Send to

Choose Destination
Lancet. 2013 Aug 3;382(9890):427-451. doi: 10.1016/S0140-6736(13)60937-X. Epub 2013 Jun 6.

Maternal and child undernutrition and overweight in low-income and middle-income countries.

Author information

Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address:
Universidade Federal de Pelotas, Pelotas, Rio Grande do Sol, Brazil.
The University of the West Indies, Tropical Medicine Research Institute, Mona Campus, Kingston, Jamaica.
The Aga Khan University and Medical Center, Department of Pediatrics, Karachi, Pakistan.
Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA.
World Health Organization, Department of Nutrition for Health and Development, Geneva, Switzerland.
Imperial College of London, St Mary's Campus, School of Public Health, MRC-HPA Centre for Environment and Health, Department of Epidemiology and Biostatistics, London, UK.
Institute of Child Health, University College London, London, UK; The University of the West Indies, Mona, Jamaica.
Emory University, Atlanta, GA, USA.
London School of Hygiene and Tropical Medicine, London, UK.

Erratum in

  • Lancet. 2013. 2013 Aug 3;382(9890):396.


Maternal and child malnutrition in low-income and middle-income countries encompasses both undernutrition and a growing problem with overweight and obesity. Low body-mass index, indicative of maternal undernutrition, has declined somewhat in the past two decades but continues to be prevalent in Asia and Africa. Prevalence of maternal overweight has had a steady increase since 1980 and exceeds that of underweight in all regions. Prevalence of stunting of linear growth of children younger than 5 years has decreased during the past two decades, but is higher in south Asia and sub-Saharan Africa than elsewhere and globally affected at least 165 million children in 2011; wasting affected at least 52 million children. Deficiencies of vitamin A and zinc result in deaths; deficiencies of iodine and iron, together with stunting, can contribute to children not reaching their developmental potential. Maternal undernutrition contributes to fetal growth restriction, which increases the risk of neonatal deaths and, for survivors, of stunting by 2 years of age. Suboptimum breastfeeding results in an increased risk for mortality in the first 2 years of life. We estimate that undernutrition in the aggregate--including fetal growth restriction, stunting, wasting, and deficiencies of vitamin A and zinc along with suboptimum breastfeeding--is a cause of 3·1 million child deaths annually or 45% of all child deaths in 2011. Maternal overweight and obesity result in increased maternal morbidity and infant mortality. Childhood overweight is becoming an increasingly important contributor to adult obesity, diabetes, and non-communicable diseases. The high present and future disease burden caused by malnutrition in women of reproductive age, pregnancy, and children in the first 2 years of life should lead to interventions focused on these groups.

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center