In Part 2 of our series on nutrition, Olivia Claxton reads into the potential consequences of malnutrition at the early stages of the life cycle. Olivia asks: how can we make sure we tackle the problem at the root, during pregnancy, childhood, and adolescence?
UNICEF (2020) reports that the world is not currently on track to meet global nutrition targets for children. As a result, malnutrition among children continues to negatively impact development outcomes in low- and middle-income countries. If children suffer nutritional deficits early on in life, then the impacts can be intergenerational, particularly if they occur during key nutrition-sensitive phases of a child’s development. Undernutrition during even the first two years of a child’s life can lead to irreversible damage that can cause physical impairments or chronic diseases to be passed down through generations.1
Pre-conception and pre-natal are recognised as the first phases during which adequate nutrition is critical for children. Malnutrition among mothers is often associated with lower birthweights in newborns, and if undernutrition goes unaddressed then the impact of low birthweights can span up to three generations.2 A low birth weight can result in poor foetal growth, and evidence has shown that undernutrition during infancy can cause structural damage to the brain. Such impairment can have serious knock-on effects on a child’s cognitive development, for example impacting their motor development and ability to move independently.3 Poor cognitive development can also have lasting impacts on children’s education outcomes, often linked to learning deficits that can hamper a child’s performance at school.4
The first 1,000 days are critical to a child’s development,5 presenting a unique window of opportunity where the foundations of optimum health, growth, and brain development across the lifespan are established. However, if, during this period, children suffer from poor nutrition, which causes them to be stunted, they may never fully recover and will experience, on average, a 26 per cent reduction in lifetime earnings. UNICEF (2020) reports that two-thirds of children living in low- and middle-income countries experience stunting, which can lead to serious health impacts for affected children such as increased susceptibility to infections and in some worst cases even mortality.6 Research often highlights the consequences of stunting on a child’s behavioural development, with the impacts of stunting often linked to late school enrolment, poorer grades, and limited job prospects.7
The critical need to invest in nutrition does not end in early childhood. Adolescence (ages 10-19 years) is a key, but often overlooked, phase for human growth and development.8 Adolescence is a period during which rapid physical growth and development occur. Nutritional needs differ between adolescent boys and girls; boys have higher nutritional requirements for building muscle mass and musculoskeletal growth, whereas girls require iron-rich diets to support beginning menstruation.9 Adolescence is often regarded as a ‘second window of opportunity,’ in which the intergenerational cycle of malnutrition can be broken, but only if nutritional needs during this period are met and sustained.10 If, however, nutrition deficits occur during adolescence, then the impacts of malnutrition can become entrenched well into adulthood. For example, undernourished adolescents are at increased risk of stunting, poor muscle growth and contracting non-communicable diseases in adulthood. But, the impacts of undernourishment are not only physical as discussed, with global research linking poor cognitive development in childhood to limited socioeconomic opportunities later in life. As such, malnutrition can perpetuate the intergenerational transmission of poverty.11
Malnutrition is therefore a burden on a country’s economy and can negatively impact the well-being of society. The World Food Programme (2020) estimated that in Sudan, where 45.7 per cent of the working-age population has suffered from stunting, a 10 per cent reduction in stunting could yield an annual average saving of SDG 5.2 billion. This huge economic benefit reflects savings through lower repetition rates at school, increased labour productivity and reductions in public spending on the health sector.
If countries wish to address to inter-generational, and in some cases irreversible, effects of malnutrition they must start prioritising investment in children’s nutrition so that everyone can realise their full potential. Improved nutrition must be invested in as early as pre-conception to significantly reduce child mortality, improve educational outcomes, and increase productivity and growth. The prevention of malnutrition is a long-term investment, which greatly benefits both present and successive generations and preserves human capital. Doing so is likely to yield long-term social and economic returns, with every US$1 invested in malnutrition interventions yielding US$3 in returns across countries in the Global South.12
1 Cesar et al. (2008). Maternal and child undernutrition: consequences for adult health and human capital.
2 Ibid.
3 Ibid.
4 Martins et al. (2011). Long-lasting effects of malnutrition.
5 Likhar and Patil. (2022). Importance of maternal nutrition in the first 1,000 days of life and its effect on development: a narrative review.
6 Soliman et al. (2021). Early and long-term consequences of nutritional stunting: from childhood to adulthood.
7 Ibid.
8 Norris et al. (2021). Nutrition in adolescent growth and development.
9 UNICEF. (2020). Nutrition for every child, UNICEF nutrition strategy 2020-2030.
10 Ibid.
11 Ibid.; Norris et al. (2021). Nutrition in adolescent growth and development.
12 Fink et al. (2016).