At least one-third of poor countries disease burden is due to malnutrition.

Abstract

The portion of the global burden of disease (mortality and morbidity 1990 figures) in developing countries that would be removed by eliminating malnutrition is estimated as 32%. This includes the effects of malnutrition on the most vulnerable groups burden of mortality and morbidity from infectious diseases only. This is therefore a conservative figure but nonetheless much higher than previous estimates mainly due to now including micronutrient malnutrition. The larger part (20%) is from malnutrition acting as a risk factor in synergy with infectious diseases modifying their effect on health and survival. About 10% of the burden is the direct effect of deficiencies with very high prevalences primarily of iron (e.g. anemia affects 40 - 55% of women B non-pregnant and pregnant) and iodine (over 600 million people with goiter) causing disability. In children of 0-4 years reducing underweight (an index of general malnutrition) would lower their disease burden by 35% mostly by reducing mortality. Vitamin A deficiency also primarily acts as a risk factor in infant and child mortality and eliminating it would save 16% of the burden in children. The mortality risk associated with iodine deficiency is the least well known; a few results indicate a possible 8% benefit in child mortality reduction. Eliminating severe anemia in pregnancy is estimated to reduce maternal disease burden by some 13%. The countries with the worst health and nutrition conditions -- Asia and Sub-Saharan Africa -- would gain most from the broad public health benefits of better nutrition. Seen in relation to the overall burden (all population groups all causes all developing countries) eliminating child underweight would save 15% and eliminating micronutrient malnutrition (in children plus anemia in reproductive age women) an additional 18%. (authors)