Rewriting the story of malnutrition
With a proven link between malnutrition and illness, human ingenuity is working to end the root cause of around half of all deaths in children under five years of age.
Over the last twenty years, global health researchers and advocates have worked to reduce the impact of malnutrition, but exciting innovations are being developed to take us even further–with the potential to save millions of lives every year. Most of us have an image of malnutrition: empty plates, bare cupboards, and emaciated figures. But malnutrition is about more than just hunger. It’s about how not having the right nutrients during childhood can define your whole future. A malnourished mother is more likely to suffer complications in pregnancy, giving birth to an undernourished child predisposed to debilitating diseases. Malnutrition through infancy impairs children’s physical and cognitive development, making them more vulnerable to illness, impacting their ability to learn, work, and earn. It’s a disturbingly common story, but from prenatal vitamins to promising microbiome discoveries, it’s a story that human ingenuity and innovation are helping to rewrite.
Malnutrition is an imbalance of the nutrients a body needs. It comes in many forms, but for nearly 400 million children—predominantly in low- and middle-income countries—undernutrition is the most common. Undernutrition is not getting enough of the full range of nutrients, vitamins, and minerals needed not just to survive, but thrive. The right balance of quality nutrients builds a child’s body, brain, and immune system, enabling them to thrive in the world.
Some of the most extreme forms of undernutrition are clearly recognizable: A stunted child who is too short for their age, or a child impacted by wasting who is severely underweight. Other deficiencies are less obvious, like micronutrient deficiencies, also known as “hidden hunger”. Micronutrients are vitamins and minerals that the body needs to produce the enzymes, hormones, and other substances that fuel healthy child growth and development. Their relative invisibility means that around half of all pre-school-aged children worldwide suffer from hidden hunger—and the long-term impacts aren’t always immediately clear. Hidden hunger impairs cognitive development, limiting prospects in school and well into adult life.
The connection between poor diet and health marks malnutrition as the root cause of nearly half of all deaths of children under five years of age every year. And for many children, malnutrition begins even before they’re born - during pregnancy and through the critical first 1,000 days of life. Every year, poor maternal nutrition contributes to more than 800,000 newborn deaths in the first month of life due to babies born too soon or too small (known as small-for-gestational age births). Malnourished mothers are also more vulnerable to childbirth complications, and in low- and middle- income countries, when a mother dies her baby’s chances of surviving their first year drops to 37 percent.
The cycle continues through childhood. Families across low- and middle-income countries often lack year-round access to safe, nutritious, and affordable foods—from fresh fruits and vegetables to dairy products and eggs—putting their children at higher risk of malnutrition. In 2021 alone, a healthy diet was unaffordable for over three billion people. For many, this writes their life story and perpetuates a cycle of malnutrition, poor health, and poverty. To change this, a range of exciting new innovations are being developed to help end child malnutrition.
Support starts in early pregnancy with an expectant mother taking a comprehensive prenatal vitamin. Research shows that pregnancy demands more vitamins and minerals than most women can get from a healthy diet alone—especially when access to food is limited. Multiple micronutrient supplements (MMS) contain 15 essential vitamins and minerals to support a healthy pregnancy for mother and baby, significantly reducing complications, such as premature and underweight births. UNIMMAP MMS, the international standard formula, is becoming more affordable and accessible to the women who need it most—and has the potential to prevent as many as 5.3 million vulnerable births and 600,000 deaths over the next five years.
A mother breastfeeds her newborn, widely recommended as the healthiest option for a baby’s first six months. It’s long been believed that newborn malnutrition can’t be treated until weaning, but recent studies challenge this. Research has identified B. infantis as a crucial gut bacteria that can enhance the nutrients in breastmilk, and with findings proving a close link between a mother’s and baby’s microbiomes, a revolutionary new approach is possible. Pioneering probiotic supplements, based on B. infantis, strengthen a pregnant mother’s microbiome, passing the good bacteria to her baby for a healthier gut at birth. When given to malnourished newborns, the probiotic helps them gain weight and restore their growth trajectory.
In clinics around the world, you’re likely to find a young child eating from a shiny silver packet labeled RUTF. Ready-to-use therapeutic foods (RUTF) are nutrient-dense pastes that have proved a crucial game changer in treating millions of malnourished children, but now science is taking them even further. Children often relapse into malnutrition, and our improved understanding of gut health reveals that pathogens can disrupt a child’s microbiome, making it harder to absorb nutrients. Now, next-generation Microbiome Directed RUTFs include good bacteria that restore and maintain a child’s gut health, facilitating growth, metabolism, and immune function while reducing the symptoms of stunting that affect around 150 million children under five worldwide.
A father kneads wheat flour into bread dough, adding more than texture—his efforts are adding critical micronutrients. Fortifying staple foods like flour, rice, and salt with key vitamins and minerals can protect millions from the effects of hidden hunger: Salt fortified with iodine has become a household staple—reaching nearly 90 percent of households worldwide, reducing the prevalence of iodine deficiencies and helping prevent severe complications from malnutrition, but 20 countries are still classified as iodine deficient. Scaling up even more fortified staples can similarly improve health outcomes for malnourished populations everywhere. And research into new fortified foods is focused on maximizing their impact: Fortifying bouillon cubes with zinc, iron, B12, and folic acid could reach 175 million people and prevent 16.6 million cases of anemia in Nigeria alone.
Groundbreaking innovations like these are helping to positively rewrite every chapter of a child’s life story. A healthy mother feeds her baby a nourishing meal, their body absorbing the nutrients it needs. Steadily, the child’s body develops and they grow up, grow stronger, and grow smarter. Through strengthened health systems, access to vaccines, and more nutritious foods over a lifetime, children have the opportunity to escape the worst effects of illness and thrive in an environment that gives them the opportunity to excel and be all they can be. This is the hopeful story of the future that’s being made possible with innovation — working to help end preventable child deaths by ending child malnutrition.
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