What is malnutrition?

Malnutrition encompasses all forms of poor nutritional status: undernutrition (stunting, wasting, micronutrient deficiency); and overnutrition (overweight and obesity). The term "double burden of malnutrition" captures the current global reality in which undernutrition and overnutrition co-exist — sometimes in the same household, when a stunted child lives with an overweight parent.

What is stunting and why does it matter?

Stunting is low height-for-age caused by chronic undernutrition — particularly in the first 1,000 days of life. It affects 148 million children under 5 globally. Beyond short stature, stunting impairs brain development, reduces cognitive function and school performance, lowers adult productivity and earnings, and increases the risk of chronic disease in adulthood. It is largely irreversible after age 2.

What is the difference between stunting and wasting?

Stunting is chronic undernutrition — low height-for-age, reflecting long-term nutritional deprivation. Wasting is acute undernutrition — low weight-for-height, reflecting recent or ongoing food deprivation. Wasting dramatically increases mortality risk: a severely wasted child has a 9-fold higher risk of death. Wasting is treated with ready-to-use therapeutic food (RUTF). Both conditions can coexist in the same child.

Why can 2.8 billion people not afford a healthy diet?

The cost of a healthy diet — as defined by FAO/WHO standards — exceeds the income of 2.8 billion people globally. Healthy foods (fruits, vegetables, legumes, animal-source foods) are typically more expensive per calorie than staple grains. Food environments in LMICs and disadvantaged communities are dominated by cheap, energy-dense but nutrient-poor foods. Poverty is the primary driver; food systems, agricultural policies and subsidies shape what is available and affordable.

What is the first 1,000 days?

The "first 1,000 days" — from conception to a child's second birthday — is the most critical window for nutrition and development. Brain development, immune system maturation and organ formation are at their most intensive and most sensitive to nutritional deficits during this period. Deficits in iron, iodine, zinc, vitamin A, protein and energy during this window have lifelong consequences that cannot be fully reversed later in life. This is why maternal nutrition during pregnancy and breastfeeding are global health priorities.

How do ultra-processed foods affect health?

Ultra-processed foods — industrially formulated products high in salt, sugar and unhealthy fats, low in fibre and micronutrients — are associated with increased risk of obesity, cardiovascular disease, type 2 diabetes, colorectal cancer and depression. The NOVA classification system (developed by Carlos Monteiro at the University of Sao Paulo) provides the most widely used framework for categorising food processing. Ultra-processed food now accounts for the majority of calories consumed in the US, UK and many other high-income countries.

What is vitamin A deficiency and why does it matter?

Vitamin A deficiency affects an estimated 190 million preschool-age children globally and is the leading cause of preventable childhood blindness. It also impairs immune function, dramatically increasing the severity of infections including measles and diarrhoea. Vitamin A supplementation — two high-dose capsules per year — is one of the most cost-effective child survival interventions, reducing all-cause mortality in deficient children by 24% (Cochrane review).

What are the WHO dietary guidelines?

WHO recommends: eating at least 400g (5 portions) of fruit and vegetables per day; reducing free sugar intake to less than 10% of total energy (ideally below 5%); limiting total fat to 30% of total energy; reducing saturated fat to less than 10% and eliminating trans fats; reducing salt intake to less than 5g per day; and consuming a varied, predominantly plant-based diet. These guidelines are based on extensive evidence from prospective studies and clinical trials.

What is the relationship between nutrition and NCDs?

Poor diet is now the leading risk factor for non-communicable disease burden globally — ahead of tobacco and alcohol. High sodium, sugar and saturated fat consumption drives hypertension, cardiovascular disease, diabetes and obesity. Low fibre and vegetable intake increases colorectal cancer risk. Addressing diet-related NCDs requires changes to food environments — taxation, marketing restrictions, labelling, agricultural subsidies — not just individual dietary advice.

What is breastfeeding and how important is it?

WHO recommends exclusive breastfeeding for the first 6 months of life and continued breastfeeding alongside appropriate complementary foods until 2 years of age or beyond. Breastfeeding protects against infections, reduces infant mortality, optimises brain development and reduces the mother's risk of breast cancer and type 2 diabetes. Only 44% of infants under 6 months are exclusively breastfed globally. The International Code of Marketing of Breast-milk Substitutes (1981) regulates formula marketing.

What is the WHO Global Action Plan for NCDs and nutrition?

The WHO Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2030 includes nutrition-specific targets: halt the rise in diabetes and obesity; reduce salt/sodium consumption by 30%; eliminate industrially produced trans-fatty acids; and increase the global rate of exclusive breastfeeding in the first 6 months to at least 50%. These targets require policy-level interventions including taxation of sugar-sweetened beverages — now implemented in over 50 countries.

How does GMJ News cover nutrition?

GMJ News follows FAO State of Food Security reports, WHO dietary guidelines updates, UNICEF malnutrition data, and policy developments including sugar taxes, food labelling legislation and ultra-processed food regulation. The Georgian Medical Journal covers nutrition-related public health issues in Georgia, including the double burden of malnutrition relevant to the South Caucasus context.

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Nutrition

GMJ News knowledge hub · last reviewed September 2026 · Georgian Medical Journal

Summary Statistics Glossary GMJ news FAQ Documents Organizations Research

The world now carries a double burden of malnutrition: about 148 million children under five are stunted and 45 million wasted, while over one billion people live with obesity — often within the same countries and even the same households (WHO/UNICEF). Malnutrition in all its forms is a leading risk factor for global disease, from anaemia affecting around a third of women of reproductive age to diet-related NCDs driven by ultra-processed foods. WHO's healthy-diet guidance, breastfeeding protection, food fortification and the taxation of sugar-sweetened beverages define the evidence-based policy menu — contested at every step by commercial interests, which is precisely why independent coverage matters.

Key messages

Double burden

The world simultaneously faces undernutrition — 733 million people going hungry — and overnutrition — 1 billion living with obesity. This "double burden of malnutrition" exists within the same countries, communities and even households.

Malnutrition underlies 45% of child deaths

Malnutrition — including undernutrition, micronutrient deficiency and overweight — contributes to approximately 45% of all deaths in children under five (UNICEF).

Food access

2.8 billion people cannot afford a healthy diet (FAO 2023). Diet quality is fundamentally shaped by food environments — what is available, affordable and marketed — not simply individual choice.

Stunting

148 million children under 5 are stunted (too short for their age) from chronic undernutrition — affecting brain development, school performance and adult productivity (UNICEF 2023).

Ultra-processed foods

Ultra-processed foods — high in salt, sugar and saturated fat, low in fibre and micronutrients — now dominate food environments in many countries and are a major driver of diet-related NCDs including cardiovascular disease, diabetes and cancer.

First 1,000 days

The period from conception to a child's second birthday — the "first 1,000 days" — is the most critical window for nutritional intervention. Deficits during this period have lifelong consequences for health and development.

Key statistics

733M

people facing hunger (2023)

FAO/SOFI 2024

148M

children stunted under 5

UNICEF 2023

45M

children wasted (acute malnutrition)

UNICEF 2023

2.8B

cannot afford healthy diet

FAO 2023

45%

of child deaths linked to malnutrition

UNICEF

living with obesity

WHO/Lancet 2024

People undernourished globally (millions) 2005-2023 — FAO State of Food Security

Source: FAO, IFAD, UNICEF, WFP and WHO. The State of Food Security and Nutrition in the World (annual).

Glossary of key terms

Stunting
WHO/UNICEFLow height-for-age — indicating chronic undernutrition. A child is stunted if they are more than 2 standard deviations below the WHO child growth standards median height-for-age. Stunting impairs brain development and has lifelong consequences.

Wasting
WHO/UNICEFLow weight-for-height — indicating acute undernutrition and a high risk of death. Children with severe acute malnutrition (SAM) have a mortality risk 9 times higher than a well-nourished child. Treated with ready-to-use therapeutic food (RUTF).

Micronutrient deficiency
WHOInadequate intake or absorption of vitamins and minerals — sometimes called "hidden hunger" because it can occur without visible signs of undernutrition. Iron, iodine, vitamin A and zinc deficiencies are the most prevalent and damaging.

Ultra-processed food
NOVA/PAHOIndustrial formulations made from extracted or modified food substances with minimal whole-food content, typically high in salt, sugar and saturated fat, low in fibre. The NOVA classification identifies four food processing groups; ultra-processed foods are Group 4.

First 1,000 days
UNICEF/WHOThe critical period from conception to a child's second birthday — 270 days of pregnancy plus 730 days of infancy. Nutritional deficits during this window have irreversible effects on brain development, growth and immune function.

Double burden of malnutrition
WHOThe co-existence of undernutrition (stunting, wasting, micronutrient deficiency) and overnutrition (overweight and obesity) within the same country, community or household. Now the norm rather than the exception globally.