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• W3135710094 abstract "13 years after the first Lancet Series on maternal and child undernutrition, we reviewed the progress achieved on the basis of global estimates and new analyses of 50 low-income and middle-income countries with national surveys from around 2000 and 2015. The prevalence of childhood stunting has fallen, and linear growth faltering in early life has become less pronounced over time, markedly in middle-income countries but less so in low-income countries. Stunting and wasting remain public health problems in low-income countries, where 4·7% of children are simultaneously affected by both, a condition associated with a 4·8-times increase in mortality. New evidence shows that stunting and wasting might already be present at birth, and that the incidence of both conditions peaks in the first 6 months of life. Global low birthweight prevalence declined slowly at about 1·0% a year. Knowledge has accumulated on the short-term and long-term consequences of child undernutrition and on its adverse effect on adult human capital. Existing data on vitamin A deficiency among children suggest persisting high prevalence in Africa and south Asia. Zinc deficiency affects close to half of all children in the few countries with data. New evidence on the causes of poor growth points towards subclinical inflammation and environmental enteric dysfunction. Among women of reproductive age, the prevalence of low body-mass index has been reduced by half in middle-income countries, but trends in short stature prevalence are less evident. Both conditions are associated with poor outcomes for mothers and their children, whereas data on gestational weight gain are scarce. Data on the micronutrient status of women are conspicuously scarce, which constitutes an unacceptable data gap. Prevalence of anaemia in women remains high and unabated in many countries. Social inequalities are evident for many forms of undernutrition in women and children, suggesting a key role for poverty and low education, and reinforcing the need for multisectoral actions to accelerate progress. Despite little progress in some areas, maternal and child undernutrition remains a major global health concern, particularly as improvements since 2000 might be offset by the COVID-19 pandemic. 13 years after the first Lancet Series on maternal and child undernutrition, we reviewed the progress achieved on the basis of global estimates and new analyses of 50 low-income and middle-income countries with national surveys from around 2000 and 2015. The prevalence of childhood stunting has fallen, and linear growth faltering in early life has become less pronounced over time, markedly in middle-income countries but less so in low-income countries. Stunting and wasting remain public health problems in low-income countries, where 4·7% of children are simultaneously affected by both, a condition associated with a 4·8-times increase in mortality. New evidence shows that stunting and wasting might already be present at birth, and that the incidence of both conditions peaks in the first 6 months of life. Global low birthweight prevalence declined slowly at about 1·0% a year. Knowledge has accumulated on the short-term and long-term consequences of child undernutrition and on its adverse effect on adult human capital. Existing data on vitamin A deficiency among children suggest persisting high prevalence in Africa and south Asia. Zinc deficiency affects close to half of all children in the few countries with data. New evidence on the causes of poor growth points towards subclinical inflammation and environmental enteric dysfunction. Among women of reproductive age, the prevalence of low body-mass index has been reduced by half in middle-income countries, but trends in short stature prevalence are less evident. Both conditions are associated with poor outcomes for mothers and their children, whereas data on gestational weight gain are scarce. Data on the micronutrient status of women are conspicuously scarce, which constitutes an unacceptable data gap. Prevalence of anaemia in women remains high and unabated in many countries. Social inequalities are evident for many forms of undernutrition in women and children, suggesting a key role for poverty and low education, and reinforcing the need for multisectoral actions to accelerate progress. Despite little progress in some areas, maternal and child undernutrition remains a major global health concern, particularly as improvements since 2000 might be offset by the COVID-19 pandemic. Maternal and child undernutrition: progress hinges on supporting women and more implementation researchMaternal and child undernutrition is a pervasive problem that has grown during the COVID-19 pandemic. Rising food prices combined with disruptions to livelihoods have put millions of people at greater risk of food and nutrition insecurity.1 These impacts are especially pronounced in low-income and middle-income countries (LMICs), where existing health system infrastructure is weak and access to life-saving interventions has been interrupted by the COVID-19 pandemic.2 Full-Text PDF The nutrition agenda must include tobacco controlThe Lancet's Series on progress in maternal and child undernutrition reminds us that malnutrition and stunting, and the double burden of obesity and malnutrition, remain important priorities for achieving Sustainable Development Goal 3 and other goals for child health. However, although recognising the importance of the environment and commercial determinants of food availability, the nutrition agenda continues to ignore the importance of tobacco control in achieving nutritional goals. Full-Text PDF The nutrition agenda must include tobacco control – Authors' replyWe thank Jonathan Klein for raising the issue of the direct and indirect effects of tobacco smoking on maternal and child undernutrition. Although our Series paper1 did not address the effects of specific risk factors such as tobacco on gestational weight gain and low birthweight, we recognise that smoking is an important determinant of fetal growth. The indirect effects relate to the trade-offs between purchasing nutritious foods and spending the limited family budget on tobacco, alcohol, and non-nutritious foods (eg, sugar-sweetened beverages). Full-Text PDF" @default.
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• W3135710094 date "2021-04-01" @default.
• W3135710094 modified "2023-10-16" @default.
• W3135710094 title "Revisiting maternal and child undernutrition in low-income and middle-income countries: variable progress towards an unfinished agenda" @default.
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• W3135710094 doi "https://doi.org/10.1016/s0140-6736(21)00394-9" @default.
• W3135710094 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/33691094" @default.
• W3135710094 hasPublicationYear "2021" @default.
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