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ZAMBIA
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.
ZAMBIA TRENDS FROM 1980 - 2013
60%
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.
The three risk factors
that account for the most disease burden
in Zambia are childhood underweight,
household air pollution from
solid fuels, and suboptimal
breastfeeding.3
50%
40%
STUNTING IN CHILDREN UNDER AGE 5: 40.1%4
30%
20%
969,331 CHILDREN
10%
5
OVERWEIGHT IN CHILDREN UNDER AGE 5: 5.7%4
0%
1980s
1990s
2000s
2010-2013
Overweight and obesity in girls younger than 20 increased 18%1
Overweight and obesity in boys younger than 20 increased 4%1
Overweight and obesity in women age 20 and older increased 27%1
Overweight and obesity in men age 20 and older decreased 15%1
Stunting in children under 5 has decreased from 58.1% in 1995 to 40.1% in 20132
137,785 CHILDREN
CHILDHOOD MALNUTRITIONBriefIN
ZAMBIA
overview
of hurdles, causes, contributors to malnutrition
CAUSES
Vitamin and mineral deficiencies
Breastfeeding practices
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
with increased risk of maternal mortality and
delivering a low birth weight baby, which can
cause further childhood growth restrictions.
Optimal breastfeeding can prevent
undernutrition and can potentially prevent
obesity and non-communicable diseases
later in life.
Vitamin A deficiency can lead to decreased
immune function, increased morbidity and
mortality, and blindness.
Exclusive breastfeeding (breast milk only)
for the first six months of life followed by
continued breastfeeding until two years of
age and beyond gives babies the foundation
for optimal health and development.
54%
2
29%
2
73%
4
58%
6
of women of
reproductive age
are anemic
of children are
vitamin A deficient
of babies were exclusively
breastfed for the first six
months of life (2013)
of children under
five are anemic
EFFECTS
Non-communicable diseases
18%
7
of premature
deaths
Non-communicable diseases are largely
associated with unhealthy diet, sedentary
lifestyles and overweight/obesity. The top
three causes in Zambia of non-communicable
diseases are household air pollution, high
blood pressure and dietary risks.3
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.
High blood pressure
High blood pressure is a leading
cause of death and a major risk factor
for heart disease.
34.1%
7
Sources:
1
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.
2
International Food Policy Research Institute.
Nutrition Country Profile: Zambia. 2014. http://
globalnutritionreport.org/files/2014/11/gnr14_cp_
zambia.pdf (accessed Feb 5, 2015)
3
Institute for Health Metrics and Evaluation. Global Burden
of Disease Country Profile: Zambia. 2013. http://www.
healthdata.org/sites/default/files/files/country_profiles/
GBD/ihme_gbd_country_report_zambia.pdf (accessed
Jan 28, 2015).
in men
Central Statistical Office. Zambia Demographic and
4
Health Survey 2013-2014: Preliminary report. Lusaka,
2014 http://dhsprogram.com/what-we-do/survey/
survey-display-406.cfm.
31.5%
7
in women
United Nations, Department of Economic and Social
5
Affairs, Population Division. World Population Prospects:
The 2012 revision. 2013. http://esa.un.org/unpd/wpp/
Excel-Data/population.htm (accessed Mar 18, 2015).
Stevens GA, Finucane MM, De-Regil LM, et al. Global,
6
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.
World Health Organization. Noncommunicable Diseases
7
Country Profiles: Zambia. 2014. http://www.who.int/nmh/
countries/zmb_en.pdf (accessed Feb 3, 2015).
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Nutrition (GAIN) for providing technical assistance.