, Jamaica, the Lebanon, Mexico, Peru, Thailand and Uganda. In nutritional circles, for example, malnutrition was often considered to be a practical problem of improving children’s nutrition with multifaceted approaches to improve the maternal and nutritional care of the young child. The promotion of breast-feeding followed by appropriate weaning was vital, together with a recognition of the fundamental human right of poor families to have adequate support. The World Health Organization (WHO) continued to encourage the monitoring of individual children’s growth by means of national statistics while other UN agencies such as UNHCR and WFP, as well as non-governmental organizations, coped with the mounting crises of refugees and displaced persons fleeing from a multitude of wars, or attempting to survive the effects of droughts, floods and consequent crop failures. Support for the steady improvement in agricultural production, on which the escalating numbers of the world’s poor depend, was universally accepted and was the responsibility of FAO and the CGIARs, funded by Western governments, the World Bank and the IMF. More recently, in response to the drive by Grant, the former Director General of UNICEF, the world’s Presidents and Prime Ministers expressed their commitment to tackling the continuing burden of childhood malnutrition at a Children’s Summit [1]. This led to the development of the Millennium Goals [2] Allison SP, Go VLW (eds): Metabolic Issues of Clinical Nutrition. Nestlé Nutrition Workshop Series Clinical & Performance Program, vol 9, pp 1–17, Nestec Ltd., Vevey/S. Karger AG, Basel, © 2004.