Asian malnutrition has a complex face. In some places it is characterised by undernutrition, in others by overnutrition. In an increasing number of states, and even within households, it is characterised by both. Why has wealth not brought health? What can be done to mitigate the profound consequences of poor nutrition for individuals, communities and nations?

A review from the International Food Policy Research Institute summarises a major study by nutrition specialists and economists. Designed to inform the nutrition policy of the Asian Development Bank, it looks at the resources needed to eradicate malnutrition and the economic gains from doing so.

Startling statistics abound:

• Seventy percent of the world’s malnourished children are Asian
• One in three Asian preschoolers suffer from stunted growth
• One third of Asians are iodine- and vitamin A-deficient.

When undernourished Asian children become adults they are more likely to suffer from diet-related chronic diseases (diabetes, coronary heart disease and hypertension) formerly thought to be associated with affluence. Undernutrition is a time bomb paving the way for overnutrition later in life. Yet the cost of meeting the nutrition needs of Asian children would be equivalent to 5 percent of current health budgets.

Overnutrition is particularly apparent in China, Sri Lanka, Indonesia, the Philippines and Thailand where 3 in 10 individuals are overweight, take little exercise and have high levels of diet-related diseases. In Indonesia 1 in 10 households contain both underweight and overweight members.

Insufficient resources are put into the interventions known to work. Community-based nutrition initiatives around dietary behaviour change, promotion of exclusive breast-feeding, reproductive health education and provision of ante- and post-natal care, micronutrient and food supplementation, and malaria chemoprophylaxis are all severely under-funded. The needs of under-two year old children and pregnant women are particularly neglected.

Other significant findings are:

• Not only are people shifting to urban areas, but so too is the concentration of under and overnutrition.
• The ageing of Asia’s population adds to the burdens of public finance imposed by spending on overnutrition-related illnesses.
• There are as yet no proven strategies to combat overnutrition and encourage a dietary shift away from fats and added sugars.

The report offers a compelling human and economic rationale for investing in nutrition. Meeting the challenge of developing health policies where dietary excess and deficit exist side-by-side involves:

• The nutrition research community broadening its horizons, working more closely with disciplines with greater familiarity with the study of human behaviour and forming alliances with those involved in debates around agriculture, health, education, governance and trade.
• Establishing community-government partnerships, focusing on support for local mobiliser/facilitators (of the kind pioneered in Thailand).
• Giving urgent attention to developing methods of systematic promotion of healthy eating.
• Planning early interventions to break the cycle that undernutrition in infancy paves the way for overnutrition later in life.

Source(s):
‘Attacking the double burden of malnutrition in Asia', a synthesis of findings from the ADB-IFPRI Regional Technical Assistance Project 5824 on nutrition trends, policies and strategies in Asia and the Pacific, International Food Policy Research Institute by Stuart Gillespie and Lawrence Haddad, December 2000

Funded by: Asian Development Bank

id21 Research Highlight: 26 September 2001

Further Information:
Stuart Gillespie
International Food Policy Research Institute (IFPRI)
2033 K Street, N.W.
Washington
DC 20006
USA

Tel: +1 202 862 8179
Fax: +1 202 467 4439
Contact the contributor: s.gillespie@cgiar.org

International Food Policy Research Institute (IFPRI), USA

Other related links:
'Halving child malnutrition by 2020: is income growth the answer?'

'New dimensions of childhood malnutrition in six African countries'

Refer to AED for information on child nutrition programmes

UNICEF focuses on nutrition

PCD aims to improve the nutrition of school-aged children

WHO databases concentrate on the prevention and reduction of malnutrition

More research from the International Union of Nutrition Sciences