Published on Investing in Health

Filling empty stomachs: when enough food is not enough

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Children having a bowl of soup (credit: Jamie Martin).

Save the Children’s recent report, A Life Free from Hunger: Tackling Child Malnutrition, reminds us that undernutrition is not a new crisis—and that the crisis will deepen if the global community fails to take serious action. If current trends persist, 11.7 million more children will be stunted in Sub-Saharan Africa by 2025, compared to 2010.


What can we do? Food is part of the answer, but it’s about the right food, at the right time—not just starchy staple foods that fill empty stomachs. According to Save the Children, more than half of children in some countries are eating diets of just three items: a staple food, a legume, and a vegetable (usually green leaves).


Availability of food and access to food are necessary but insufficient to ensure good nutrition. Insidiously, malnutrition (undernutrition) is not hunger, although malnourished children are often hungry. And undernutrition is frequently invisible, but increases the risk of child death; steals children’s growth; decreases cognitive potential, school performance, and adult productivity; and contributes to the development of non-communicable diseases later in life.


Many countries have succeeded in meeting one of the target indicators for the Millennium Development Goal for hunger, which we measure by food supplies that ensure adequate “nourishment”. This indicator is linked to the amount of staple foods required to keep a population above a minimum dietary energy intake. But missing from this equation is the complexity of intra-household allocation of food based on gender, age, and other factors, and the critical need for diverse and nutritious diets, nutrition knowledge, hand-washing and other hygiene, and the prevention and treatment of diseases.


According to Save the Children, together, we need to agree on a target for reducing child stunting, or chronic undernutrition, which has affected 171 million children, 80% of whom live in just 20 countries, some of which are solidly lower-middle-income, such as India. We  need to invest in evidence-based “direct” nutrition interventions (e.g., improved infant and young child feeding practices and micronutrient supplementation), bridge the health worker gap so that underserved populations have access to health and nutrition services, implement programs—including social safety nets—to protect families from falling into poverty, work with the agriculture community to make positive nutrition outcomes an explicit objective of its policies, and pressure political leaders to ensure that nutrition is on the global agenda.


Right now, global attention is on food security and supporting agriculture productivity—and food prices are exacerbating the slow pace of improvement and persistent stagnation of child stunting rates in Sub-Saharan Africa and South Asia. Yes, we need to put food first, but nutrition can’t fall behind (watch video).



Nutrition and the World Bank

Scaling Up Nutrition: A Framework for Action

Video: Put Food First

Secure Nutrition: bridging gaps in agriculture, food security, and nutrition


Leslie Elder

Senior Nutrition Specialist, Global Financing Facility

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