Global Trends in Malnutrition
Summary of published paper1

Child with Kwashiorkor in Kalongo, Pader.
A recent study set out to estimate trends in childhood underweight by geographic regions of the world in order to determine whether the UN Millennium Development Goals (MDGs) were on track. The MDGs aim to reduce by half the prevalence of underweight among children younger than 5 years between 1990-2015. The source of data for the study was the World Health Organisation (WHO) global database on child growth and malnutrition which includes data on approximately 31 million children under five years participating in 419 national nutritional surveys in 139 countries from 1965 through to 2002. The work was based on a time series study of prevalence of underweight, defined as: weight 2 standard deviations below the mean weight for age of the NCHS2 and WHO reference population. Linear mixed-effects modelling was used to estimate prevalence rates and numbers of underweight children by region in 1990 and 2015 and to calculate the changes to these values between the two years.
Worldwide, underweight prevalence was projected to decline from 26.5% in 1990 to 17.6% in 2015, a change of -34% (95% confidence interval, -43% to -23%). In developed countries, the prevalence was estimated to decrease from 1.6% to 0.9%, a change of -41% (95% CI, -92% to 343%). In developing regions, the prevalence was forecasted to decline from 30.2% to 19.3%, a change of - 36% (95% CI, - 45% to -26%). In Africa, the prevalence of underweight was forecasted to increase from 24% to 26.8%, a change of 12% (95% CI, 8% to 16%). In Asia, the prevalence was estimated to decrease from 35.1% to 18.5%, a change of -47% (95% CI, -58% to -34%). Worldwide, the number of underweight children was projected to decline from 163.8 million in 1990 to 113.4 million in 2015, a change of -31% (95% CI, -40% to - 20%). Numbers are projected to decrease in all subregions except those of sub-Saharan, Eastern, Middle and Western Africa, which are expected to experience substantial increases in the number of underweight children.
A number of limitations to the study are highlighted. These include limited availability of trend data, surveys not always done randomly, variations in data quality and not accounting for uncertainty in each survey's prevalence estimate (an estimate of variance for each prevalence was not included in the regression analysis so confidence intervals are likely to be too narrow)
The authors conclude that an overall improvement in the global situation is anticipated; however neither the world as a whole nor the developing regions, are expected to achieve the MDGs. This is largely due to the deteriorating situation in Africa where all sub-regions except northern Africa, are expected to fail to meet the goals. This deterioration is likely to be partly due to the effect of HIV/AIDS together with the political and social instability in many African countries.
1De Onis. M et al (2004): Estimates of Global Prevalence of Childhood Underweight in 1990 and 2015. JAMA, June 2nd, 2004, vol 291, No 21, pp 2600-2606.
2National Center for Health Statistics / CDC Atlanta US.
More like this
NEX: Joint UNICEF/WHO/The World Bank Child malnutrition database
In September 2013 UNICEF, WHO and the World Bank updated their joint database on child malnutrition and released new global and regional estimates for 2012. For the first time,...
FEX: Research snapshots
Factors influencing pastoral and agropastoral household vulnerability to food insecurity in Kenya Kenya has a population of more than 38 million, 10% of whom are classified as...
FEX: Update of UNICEF/WHO/World Bank database on child malnutrition
Summary of research1 Location: Global What we know: A joint database on child malnutrition is maintained by UNICEF, WHO and the World Bank. To date this has not included...
FEX: Survey data exploring the prevalence of concurrent wasting and stunting in Southern Angola, Huila and Cunene
View this article as a pdf This article features a snapshot of the burden of concurrent wasting and stunting in Angola using prevalence data from survey data in two...
FEX: Child wasting and concurrent stunting in low- and middle-income countries
View this article as a pdf Click here to listen to an interview with one of the authors on the ENN podcast channel Summary of research1 What we know: Cross-sectional,...
FEX: Analysis of trends in SMART nutrition survey data from South Sudan between 2004 and 2016
View this article as a pdf Research snapshot1 Despite decades of nutrition and health interventions, emergency levels of global acute malnutrition (GAM) persist in former...
FEX: Climate change and food security: The view from sub-Saharan Africa
View this article as a pdf This is a summary of the following paper: Adesete A, Olanubi O & Dauda R (2022) Climate change and food security in selected sub-Saharan African...
FEX: The effects of HIV on Botswana’s development progress
By Siddharth Krishnaswamy Siddharth was a part of the Vulnerability & Mapping Unit (VAM) of the WFP. Prior to this he worked for an international NGO in Northern Uganda. He...
FEX: Effect of adding RUSF to ageneral food distribution on child nutritional status and morbidity: a cluster randomised controlled trial
Summary of research1 Child during appetite test at a health facility offering treatment in Monrovia, Liberia The authors of a recent study hypothesized that including a daily...
FEX: Improving estimates of numbers of children with severe acute malnutrition using cohort and survey data
Summary of Research Isanaka S, Boundy EO, Graise RF, Myatt M and Briend A. (2016). Improving Estimates of Numbers of Children With Severe Acute Malnutrition Using Cohort and...
FEX: Growth faltering in rural Gambian children after four decades of interventions: a retrospective cohort study
Summary of Research1 Nabwera HM, Fulford AJ, Moore SE and Prentice AM. (2017). Growth faltering in rural Gambian children after four decades of interventions: a retrospective...
FEX: Children concurrently wasted and stunted: A meta- analysis of prevalence data of children 6-59 months from 84 countries
Research summary1 Location: Global What we know: Wasting and stunting are often present in the same geographical populations and can exist concurrently in the same children,...
FEX: Burden of child and maternal malnutrition and trends in states of India 1990-2017
View this article as a pdf Research snapshot1 India has a large and persistent burden of malnutrition. However, with a population of 1.4 billion people residing across states...
FEX: High burden of undernutrition among at-risk children in neonatal follow-up clinic in Rwanda
View this article as a pdf Research snapshot1 A Paediatric Development Clinic (PDC) in rural Rwanda provides a medical home model for the medical, nutritional and...
FEX: Ethiopia: Are children of employed mothers less stunted than those of unemployed mothers?
View this article as a pdf Kedir Mohammed is the Nutrition Cluster Coordinator of the Sub-National Emergency Nutrition Coordination Unit (ENCU), Semera, Afar Region,...
FEX: Effect of a community-led sanitation intervention on child diarrhoea and child growth in rural Mali
Summary of research1 Location: Mali What we know: Community-led total sanitation (CLTS) is being scaled up, but there is limited evidence on child health impacts. What this...
FEX: Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect
Summary of research1 Location: Global What we know: The decision not to breastfeed a child impacts on the health, nutrition and development of a child and on women's...
en-net: Caseload calculations (incidence rate)
I'm currently training some folks on how to calculate expected CMAM caseload using the (prevalence + incidence) * coverage equation. I'm having difficulty explaining to my team...
FEX: Diet and nutrition status among school-age children and adolescents in Tanzania
View this article as a pdf By Sauli John, Geofrey Mchau, Heavenlight Ayubu, Stanslaus Mafung'a, Samafilan Ainan, Wiggins Kyatikila, Elizabeth Lyimo, Frank Chacky, Fatoumata...
en-net: Wide confidence interval SAM
I'm looking at a national SMART survey. The confidence intervals appear quite wide for SAM. As an example one province has SAM prevalence of 2.1 (95%CI 1.1 - 4.0), another...
Reference this page
Global Trends in Malnutrition. Field Exchange 23, November 2004. p4. www.ennonline.net/fex/23/global
(ENN_2443)