This is the 131st article in the series–The China Chronicles.
Nutrition is intrinsic to health across the lifecycle and impacts cognitive and social development. Economic and social resources are linked to malnutrition, both over and undernutrition. An
estimated 45 percent of deaths in children under five years from low- and middle-income countries are related to malnutrition.
Malnutrition delays a child’s growth and development and impedes them from achieving their full potential. Furthermore, according to a
World Bank study in 2006, stunting is associated with a 1.4-percent loss in economic productivity. Despite this,
worldwide, 149.2 million children under five years are stunted, 45.4 million are wasted, and 38.9 million are overweight.
Recognising the burden of malnutrition and the need for enhanced action,
<1> in 2012, the
World Health Assembly endorsed a “Comprehensive Implementation Plan on Maternal, Infant, and Young Child Nutrition that included six global targets (Figure 1): Reducing stunting and wasting in children under five; halting the epidemic of obesity; reducing anaemia in women of reproductive age; reducing low birth weight and increasing the rate of exclusive breastfeeding in the first six months up to at least 50 percent” to achieve by 2025. In addition to this, the United Nations (UN) launched the
Sustainable Development Goals in 2015 with 17 goals to be met by 2030. SDG 2 focuses on ‘Zero Hunger’ for improved nutrition and ending all forms of malnutrition.
Figure 1: Global Nutrition Targets 2025
Source: Global Nutrition Report 2017
As per the Global Nutrition Report 2021, at the present rate, it is impossible to achieve Global Nutrition Targets (GNTs) by 2025, with COVID-19 further impeding the progress made in past decades. China had made remarkable progress in child undernutrition during the Millennium Development Goals (2000-2015). It has also shown significant improvement in health and nutritional status among women and children over the decades (fig 2).
Data reveals that only 1.9 percent of children under five years are wasted and merely 4.8 percent are stunted. However, the number of overweight children is on the rise at 8.5 percent.
Figure 2: Burden of Malnutrition in China (2000-2015)
Source: Global Nutrition Report 2021
Anaemia among children below five years of age is stagnant at
19 percent and is nearly 15.5 percent in women of reproductive age. Amongst
Chinese adults, 34.3 percent and 16.4 percent were affected by overweight and obesity respectively.
China reported no progress in ensuring exclusive breastfeeding with only 20.8 percent of infants up to five months being exclusively breastfed. Furthermore, no progress has been made towards achieving the target for low birth weight, with 5 percent of infants born with low birth weight. Except for two Maternal, Infant and Young Child Nutrition targets, China is off track to achieving all other GNTs (fig 3).
Figure 3: China’s progress on the Global Nutrition Targets
Source:Global Nutrition Report 2021
At the same time, China has shown limited progress toward fighting the diet-related non-communicable disease—obesity. An estimated 8 percent of adult women (aged 18 and above) and 7.7 percent of adult men in China are obese. Meanwhile, diabetes affects 8.6 percent of adult women as to 12.4 percent of adult men. Figure 4 shows that deaths attributable to dietary composition are highest for coronary heart disease, followed by stroke and cancer. Data on comparison of dietary intakes amongst adults aged 25 years and over, revealed that except for vegetables and fish, Chinese diets do not meet the recommended dietary targets for essential food groups
<2>, as set by
EAT-Lancet Commission on healthy diets from sustainable food systems.
Figure 4: Mortality attributable to dietary composition and weight
Source: Global Nutrition Report 2021
China is predicted to be self-sufficient in staple grains such as rice and wheat by 2025. Despite this, 56 million people in rural areas are living in poverty and 186 million people are exposed to the effects of droughts and floods. China faces severe challenges to food security with rising incomes and geopolitical turmoil straining resources.
The country ranks 34 among 113 countries on the Global Food Security Index 2021. There is also the
consumption of more energy-dense and low-nutrition foods with increased
marketing of unhealthy foods and beverages, increasing the risk of obesity.
The Chinese Government launched various initiatives such as the
National Program for the Development of Children (2011-2020) and the
National Nutrition Program (2017-2030) to meet nutrition and SDG targets by 2030. The
Healthy China Action has set goals for promoting good health, and preventing and treating non-communicable diseases. However, the growing trend of overweight and obese children is alarming and the government should set priorities and strengthen efforts for children to improve their nutritional status. There is a need for multi-level interventions to ensure sustainable eating by adding nutrient-dense foods to prevent nutritional deficiency and diet-related NCDs. More investment in nutrition is required to address pandemic-induced nutritional loss along with systemic monitoring to achieve global nutrition targets by 2025.
<1> The simultaneous manifestation of both undernutrition and overweight/obesity
<2> This includes minimum recommended intakes of health promoting food groups (fruits, vegetables, legumes, nuts, and wholegrains) and maximum recommended intakes of food groups with detrimental health and/or environmental impacts (red meat, dairy, and fish).
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