Prevalence of undernourishment Prevalence of child malnutrition Prevalence of overweight children Low- birthweight babies Exclusive breast- feeding Consumption of iodized salt Vitamin A supplemen- tation Prevalence of anemia % % of population
% of children under age 5 % of children
under age 5 % of births
% of children under 6 months % of households % of children 6–59 months Children under age 5 Pregnant women Underweight Stunting 1990–92 2004–06 2000–08a 2000–08a 2000–08a 2003–08a 2003–08a 2003–08a 2008 2000–06a 2000–06a
Data on undernourishment are from the Food and Agriculture Organization (FAO) of the United Nations and measure food deprivation based on average food available for human consumption per person, the level of inequality in access to food, and the mini- mum calories required for an average person.
From a policy and program standpoint, however, this measure has its limits. First, food insecurity exists even where food availability is not a problem because of inad equate access of poor households to food. Second, food insecurity is an individual or household phe nomenon, and the average food available to each person, even corrected for possible effects of low income, is not a good predictor of food insecurity among the population. And third, nutrition security is determined not only by food security but also by the quality of care of mothers and children and the quality of the household’s health environ- ment (Smith and Haddad 2000).
Estimates of child malnutrition, based on weight for age (underweight) and height for age (stunting), are from national survey data. The proportion of under- weight children is the most common malnutrition indica tor. Being even mildly underweight increases the risk of death and inhibits cognitive development in children. And it perpetuates the problem across generations, as mal nourished women are more likely to have low-birth weight babies. Height for age reflects linear growth achieved pre- and postnatally; a deficit indicates long-term, cumulative effects of inadequate health, diet, or care. Stunting is often used as a proxy for multifaceted deprivation and as an indicator of long-term changes in malnutrition.
Estimates of overweight children are also from national survey data. Overweight children have become a growing concern in developing countries. Research shows an association between childhood obesity and a high prevalence of diabetes, respiratory disease, high blood pressure, and psy chosocial and orthopedic disorders (de Onis and Blössner 2000). New international growth reference standards for infants and young children were released in 2006 by the World Health Organization (WHO) to monitor chil- dren’s nutritional status. They are also key in moni- toring health targets for the Millennium Development Goals. Differ ences in growth to age 5 are influenced more by nutrition, feeding practices, environment, and healthcare than by genetics or ethnicity. The previously reported data were based on the U.S. National Center for Health Statistics–WHO growth reference. Because of the change in standards, the data in this edition should not be compared with data in editions prior to 2008.
Low birthweight, which is associated with maternal malnutrition, raises the risk of infant mortality and stunts growth in infancy and childhood. There is also emerging evidence that low-birthweight babies are more prone to noncommunicable diseases such as diabetes and cardiovascular diseases. Estimates of low-birthweight infants are drawn mostly from hos- pital records and household surveys. Many births in developing countries take place at home and are seldom recorded. A hospital birth may indi cate higher income and therefore better nutrition, or it could indi- cate a higher risk birth, possibly skewing the data on birthweights downward. The data should therefore be used with caution.
Improved breastfeeding can save an esti mated 1.3 million children a year. Breast milk alone contains all the nutrients, antibodies, hormones, and antioxi- dants an infant needs to thrive. It protects babies from diarrhea and acute respiratory infections, stimu- lates their immune systems and response to vaccina- tion, and may confer cognitive benefits. The data on breastfeeding are derived from national surveys.
Iodine deficiency is the single most important cause of preventable mental retardation, and it con tributes significantly to the risk of stillbirth and mis carriage. Widely used and inexpensive, iodized salt is the best source of iodine, and a global cam- paign to iodize edible salt is significantly reducing the risks (www.childinfo.org). The data on iodized salt are derived from household surveys.
Vitamin A is essential for immune system function- ing. Vitamin A deficiency, a leading cause of blind- ness, also causes a 23 percent greater risk of dying from a range of childhood ail ments such as measles, malaria, and diarrhea. Giv ing vitamin A to new breast- feeding mothers helps protect their children during the first months of life. Food fortification with vitamin A is being intro duced in many developing countries.
Data on anemia are compiled by the WHO based mainly on nationally representative surveys between 1993 and 2005, which measured hemoglobin in the blood. WHO’s hemoglobin thresholds were then used to determine anemia status based on age, sex, and physiological status. Children under age 5 and preg- nant women have the highest risk for anemia. Data should be used with caution because surveys dif- fer in quality, coverage, age group interviewed, and treatment of missing values across countries and over time.
For indicators from household surveys, the year in the table refers to the survey year. For more informa- tion, consult the original sources.
• Prevalence of undernourishment is the percent- age of the population whose dietary energy consump- tion is continuously below a minimum requirement for maintaining a healthy life and carrying out light physical activity with an acceptable minimum weight for height. • Prevalence of child malnutrition is the percent age of children under age 5 whose weight for age (underweight) or height for age (stunting) is more than two standard deviations below the median for the international reference population ages 0–59 months. Height is measured by recumbent length for children up to two years old and by stature while standing for older children. Data are for the WHO child growth standards released in 2006. • Prevalence
of over weight children is the percentage of children under age 5 whose weight for height is more than two stan dard deviations above the median for the interna- tional reference population of the corresponding age as established by the WHO child growth stan dards released in 2006. • Lowbirthweight babies are the percentage of newborns weighing less than 2.5 kilograms within the first hours of life, before signifi- cant postnatal weight loss has occurred. • Exclusive
breastfeeding is the percentage of children less than six months old who were fed breast milk alone (no other liquids) in the past 24 hours. • Consumption of
iodized salt is the percentage of households that use edible salt fortified with iodine. • Vitamin A supple- mentation is the percentage of children ages 6–59 months old who received at least one dose of vitamin A in the previous six months, as reported by mothers.
• Prevalence of anemia, children under age 5, is the percentage of children under age 5 whosehemoglo- bin level is less than 110 grams per liter at sea level.
• Prevalence of anemia, pregnant women, is the per- centage of pregnant women whose hemoglobin level is less than 110 grams per liter at sea level.
Data sources
Data on undernourishment are from www.fao. org/faostat/foodsecurity/index_en.htm. Data on malnutrition and overweight children are from the WHO’s Global Database on Child Growth and Malnutrition (www.who.int/nutgrowthdb). Data on low-birthweight babies, breastfeeding, iodized salt consumption, and vitamin A supplementation are from the United Nations Children’s Fund’s State of the World’s Children 2010 and Childinfo. Data on anemia are from the WHO’s Worldwide Prevalence of Anemia 1993 –2005 (2008) and Integrated WHO Nutrition Global Databases.
Afghanistan .. .. 189 8.6 .. .. .. .. .. .. .. .. Albania 43 4 16 4.5 .. .. .. .. .. .. .. .. Algeria 26 0b 58 8.5 .. 0.1 25.0 28.6 0.1 0.1 .. .. Angola .. .. 292 3.5 0.3 2.1 60.9 61.1 0.2 0.3 .. .. Argentina 34 24 30 5.7 0.2 0.5 25.0 26.7 0.6 0.3 .. .. Armenia 61 3 73 7.8 .. 0.1 <27.8 <41.7 0.2 0.1 32 7 Australia 22 19 7 5.7 0.1 0.2 <7.1 6.7 0.2 <0.1 .. .. Austria 47 41 0 8.9 <0.1 0.2 27.3 29.6 0.2 0.1 .. .. Azerbaijan .. .. 110 7.5 .. 0.2 .. 16.7 0.3 0.1 25 1 Bangladesh 43 1 225 6.6 .. .. <1.3 16.7 .. .. .. .. Belarus 64 22 43 7.6 .. 0.2 27.5 30.0 0.3 0.1 .. .. Belgium 30 24 9 5.3 0.1 0.2 26.2 27.3 0.2 0.1 .. .. Benin 13 1 92 4.6 0.1 1.2 63.3 62.7 0.3 0.9 39 10 Bolivia 34 26 144 6.0 0.1 0.2 24.6 27.8 0.2 0.1 29 10
Bosnia and Herzegovina 49 35 51 7.1 .. <0.1 .. .. .. .. .. ..
Botswana .. .. 712 5.4 4.7 23.9 59.3 60.7 5.1 15.3 .. .. Brazil 19 12 46 6.4 0.4 0.6 34.4 33.8 1.0 0.6 .. .. Bulgaria 49 38 43 6.5 .. .. .. .. .. .. .. .. Burkina Faso 13 1 220 3.8 1.9 1.6 45.4 50.8 0.5 0.9 54 17 Burundi .. .. 357 1.8 1.7 2.0 59.2 58.9 0.4 1.3 .. .. Cambodia 46 6 490 5.2 0.7 0.8 25.8 28.6 0.8 0.3 31 3 Cameroon 9 1 187 3.9 0.8 5.1 61.2 60.0 1.2 4.3 52 24 Canada 21 18 5 9.2 0.2 0.4 26.5 27.4 0.4 0.2 .. ..
Central African Republic .. .. 336 4.5 1.8 6.3 66.7 65.0 1.1 5.5 .. ..
Chad 12 1 291 3.7 0.7 3.5 60.7 61.1 2.0 2.8 18 7
Chile 42 31 11 5.7 <0.1 0.3 26.0 28.1 0.3 0.2 .. ..
China 59 4 97 4.2 .. 0.1c 25.5c 29.0c 0.1c 0.1c .. ..
Hong Kong SAR, China .. .. 91 8.5 .. .. .. .. .. .. .. ..
Colombia .. .. 36 5.2 0.1 0.6 26.9 29.4 0.7 0.3 .. 23
Congo, Dem. Rep. 10 1 382 3.2 .. .. .. .. .. .. 16 26
Congo, Rep. 9 0b 393 5.1 5.1 3.5 58.4 58.9 0.8 2.3 36 16 Costa Rica 26 7 11 9.3 0.1 0.4 27.5 28.1 0.4 0.2 .. .. Côte d’Ivoire 11 1 410 4.7 2.2 3.9 58.2 59.5 0.8 2.4 .. .. Croatia 39 29 25 6.9 .. <0.1 .. .. .. .. .. .. Cuba 36 28 6 9.5 .. 0.1 <43.5 29.0 0.1 0.1 .. .. Czech Republic 35 27 9 6.4 .. .. <38.5 <33.3 <0.1 .. .. .. Denmark 35 30 7 5.6 0.1 0.2 .. 22.9 0.2 0.1 .. .. Dominican Republic 15 11 73 11.2 0.6 1.1 54.0 50.8 0.3 0.6 58 19 Ecuador 23 5 72 5.9 0.1 0.3 25.8 28.4 0.4 0.2 .. ..
Egypt, Arab Rep. 24 1 20 11.4 .. .. 26.8 28.9 .. .. .. ..
El Salvador .. .. 32 9.0 0.1 0.8 25.7 28.5 0.9 0.5 .. .. Eritrea 15 1 97 2.5 0.1 1.3 60.0 60.0 0.3 0.9 .. 2 Estonia 48 25 34 7.6 .. 1.3 <28.6 24.2 1.6 0.7 .. .. Ethiopia 8 1 368 2.5 0.7 2.1 59.5 59.6 0.5 1.5 18 2 Finland 33 23 7 5.7 .. 0.1 <50.0 <41.7 0.1 <0.1 .. .. France 36 27 6 6.7 0.1 0.4 25.0 27.1 0.4 0.2 .. .. Gabon .. .. 452 5.0 0.9 5.9 58.3 58.7 1.3 3.9 .. .. Gambia, The 17 1 263 4.3 .. 0.9 59.0 60.0 0.2 0.6 .. .. Georgia 57 6 107 7.5 .. 0.1 20.0 37.0 0.1 0.1 .. .. Germany 37 26 5 8.9 <0.1 0.1 27.3 28.8 0.1 0.1 .. .. Ghana 7 1 202 4.3 0.1 1.9 58.3 60.0 0.4 1.3 45 19 Greece 63 39 6 6.0 0.1 0.2 26.5 27.3 0.2 0.1 .. .. Guatemala 24 4 63 8.6 <0.1 0.8 97.9 98.1 .. 1.5 .. .. Guinea .. .. 302 4.3 0.2 1.6 59.6 59.3 0.4 1.2 35 10 Guinea-Bissau .. .. 224 3.9 0.2 1.8 59.2 58.0 0.4 1.2 .. .. Haiti .. .. 246 7.2 1.2 2.2 45.7 52.7 0.6 1.4 42 37 Honduras .. .. 64 9.1 1.3 0.7 25.7 28.5 0.7 0.4 .. 7