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Global trends and burden of malnutrition: nutrition across country income groups

By Vittoria Acampora

In current times, several factors such as conflicts, climate change, and the ongoing repercussions of the COVID-19 pandemic are still impacting malnutrition, birthweight, and essential caregiving practices such as exclusive breastfeeding. Assessing the full extent of these crises over malnutrition remains challenging, primarily due to limited data availability and the prolonged effects on nutritional outcomes. However, these issues are anticipated to negatively affect various forms of malnutrition worldwide. The prevalence of malnutrition varies significantly among countries in different income groups and over time.


The most recent data on low birthweight indicates that in 2020, 14.7% of new births were born with a low birthweight. Surviving infants confront long-term developmental and health consequences, including an elevated risk of stunting, reduced intelligence quotient, and an increased likelihood of obesity and diabetes as they reach adulthood. Low-income countries (LICs) and lower-middle-income countries (LMICs) bore the majority of the burden of low birthweight among newborns in both 2012 and 2020, accounting for a total of 84% of the global burden of low birthweight in 2020. This is noteworthy because these two income groups represented only 70% of the total global annual births.


Stunting is a condition characterized by being too short for one's age. It works as an indicator of long-term chronic malnutrition, resulting from a combination of nutritional deficiencies and other factors that simultaneously hinder the physical and cognitive growth of children while increasing their vulnerability to common infections. Early-life stunting and other forms of undernutrition may also predispose children to overweight and non-communicable diseases in their later years. Globally, the prevalence of stunting among children under five years old has been steadily decreasing, dropping from an estimated 33.0% in 2000 to 22.3% in 2022. The percentage of children under the age of five experiencing stunting increased in LICs countries from 21% in 2012 to 26% in 2022. Concurrently, the proportion of children under five residing in LICs grew from 14% to 17%. When considering both LICs and LMICs together, the proportion of stunted children rose from 88% in 2012 to 90% in 2022.


Child wasting is a life-threatening condition caused by insufficient nutrient intake, poor nutrient absorption, and/or frequent or prolonged illness. Children affected by this condition become dangerously thin, with weakened immunity, and face a higher risk of mortality. The prevalence of wasting among children under five showed a minimal decrease from 8.7% in 2000 to 6.8% in 2022. Wasting is an acute condition that can change rapidly, influenced by seasonal variations in various contexts, making it challenging to reliably assess and interpret national trends over time. Similar to low birthweight and stunting, LICs and LMICs carry the heaviest burden of wasting, representing a combined 92% of all wasted children under five in 2012, increasing to 94% in 2022. 


On the other hand, children who are overweight face both immediate and potentially long-term health consequences: Individuals affected by this condition are at a higher risk of non-communicable diseases as they grow older. Child overweight has been on the rise in many countries, driven by inadequate levels of physical activity and increased access to highly processed foods. Globally, the prevalence of overweight among children under five years old showed a non-significant increase from 5.3% in 2000 to 5.6% in 2022. The percentage of overweight children among LICs and LMICs combined slightly increased from 49% in 2012 to 53% in 2022; the majority of overweight children, accounting for 77%, reside in LMICs and UMICs.


In summary, this analysis underscores that LICs and LMICs are home to a significant portion of infants benefitting from exclusive breastfeeding and carry the most substantial burden of low birth weight, stunting, wasting, and overweight among children under five years of age.




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