Nutrition progress stalls: Most nations lag behind 2030 goals

Global efforts to combat malnutrition reveal uneven progress, with critical gaps in tackling anemia and childhood obesity threatening health outcomes worldwide.

Study: Global, regional, and national progress towards the 2030 global nutrition targets and forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Image Credit: kwanchai.c / Shutterstock

In a recent article published in The Lancet, researchers evaluated the progress, trends, and projections of six global nutrition targets (GNTs) associated with anemia, child growth, exclusive breastfeeding, and low birth weight between 2012 to 2021.

While some countries have made progress in meeting certain targets, fewer than 25% are projected to meet any GNTs by 2030, identifying substantial challenges to addressing anemia and overweight children.

Background

Maternal, child, and neonatal health have long been indicators of the performance of health systems, with suboptimal nutrition contributing significantly to disability and death in these groups.

The 2012 World Health Assembly set GNTs to address six key nutrition indicators – anemia among females of reproductive age, child wasting, child stunting, child overweight, low birth weight, and exclusive breastfeeding – by 2025. These targets are integral to the United Nations’ Sustainable Development Goal of eliminating hunger by 2030. The World Health Organization extended these targets to 2030 for all indicators except child overweight, which retains the original 2025 target definition.

About the study

The study used Bayesian meta-regression modeling and spatiotemporal Gaussian process regression (ST-GPR) to estimate the prevalence and burden of six GNT indicators for various countries, regions, and demographics. Data were collected from population-representative surveys, administrative sources, and published scientific literature.

Researchers used models to estimate prevalence for each indicator, accounting for factors like age, sex, and location. Socioeconomic and health-related covariates, such as maternal education, sanitation, income, and urbanization, were incorporated into these models. Different statistical models were tested and optimized to predict the prevalence of low birth weight, stunting, wasting, child overweight, anemia, and exclusive breastfeeding.

Each indicator’s attributed burden, measured in disability-adjusted life years (DALYs), was calculated based on its relationship to health outcomes like mortality and morbidity. The study also analyzed the annualized rate of change (ARC) in the prevalence of these indicators from 2012 to 2021 and compared it with expected trends based on Socio-Demographic Index (SDI) levels.

To predict future prevalence up to 2050, the researchers incorporated SDI projections, socioeconomic changes, disruptions caused by the COVID-19 pandemic, and future health trends.

Findings

From 2012 to 2021, the prevalence of key malnutrition indicators varied widely across countries. In 2021, several countries, including Georgia, Mongolia, and South Korea, met two out of six GNTs, while most countries fell short of their targets.

Global prevalences of low birth weight slightly declined but remained above the 30% reduction target, with no country achieving the GNT for this indicator. Exclusive breastfeeding improved globally, with a higher percentage of countries meeting the target, especially Rwanda, Burundi, and Sri Lanka.

However, the prevalence of stunting in children under five remained a major challenge, with many countries, especially in South Asia and sub-Saharan Africa, failing to meet reduction goals. While stunting showed improvement in several regions, it remained a significant issue in 155.7 million children under five globally in 2021.

The global incidence of child overweight increased from 2012 to 2021, with a few countries like Georgia managing to stabilize it. Anemia in women of reproductive age slightly worsened globally, with no country achieving the target of halving its prevalence. Notably, anemia and child overweight trends deviated significantly from expected progress based on SDI levels in many regions.

Looking ahead to 2030, the projections indicate that more countries will meet the wasting target, with some countries achieving the exclusive breastfeeding and stunting targets. However, the targets for low birth weight, child overweight, and anemia reduction are unlikely to be met by 2030. Projections for 2050 suggest that even with continued progress, anemia, and child overweight will remain unmet in most regions globally.

Conclusions

This study analyzed country-level and global progress between 2012 and 2021, assessing trends and projecting future prevalence up to 2050. It found that progress has been slow and inconsistent, with few countries on track to meet the targets by 2030.

Researchers also highlighted the importance of adapting policies and addressing factors like the impact of the COVID-19 pandemic, emphasizing the need for multisectoral, long-term interventions to tackle the determinants of suboptimal nutrition.

This study faces several limitations, including inconsistent data quality, particularly in low- and middle-income countries (LMICs), and sparse data after 2019 due to factors like conflict and the COVID-19 pandemic. Data on exclusive breastfeeding may be overestimated due to reliance on self-reporting, and the models for childhood overweight are not directly comparable to future targets for children under five years.

The study also excludes factors like malaria and uterine fibroids that could affect predictions of anemia. Additionally, disruptions to food security and healthcare may worsen the estimates. Future research should improve data collection, particularly on low birth weight, and consider the long-term effects of anemia and childhood obesity.