Written by Arathi Vinod | Edited by Sameer Rajesh and Nicole Xu

For many, the word malnutrition quickly brings to mind the image of undernourished children in developing countries, experiencing hunger as a result of a severe lack in resources. However, contrary to popular belief, malnutrition encompasses a wide range of conditions resulting from a complex web of circumstances, and every country in the world is vulnerable to it. Regardless of the various forms and causes of malnutrition, though, one thing is certain: nutrition equity is quickly becoming a significant health concern across the world. 

One critical condition that falls under malnutrition is undernutrition. Classified based on weight-to-height ratio, weight-to-age ratio, or height-to-age ratio, undernutrition is evident through wasting, underweight, and stunting respectively (“Malnutrition”). As expected, undernutrition is the result of a persistent lack of food, either due to an environment scarce in nutrients or due to diseases that cause a decrease in food intake. However, even if nutritional needs are mostly being met, malnutrition can occur if particular vitamins and minerals are not consumed. Known as micronutrient-related malnutrition, this type of malnutrition commonly targets individuals lacking essential nutrients such as iron, iodine, and Vitamin A (“Malnutrition”). Deficiencies in such vitamins or minerals can have devastating impacts on the individual’s health. For instance, thyroid hormones depend on a surplus of iodine in the diet to help maintain metabolism, and if the body  experiences iodine deficiency, the thyroid gland will not be able to produce enough hormones, leading to hypothyroidism (“Iodine Deficiency”). Finally, the third form of malnutrition is overweight and obesity. Like undernutrition, overweight and obesity are also tracked by weight-to-height ratios, through measurements of BMI, or body mass index. A BMI of 25 or more is considered overweight, and 30 or over is classified as obese (“Malnutrition”). These conditions are caused by the overconsumption of energy-rich foods, accompanied by a deficiency in other food types and a lack of physical movement. The buildup of visceral fat caused by overweight and obesity is the root of a multitude of serious health conditions, most notably heart disorders and type 2 diabetes.

In short, malnutrition can be summed up as a lack of food security, which is defined by the Food and Agricultural Organization of the United Nations as a state when individuals always have “‘physical and economic access’” to food that is “‘sufficient, safe and nutritious’” (Fanzo). All three forms of malnutrition can be broken down using the social determinants. There are officially five components to the Social Determinants of Health (SDOH): economic stability, education, health care access and quality, neighborhood and built environment, and social and community context (“Social Determinants of Health”). Contextualizing these determinants within the topic of nutrition equity, the potential origins of malnutrition can be deduced. Perhaps most apparently, environment and socioeconomic status can play a key role in an individual’s malnutrition, either because of a literal shortage of food in the area, or because of the large part wealth plays in access to nutritious food. However, there are also more subtle causes of food insecurity. For example, cultural values and societal norms might directly or indirectly enforce eating behaviors that are detrimental to the individual (“Towards Global Nutrition Equity”). Furthermore, there is a significant political facet to nutrition equity; the institutions and policies set in place by the government have a large say in the types of food that individuals have access to and grow up with, influencing the nutritional choices that they then pass on to the next generation.

Fortunately, many policies have been put forth in recent years to try to combat these deep-rooted causes of nutrition inequity. For instance, the United Nations began a program called Decade of Action on Nutrition in 2016, through which they hope to eliminate malnutrition by the year 2025 by taking all the actions necessary to guarantee food security for everyone (“Towards Global Nutrition Equity”). Other policies aim to relieve the effects of malnutrition. The Medical Nutrition Equity Act (MNEA) is a piece of legislation introduced in 2019 that hopes to allow insurance coverage for those with nutrition-deficiency related disorders, including digestive conditions like malabsorption and inherited conditions like phenylketonuria (“Medical Nutrition Equity Act”). Through such well-meaning endeavors, as well as a resolve to continue understanding and spreading awareness about the complexities of malnutrition, there is still hope for the world to achieve nutrition equity.

Bibliography

Fanzo, Jess. “A Piece of the Pie in Health Equity: Improving Food & Nutrition Security.” Johns Hopkins Alliance for a Healthier World, Johns Hopkins Alliance for a Healthier World, 14 July 2018, www.ahealthierworld.jhu.edu/ahw-updates/2018/7/13/a-piece-of-the-pie-in-health-equity-improving-food-nutrition-security. 

“Iodine Deficiency.” Temple Health, 2020, www.templehealth.org/services/conditions/iodine-deficiency. 

“Malnutrition.” World Health Organization, World Health Organization, 1 Apr. 2020, www.who.int/news-room/fact-sheets/detail/malnutrition. 

“Medical Nutrition Equity Act – Action Needed!” APFED, 17 Mar. 2020, apfed.org/advocacy/medical-nutrition-equity-act/. 

“Social Determinants of Health.” Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, health.gov/healthypeople/objectives-and-data/social-determinants-health. 

“Towards Global Nutrition Equity.” Global Nutrition Report, 2020, globalnutritionreport.org/reports/2020-global-nutrition-report/introduction-towards-global-nutrition-equity/.