Epidemiology of malnutrition

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Disability-adjusted life year for nutritional deficiencies per 100,000 inhabitants in 2002. Nutritional deficiencies included: protein-energy malnutrition, iodine deficiency, vitamin A deficiency, and iron deficiency anaemia.
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Disability-adjusted life year for nutritional deficiencies per 100,000 inhabitants in 2002. Nutritional deficiencies included: protein-energy malnutrition, iodine deficiency, vitamin A deficiency, and iron deficiency anaemia.
  no data
  less than 150
  150-300
  300-450
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  900-1050
  1050-1200
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  1350-1500
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  more than 1750

There were 735.1 million malnourished people in the world in 2022, a decrease of 58.3 million since 2005, [2] despite the fact that the world already produces enough food to feed everyone (8 billion people) and could feed more than that (12 billion people). [3]

Contents

Reducing malnutrition is key part of Sustainable Development Goal 2, "Zero hunger", with a malnutrition target alongside reducing under nutrition and stunted child growth. [4] Because of the Sustainable Development Goals, various UN agencies are responsible for measuring and coordinating action to reduce malnutrition. According to the World Food Programme, 135 million suffer from acute hunger, [5] largely due to manmade conflicts, climate changes, and economic downturns. COVID-19 could double the number of people at risk of suffering acute hunger by the end of 2020. [5]

By country

Number of undernourished globally [2]
Year2005200620072008200920102011201220132014
Number in millions798.3743.1679.1644.8637.4604.8575573.6562.7538.7
Percentage (%)12.2%11.2%10.1%9.5%9.2%8.7%8.1%8%7.8%7.3%
Year2015201620172018201920202021202220232024
Number in millions570.2568.3541.3557581.3669.3708.7723.8733.4
Percentage (%)7.7%7.6%7.1%7.2%7.5%8.5%9%9.1%9.1%
Number of undernourished in the developing world [6] [7] [8]
Year19701980199119962002200420062011
Number in millions875841820790825848927805
Percentage (%)37%28%20%18%17%16%17%14%
The percentage of the population affected by undernutrition by country, according to United Nations statistics from 2012 Percentage population undernourished world map.PNG
The percentage of the population affected by undernutrition by country, according to United Nations statistics from 2012

The number of undernourished people (million) in 2010–2012 and 2014–2016 (projected). According to the UN Food and Agriculture Organization (FAO), these countries had 5 million or more undernourished people in 2001–2003 and in 2005–2007. [9]

Country2010–20122014–20162017–2018
Flag of India.svg  India 189.9175.0164.4
Flag of the People's Republic of China.svg  China 163.2133.8121.4
Flag of Pakistan.svg  Pakistan 38.341.440.0
Flag of Nigeria.svg  Nigeria 10.212.925.6
Flag of Bangladesh.svg  Bangladesh 26.526.324.2
Flag of Indonesia.svg  Indonesia 26.919.422.0
Flag of Ethiopia.svg  Ethiopia 32.131.621.6
Flag of Tanzania.svg  Tanzania 16.116.817.6
Flag of Uganda.svg  Uganda 8.710.317.6
Flag of Kenya.svg  Kenya 10.09.914.6
Flag of the Philippines.svg  Philippines 12.713.713.9
Flag of North Korea.svg  North Korea 10.310.512.2
Flag of Madagascar.svg  Madagascar 7.08.011.4
Flag of Iraq.svg  Iraq 7.88.111.1
Flag of Yemen.svg  Yemen 6.16.711.1
Flag of Vietnam.svg  Vietnam 12.210.38.8
Flag of Zambia.svg  Zambia 6.97.48.5
Flag of Zimbabwe.svg  Zimbabwe 4.55.08.5
Flag of Mozambique.svg  Mozambique 7.36.98.3
Flag of Sudan.svg  Sudan N/AN/A8.2
Flag of Myanmar.svg  Myanmar 9.47.75.7
Flag of Haiti.svg  Haiti 4.95.75.4
Flag of Thailand.svg  Thailand 6.05.05.4
Flag of Colombia.svg  Colombia 5.34.42.4

Note: This table measures "undernourishment", as defined by the FAO, and represents the number of people consuming (on average for years 2010 to 2012) less than the minimum amount of food energy (measured in kilocalories per capita per day) necessary for the average person to stay in good health while performing light physical activity. It is a conservative indicator that does not take into account the extra needs of people performing extraneous physical activity, nor seasonal variations in food consumption or other sources of variability such as inter-individual differences in energy requirements. Malnutrition and undernourishment are cumulative or average situations, and not the work of a single day's food intake (or lack thereof). This table does not represent the number of people who "went to bed hungry today."

The below is a list of countries by percentage of population with undernourishment, as defined by the United Nations World Food Programme and the FAO in its "The State of Food Insecurity in the World" 2009 report.

RankCountryPercentage of population undernourished [10] [11]
2021 [12] 2004–061990–92
1Flag of Eritrea.svg  Eritrea 66%67%
2Flag of Burundi.svg  Burundi 63%44%
3Flag of Madagascar.svg  Madagascar 51%35%32%
4–5Flag of the Central African Republic.svg  Central African Republic 49%41%47%
Flag of Somalia.svg  Somalia 49%
6–7Flag of Lesotho.svg  Lesotho 46%15%15%
Flag of North Korea.svg  North Korea 46%32%21%
8Flag of Haiti.svg  Haiti 45%58%63%
9–11Flag of Guinea-Bissau.svg  Guinea-Bissau 38%
Flag of Liberia.svg  Liberia 38%38%30%
Flag of Zimbabwe.svg  Zimbabwe 38%39%40%
12–13Flag of the Democratic Republic of the Congo.svg  Democratic Republic of the Congo 35%75%29%
Flag of Yemen.svg  Yemen 35%32%30%
14Flag of the Republic of the Congo.svg  Congo, Republic of the 33%21%40%
15–16Flag of Rwanda.svg  Rwanda 32%40%45%
Flag of Uganda.svg  Uganda 32%15%19%
17–18Flag of Chad.svg  Chad 31%38%59%
Flag of Mozambique.svg  Mozambique 31%37%59%
19–20Flag of the Taliban.svg  Afghanistan 30%
Flag of Zambia.svg  Zambia 30%45%40%
21–24Flag of Kenya.svg  Kenya 28%30%33%
Low-income countries 28%
Flag of Sierra Leone.svg  Sierra Leone 28%46%45%
Flag of the Syrian revolution.svg  Syria 28%<5%<5%
25Flag of Tanzania.svg  Tanzania 24%35%28%
26–28Flag of Botswana.svg  Botswana 23%26%20%
Flag of Gabon.svg  Gabon 23%
Flag of Papua New Guinea.svg  Papua New Guinea 23%
29–31Flag of Angola.svg  Angola 22%44%66%
Flag of Ethiopia.svg  Ethiopia 22%44%71%
Flag of East Timor.svg  Timor-Leste 22%
32Flag of South Sudan.svg  South Sudan 21%
33Flag of The Gambia.svg  Gambia 20%29%20%
34–37Flag of Bolivia.svg  Bolivia 19%23%24%
Flag of Honduras.svg  Honduras 19%12%19%
Flag of Pakistan.svg  Pakistan 19%22%24%
Flag of the Solomon Islands.svg  Solomon Islands 19%
38–41Flag of Cape Verde.svg  Cape Verde 18%
Flag of Malawi.svg  Malawi 18%29%45%
Flag of Nicaragua.svg  Nicaragua 18%21%52%
Flag of Venezuela.svg  Venezuela 18%24%12%
42–45Flag of Djibouti.svg  Djibouti 17%
Flag of India.svg  India 17%20%29%
Flag of Namibia.svg  Namibia 17%19%29%
Flag of Togo (3-2).svg  Togo 17%37%45%
46–49Flag of Burkina Faso.svg  Burkina Faso 16%9%14%
Flag of Niger.svg  Niger 16%28%38%
Flag of Nigeria.svg  Nigeria 16%8%15%
Flag of Iraq.svg  Iraq 16%
50–51Flag of the Comoros.svg  Comoros 14%
Flag of Ecuador.svg  Ecuador 14%13%24%
52–54Flag of Guatemala.svg  Guatemala 13%16%14%
Flag of Guinea.svg  Guinea 13%
Flag of Sao Tome and Principe.svg  São Tomé and Príncipe 13%
55–59Flag of Eswatini.svg  Eswatini 12%18%12%
Flag of Kiribati.svg  Kiribati 12%
Flag of Mali.svg  Mali 12%10%14%
Flag of Sudan.svg  Sudan 12%20%31%
Flag of Trinidad and Tobago.svg  Trinidad and Tobago 12%10%11%
60Flag of Bangladesh.svg  Bangladesh 11%26%36%
61–62Flag of Benin.svg  Benin 10%19%28%
Flag of Vanuatu.svg  Vanuatu 10%
63–67Flag of Mauritania.svg  Mauritania 9%
Middle income countries 9%
Flag of Suriname.svg  Suriname 9%7%11%
Flag of Tajikistan.svg  Tajikistan 9%26%34%
World 9%
68–74Flag of Cote d'Ivoire.svg  Côte d'Ivoire 8%14%15%
Flag of El Salvador.svg  El Salvador 8%10%9%
Flag of Jamaica.svg  Jamaica 8%5%11%
Flag of Libya.svg  Libya 8%<5%<5%
Flag of Macau.svg  Macau 8%
Flag of Mongolia.svg  Mongolia 8%29%30%
Flag of South Africa.svg  South Africa 8%<5%<5%
75–80Flag of Colombia.svg  Colombia 7%10%15%
Flag of Dominica.svg  Dominica 7%
Flag of Egypt.svg  Egypt 7%<5%<5%
Flag of Fiji.svg  Fiji 7%
Flag of Mauritius.svg  Mauritius 7%6%7%
Flag of Peru.svg  Peru 7%13%28%
81–87Flag of Cameroon.svg  Cameroon 6%23%34%
Flag of the Dominican Republic.svg  Dominican Republic 6%21%27%
Flag of Indonesia.svg  Indonesia 6%16%19%
Flag of Iran.svg  Iran 6%<5%<5%
Flag of Morocco.svg  Morocco 6%<5%5%
Flag of Senegal.svg  Senegal 6%25%28%
Flag of Turkmenistan.svg  Turkmenistan 6%6%9%
88–104Flag of Belize.svg  Belize 5%
Flag of Brazil.svg  Brazil 5%<5%6%
Flag of Cambodia.svg  Cambodia 5%25%38%
Flag of French Polynesia.svg  French Polynesia 5%
Flag of Ghana.svg  Ghana 5%8%34%
Flag of Kyrgyzstan.svg  Kyrgyzstan 5%<5%9%
Flag of Laos.svg  Laos 5%19%27%
Flag of Malta.svg  Malta 5%
Flag of Nepal.svg    Nepal 5%16%21%
Flags of New Caledonia.svg  New Caledonia 5%
Flag of Panama.svg  Panama 5%17%18%
Flag of the Philippines.svg  Philippines 5%15%21%
Flag of Samoa.svg  Samoa 5%
Flag of Sri Lanka.svg  Sri Lanka 5%21%27%
Flag of Thailand.svg  Thailand 5%17%29%
Flag of Ukraine.svg  Ukraine 5%
Flag of Vietnam.svg  Vietnam 5%13%28%
105–106Flag of Jordan.svg  Jordan <5%<5%
Flag of Lebanon.svg  Lebanon <5%<5%
107–113Flag of Albania.svg  Albania 4%
Flag of Argentina.svg  Argentina 4%<5%<5%
Flag of Myanmar.svg  Myanmar 4%17%44%
Flag of North Macedonia.svg  North Macedonia 4%
Flag of Paraguay.svg  Paraguay 4%12%16%
Flag of Saudi Arabia.svg  Saudi Arabia 4%<5%<5%
Flag of Seychelles.svg  Seychelles 4%
114–179Flag of Algeria.svg  Algeria 3%<5%<5%
Flag of Armenia.svg  Armenia 3%10%43%
Flag of Australia (converted).svg  Australia 3%
Flag of Austria.svg  Austria 3%
Flag of Azerbaijan.svg  Azerbaijan 3%25%27%
Flag of Barbados.svg  Barbados 3%
Flag of Belarus.svg  Belarus 3%
Flag of Belgium (civil).svg  Belgium 3%
Flag of Bosnia and Herzegovina.svg  Bosnia and Herzegovina 3%
Flag of Bulgaria.svg  Bulgaria 3%
Flag of Canada (Pantone).svg  Canada 3%
Flag of Chile.svg  Chile 3%<5%7%
Flag of the People's Republic of China.svg  China 3%10%15%
Flag of Costa Rica.svg  Costa Rica 3%<5%6%
Flag of Croatia.svg  Croatia 3%
Flag of Cuba.svg  Cuba 3%<5%5%
Flag of Cyprus.svg  Cyprus 3%
Flag of the Czech Republic.svg  Czech Republic 3%
Flag of Denmark.svg  Denmark 3%
Flag of Estonia.svg  Estonia 3%
Flag of Finland.svg  Finland 3%
Flag of France.svg  France 3%
Flag of Georgia.svg  Georgia 3%12%47%
Flag of Germany.svg  Germany 3%
Flag of Greece.svg  Greece 3%
Flag of Guyana.svg  Guyana 3%6%18%
High income countries 3%
Flag of Hong Kong.svg  Hong Kong 3%
Flag of Hungary.svg  Hungary 3%
Flag of Kazakhstan.svg  Kazakhstan 3%<5%<5%
Flag of Kuwait.svg  Kuwait 3%<5% 20%
Flag of Iceland.svg  Iceland 3%
Flag of Ireland.svg  Ireland 3%
Flag of Israel.svg  Israel 3%
Flag of Italy.svg  Italy 3%
Flag of Japan.svg  Japan 3%
Flag of Latvia.svg  Latvia 3%
Flag of Lithuania.svg  Lithuania 3%
Flag of Luxembourg.svg  Luxembourg 3%
Flag of Malaysia.svg  Malaysia 3%<5%<5%
Flag of Mexico.svg  Mexico 3%<5%5%
Flag of Moldova.svg  Moldova 3%
Flag of Montenegro.svg  Montenegro 3%
Flag of the Netherlands.svg  Netherlands 3%
Flag of New Zealand.svg  New Zealand 3%
Flag of Norway.svg  Norway 3%
Flag of Oman.svg  Oman 3%
Flag of Poland.svg  Poland 3%
Flag of Portugal.svg  Portugal 3%
Flag of Romania.svg  Romania 3%
Flag of Russia.svg  Russia 3%
Flag of Serbia.svg  Serbia 3%
Flag of Slovakia.svg  Slovakia 3%
Flag of Slovenia.svg  Slovenia 3%
Flag of South Korea.svg  South Korea 3%
Flag of Spain.svg  Spain 3%
Flag of Saint Vincent and the Grenadines.svg  St. Vincent and the Grenadines 3%
Flag of Sweden.svg  Sweden 3%
Flag of Switzerland (Pantone).svg   Switzerland 3%
Flag of Tunisia.svg  Tunisia 3%<5%<5%
Flag of Turkey.svg  Turkey 3%
Flag of the United Arab Emirates.svg  United Arab Emirates 3%
Flag of the United Kingdom.svg  United Kingdom 3%
Flag of the United States.svg  United States 3%
Flag of Uruguay.svg  Uruguay 3%
Flag of Uzbekistan.svg  Uzbekistan 3%13%5%

Middle East

Malnutrition rates in Iraq had risen from 19% before the US-led invasion to a national average of 28% four years later. [13] By 2010, according to the UN Food and Agriculture Organization, only 8% were malnourished. (See data above.)

South Asia

According to the Global Hunger Index, South Asia (also known as the Indian Subcontinent) has the highest child malnutrition rate of world's regions. [14] India, a largely vegetarian country and second largest country in the world by population, contributes most number in malnutrition in the region. The 2006 report mentioned that "the low status of women in South Asian countries and their lack of nutritional knowledge are important determinants of high prevalence of underweight children in the region" and was concerned that South Asia has "inadequate feeding and caring practices for young children". [15]

30% children of India are underweight, [16] one of the highest rates in the world and nearly double the rate of Sub-Saharan Africa. [17]

Research on overcoming persistent under-nutrition published by the Institute of Development Studies, argues that the co-existence of India as an 'economic powerhouse' and home to one-third of the world's under-nourished children reflects a failure of the governance of nutrition: "A poor capacity to deliver the right services at the right time to the right populations, an inability to respond to citizens' needs and weak accountability are all features of weak nutrition governance." [18] The research suggests that to make under-nutrition history in India the governance of nutrition needs to be strengthened and new research needs to focus on the politics and governance of nutrition. At the current rate of progress the MDG1 target for nutrition will only be reached in 2042 with severe consequences for human wellbeing and economic growth. [18]

United States

U.S. Census Bureau, 2012 American Community Survey Percentage Receiving Food Stamps or SNAP (2010) Map.jpg
U.S. Census Bureau, 2012 American Community Survey

According to the United States Department of Agriculture in 2015, 50 million Americans experienced food insecurity in 2009, including 17 million children. This represents nearly one in four American children. [19] [20] [21]

Although the United States Department of Agriculture reported in 2012 that an estimated 85.5 percent of households in the country are food secure, millions of people in America struggle with the threat of hunger or experience hunger on a daily basis. [22] The USDA defines food security as the economic condition of a household wherein which there is reliable access to a sufficient amount of food so all household members can lead a healthy productive life. [23] Hunger is most commonly related to poverty since a lack of food helps perpetuate the cycle of poverty. Most obviously, when individuals live in poverty they lack the financial resources to purchase food or pay for unexpected events, such as a medical emergency. When such emergencies arise, families are forced to cut back on food spending so they can meet the financial demands of the unexpected emergency. [24] There is not one single cause of hunger but rather a complex interconnected web of various factors. Some of the most vulnerable populations to hunger are the elderly, children, people from a low socioeconomic status, and minority groups; however, hunger's impact is not limited to these individuals.[ citation needed ]

Bill Mead, a volunteer with Feeding America, paints food pallets at the new Feeding America warehouse in San Diego 25 March. The new facility can support 16 million pounds of food, including a new cold storage unit for dairy, eggs and meat. USMC-110325-M-2306T-003.jpg
Bill Mead, a volunteer with Feeding America, paints food pallets at the new Feeding America warehouse in San Diego 25 March. The new facility can support 16 million pounds of food, including a new cold storage unit for dairy, eggs and meat.

The largest nonprofit food relief organization in the United States, Feeding America, feeds 46.5 million citizens a year to address the nation's food insecurity issue. [23] This equates to one in seven Americans requiring their aid in a given year. An organization that focuses on providing food for the elderly population is Meals on Wheels, which is a nonprofit that delivers meals to seniors' homes. The government also works towards providing relief through programs such as the Supplemental Nutrition Assistance Program (SNAP) which was formerly known to the public as Food Stamps. Another well known government program is the National School Lunch Program (NSLP) which provides free or reduced lunches to students who qualify for the program.

The number of Americans suffering from hunger rose after the 2008 financial crisis, with children and working adults now making up a large proportion of those affected. In 2012, Gleaners Indiana Food bank reported that there were now 50 million Americans struggling with food insecurity (about 1 in 6 of the population), and that the number of folks seeking help from food banks had increased by 46% since 2005. [25] According to a 2012 study by UCLA Center for Health Policy Research, even married couples who both work but have low incomes sometimes require the aid of food banks. [26] [27]

Childhood malnutrition is generally thought of as being limited to developing countries, but although most malnutrition occurs there, it is also an ongoing presence in developed nations. For example, in the United States of America, one out of every six children is at risk of hunger.[ citation needed ] A study, based on 2005–2007 data from the U.S. Census Bureau and the Agriculture Department, shows that an estimated 3.5 million children under the age of five are at risk of hunger in the United States. [28]

In developed countries, this persistent hunger problem is not due to lack of food or food programs, but is largely due to an underutilization of existing programs designed to address the issue, such as food stamps or school meals. Many citizens of rich countries such as the United States of America attach stigmas to food programs or otherwise discourage their use. In the USA, only 60% of those eligible for the food stamp program actually receive benefits. [29]

The U.S. Department of Agriculture reported that in 2003, 1 out of 200 U.S. households with children were so severely food insecure that any of the children went hungry at least once during the year. A substantially larger proportion of these same households (3.8 percent) had adult members who were hungry at least one day during the year because of their households' inability to afford enough food. [30]

Africa

According to World Vision there are 257 million people in Africa who are experiencing malnutrition. [31] This is around 20% of the entire population of Africa. [31] The regions in Africa with the highest rates of malnutrition are the Sub-Saharan region and parts of southern Africa. [31] In the Sub-Saharan region, the countries that have the highest rates include, but are not limited to South Sudan, Sudan, Central African Republic, and Chad. [31] In this region there are 237 million people who are experiencing hunger [31] and according to Action Against Hunger, there are 319 million people without a reliable source of drinking water. [32] In the Southern region of Africa, the countries that have the highest rates include, but are not limited to Mozambique, Zimbabwe, Zambia, and Angola. [31] In this region there are 41 million people who are food insecure and 9 million who are in a food crisis and need immediate assistance with food. [31]

There are many factors that contribute to malnutrition in Africa. [33] There are environmental factors such as degradation of land and unexpected weather changes. [33] The changes in weather such as droughts and storms, impact their food and water supply. [33] Another factor that contributes to malnutrition is conflict. [33] Conflict can lead to uncertainty in resources, which puts them at a higher risk of malnutrition. [33] In addition, the areas in Africa with the highest rates of malnutrition also experience poverty which impact and limit the supply of food and necessary services. [33] For example, some experience limited access to health services, sanitation, clean water, consistent food supply. [33] Not only do these things directly contribute to malnutrition, but they can also lead to illnesses such as malaria and water-borne disease. [33]

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