A bitter newsitem reaches the eye: increasing numbers of Dutch children are admitted to the hospital due to malnourishment. Pediatricians are worried by the trend that especially highly educated parents subject their children to popular diets without grains or dairy, but filled with the so called ‘superfoods‘. These pricey parts of plants, such as goji berries and chia seed, are believed to be super healthy according to diets that are popular among some that have money to spend. More common foods, such as wheat, dairy and potatoes are sometimes portrayed as poison in these diets that often have hints of scientific basis. However: Consensus among scientists and doctors, wrapped in a less popular and more pragmatic sauce, points at the direct opposite: no evidence for the proclaimed magical powers of superfood. The result of these myths and diets so far, malnourished children in a country where healthy food is such widely available, leaves a bitter taste.
Initially, malnourishment reminds of countries where a variety of healthy food is not available, due to for example droughts, war and displacement. Countries such as Afghanistan, where over 50 percent of children are stunted, and in the worst affected regions, 29.5 % children suffer from acute malnourishment.
This picture shows a simplification of three types of malnutrition and combinations of these three types are possible. (Specific micronutrient deficiencies and overweight are not included (1). It is important to realize that stunting starts from conception: an underfed mother gives birth to a stunted baby.
Worldwide, acute malnutrition affects 20 million children in preschool-age, mostly in Africa and South East Asia. Worldwide, 195 million children are stunted, and stunting affects 800 million people. The effects? Among others:
- increased risk of chronic disease later in life
- less cognitive growth, resulting in:
- complete fewer years of schooling
- earn less income as adults (also referred to as lower economic potential)
- give birth to smaller children
This lower income, poor health and reduced access to proper nutrition, influences the way the next generation is fed and raised: a cycle is born.(2) To break this cycle, mothers need to be properly fed as well: since stunting starts in the whomb and the effects are irreversible.
What is being done? Acute malnutrition asks for a direct intervention: therapeutic feeding. These children are fed with for example PlumpyNut, a high calorie peanut paste. Unfortunately not all children that need this recovery are reached at the moment. Scaling up of interventions is needed. Prevention is needed.
Here we address the topic of knowledge. Just as in the Netherlands, a lot of children in the world are malnourished, not because of a lack of food, but because of a lack of knowledge about the importance suitable feeding for children (3).
Acute malnourishment is just a terrible tip of the iceberg, when looking at malnourishment. Breaking it down:
This pyramid shows, in a situation where food is available: knowledge is key.(4,5)
Yes: PlumpyNut and other interventions are needed for regions that have a lack of suitable food. But knowledge is needed worldwide. As the effect of super foods on highly educated in one of the world’s richest countries shows: knowledge about how to feed one’s child is essential for a nourished, healthy future.
1.For a very clear and complete oversight on different types of malnourishment, I recommend this Unicef learning module.
2.A short clip that shows the cycle of malnutrition and also gives a view on the costs of prevention:
4. The breaking down pyramid is a very simplified version. The topic of food security asks for a whole post. Also, since micronutrients deficients were not included, the fortification of food is also left out in this post. Related information can be found on the website of the World Food Program.