Pedro A Sanchez, M S Swaminathan
worldwide. Various dimensions of malnutrition (eg, underweight, zinc deficiency, iron deficiency, vitamin A deficiency) account for seven of the 13 leading risk factors associated with the global burden of diseases. For both children and adults, malnutrition reduces the body’s natural defences against a vast range of diseases. The death rate from diseases such as lower respiratory infection, malaria, and measles, which account for a large proportion of children’s deaths, are much higher in children who are underweight or have specific nutrient deficiencies than in those who are not. Undernourished people infected with HIV/AIDS develop the full symptoms of the disease more quickly than people who are well fed. Yet one of the earliest side-effects of AIDS is reduced consumption of food in affected households.
Inadequate sanitation, repeated bouts of infectious disease, chronic parasitic infections, poor health facilities, and unsafe water sources contribute significantly to malnutrition by increasing the burden of illness for both children and adults. Households that are dependent on well or surface water for drinking are more likely to have underweight children because the water is more likely to be contaminated.
The fact that malnutrition has many causes, including infectious disease itself, has led to the recognition that multiple, synergistic interventions are needed to fight malnutrition, including improved diets, safe drinking water and sanitation, special attention to vulnerable groups (pregnant women, lactating mothers, young children, unemployed people, those with HIV/AIDS, socially excluded groups), and access to health services to prevent and treat infections. Disease prevention and treatment is both an end in itself and an input to improved long-term absorption and use of food