Malnutrition in the developing world: the lack of food scenario.

The current literature concurs that the prevalence of malnutrition, and stunting among children in particular, is a reasonably accurate reflection on the prevailing socioeconomic status in a given environment. In this regard, malnutrition is known to adversely impact on mental development, scholastic achievement, productivity, child and woman morbidity and mortality as well as the risk for infection. As such, it is hardly surprising that nutritional status is one of the key Millennium Development Goals [1]. Poverty and food insecurity are almost universally accepted to be very significant contributory factors. Although slow, but welcome improvements are being achieved in many developing countries, child malnutrition, poverty and household food insecurity appear to be actually increasing (fig. 1) in India and Sub-Saharan Africa [2]. In South Africa for instance and at the national level, three of four households have been reported to be either ‘hungry’ or at ‘risk of hunger’ (table 1), the extent of hunger being related to adverse growth patterns (fig. 2), lower energy intake (fig. 3), lower income as well as a lower intake of a number of nutrients among children 1–9 years of age [3]. In this regard, the World Bank and the International Monetary Fund have recently predicted [4] that although the income poverty goal is likely to be achieved at the global level, Africa will fall well short. The predicted shortfalls appear especially serious for the health and environmental goals, namely child and maternal mortality, and access to safe drinking water and basic sanitation. The likely increasing number of malnourished people in these regions assumes even greater importance against the background of the HIV/AIDS pandemic in such developing countries, since HIV/AIDS exacerbates food insecurity by decreasing the available agricultural labor force and food production [2]. Lochs H, Thomas DR (eds): Home Care Enteral Feeding. Nestlé Nutrition Workshop Series Clinical & Performance Program, vol 10, pp 1–13, Nestec Ltd., Vevey/S. Karger AG, Basel, © 2005.