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SPAIN
THE CHANGING FACE OF MALNUTRITION
Almost every country in the world, low-, middle- or high-income, faces
some form of malnutrition including undernutrition, overweight/
obesity, or a combination of these conditions.
This overlap of different types of malnutrition — undernutrition (e.g.,
stunting, vitamin and mineral deficiencies) co-existing with increasing
rates of overweight and obesity — is known as the double burden
of malnutrition.
Stunting (being too short for age) in young children is the result of
undernutrition in the womb and early in life. In young children,
stunting also is associated with poor brain development and
educational performance, which leads to lower adult wages and lost
productivity. When accompanied by excessive weight gain later in
childhood, stunting is associated with increased risk of nutrition-related
chronic diseases, such as diabetes.
While stunting and vitamin and mineral deficiencies remain high in
many low- and middle-income countries, rising income, urbanization,
changes in diet and reductions in physical activity also are driving a
transition to the co-existence of undernutrition and overweight/obesity.
The double burden presents enormous health, social and economic
challenges to countries and action is needed now to address this
changing face of malnutrition.
In high-income countries, although stunting is a less significant
problem, micronutrient deficiencies and overweight and obesity are
burdensome public health issues that increase and compound the risk
of many health problems, including heart disease and certain cancers.
SPAIN TRENDS FROM 1980 - 2013
70%
In Spain,
nearly 60% of
adults age 20 and older are
overweight or obese.2
60%
50%
INSUFFICIENT PHYSICAL ACTIVITY FOR
ADOLESCENTS AGE 11-17:3
40%
30%
70%
20%
boys
84%
girls
10%
OVERWEIGHT IN CHILDREN AGE 5-17:4
0%
1980s
1990s
2000s
2010-2013
Overweight and obesity in girls younger than 20 increased 35%1
26%
Overweight and obesity in boys younger than 20 increased 37%1
Overweight and obesity in women age 20 and older increased 14%
1
Overweight and obesity in men age 20 and older increased 21%1
boys
24%
girls
MALNUTRITION IN SPAIN
Brief overview of hurdles, causes, contributors to malnutrition
CAUSES
Vitamin and mineral deficiencies
A lack of essential vitamins and minerals
increases the risk of infectious illnesses and
can lead to anemia, poor growth and nutritionrelated diseases such as blindness, rickets, goiter
and neural tube defects.
Iron deficiency can lead to anemia, impaired
physical and cognitive development and
increased risk of morbidity in children. Maternal
iron deficiency can cause anemia and is associated
Primary risk factors
with increased risk of maternal mortality and
delivering a low birth weight baby, which can
cause further childhood growth restrictions.
Overall, the three risk factors that account for the
most disease burden in Spain are dietary risks,
high body mass index and tobacco smoking.6
Physical inactivity is a leading risk factor for
obesity, non-communicable diseases and
global mortality.2
Vitamin A deficiency can lead to decreased
immune function, increased morbidity and
mortality, and blindness.
Leading dietary risk factors in order of
greatest impact:7
Diets low in fruits
Diets high in sodium
18%
14%
2
5
Diets low in nuts and seeds
of women of
reproductive age
are anemic
of children under
five are anemic
Diets low in whole grains
Diets low in vegetables
EFFECTS
Non-communicable diseases
12%
8
High blood pressure
High blood pressure is a leading
cause of death and a major risk factor
for heart disease.
Sources:
1
2
of premature
deaths
30%
8
in men
Non-communicable diseases are largely
associated with unhealthy diet, sedentary
lifestyles and overweight/obesity.
Cardiovascular diseases and diabetes
are among the leading causes of loss of
healthy life.6
3
4
5
24%
8
Undernutrition in the form of stunting is
associated with increased risk of nutritionrelated non-communicable diseases when
accompanied by excessive weight gain
later in childhood.
in women
6
7
8
Scaling Up Nutrition, or SUN, is founded
on the principle that all people have a
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the United Nations, donors, businesses
and researchers—in a collective effort to
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Ng M, Fleming T, Robinson M, et al. Global, regional,
and national prevalence of overweight and obesity in
children and adults during 1980–2013: a systematic
analysis for the Global Burden of Disease Study 2013.
Lancet 2014; 6736: 766–81.
International Food Policy Research Institute.
Nutrition Country Profile: Spain. 2014. http://
globalnutritionreport.org/files/2014/12/gnr14_cp_
spain.pdf (accessed Jan 15, 2015)
World Health Organization. Global status report on
noncommunicable diseases 2014. Geneva, 2014.
Organisation for Economic Co-operation and
Development. OECD: Obesity Update 2014. 2014
http://www.oecd.org/els/health-systems/obesityupdate.htm. (accessed Jan 14, 2015)
Stevens GA, Finucane MM, De-Regil LM, et al. Global,
regional, and national trends in haemoglobin
concentration and prevalence of total and severe
anaemia in children and pregnant and non-pregnant
women for 1995-2011: A systematic analysis of
population-representative data. Lancet Glob Heal
2013; 1. DOI:10.1016/S2214-109X(13)70001-9.
Institute for Health Metrics and Evaluation. Global
Burden of Disease Country Profile: Spain. 2013. http://
www.healthdata.org/sites/default/files/files/country_
profiles/GBD/ihme_gbd_country_report_spain.pdf
(accessed Jan 10, 2015).
Institute for Health Metrics and Evaluation. Global
Burden of Disease (GBD) Compare. 2013. http://
vizhub.healthdata.org/gbd-compare/ (accessed
Jan 10, 2015).
World Health Organization. Noncommunicable
Diseases Country Profiles: Spain. 2014. http://www.
who.int/nmh/countries/esp_en.pdf?ua=1 (accessed
Jan 17, 2015)
Thanks to The Global Alliance for Improved
Nutrition (GAIN) for providing technical assistance.