Asian Development Bank Institute, Chiyoda-ku, Tokyo, Japan.
Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea.
Nutrition. 2024 Apr;120:112346. doi: 10.1016/j.nut.2023.112346. Epub 2023 Dec 29.
Child malnutrition, comprising of undernutrition and obesity, is a global concern with severe implications for survival, leading to acute and chronic diseases that adversely affect the productivity of individuals and society. Asia shoulders the greatest burden, with 7 out of 10 undernourished children residing in the region. Despite the decline in global child stunting, particularly in Asia, its prevalence remains significant. In 2017, an estimated 151 million children under five experienced stunting, and an additional 38 million were overweight, with Africa and Asia accounting for 25% and 46% of the global figures, respectively. Therefore, this paper aims to analyze the geospatial and environmental determinants of undernutrition in rural South and Southeast Asia.
To explore the geospatial and environmental determinants of undernutrition (stunting, wasting, and underweight), we use Poisson regression and the data from recent rounds of the Demographic and Health Survey (DHS) from India, Bangladesh, Pakistan, Nepal, Cambodia, and Timor-Leste.
This study found a high prevalence of stunting, wasting, and underweight among children aged 0 to 59 months in rural areas of South and Southeast Asia, with considerable variation between countries and clusters/primary sampling units. Results show a positive association between child malnutrition and factors such as maternal illiteracy, unsafe drinking water, and dirty cooking fuel in South and Southeast Asia. Children from impoverished households in India, Pakistan, and Cambodia were disproportionately affected. In addition to socio-economic factors, climatic risks such as temperature increase and rainfall variations also emerged as important determinants of child malnutrition in India, Bangladesh, and Timor-Leste.
This paper emphasizes the role of environmental and climatic factors on child nutrition, underscoring their significance regardless of socio-economic conditions. As the impacts of climate change continue to intensify, and agrarian societies bear the brunt, these factors will play a critical role in shaping child nutritional outcomes. Thus, amid growing climate change, nutritional security should be prioritized, considering the spatial domain and targeting climate distress areas along with other socio-economic and demographic aspects.
儿童营养不良包括营养不足和肥胖，是一个全球性问题，对生存造成严重影响，导致急性和慢性疾病，对个人和社会的生产力产生不利影响。亚洲承受着最大的负担，该地区有 7 个国家/地区的 10 名儿童中有 7 名营养不足。尽管全球儿童发育迟缓（特别是在亚洲）的比例有所下降，但仍然很高。2017 年，估计有 1.51 亿五岁以下儿童发育迟缓，另有 3800 万儿童超重，非洲和亚洲分别占全球的 25%和 46%。因此，本文旨在分析南亚和东南亚农村地区营养不足的地理空间和环境决定因素。
为了探索南亚和东南亚农村地区营养不足（发育迟缓、消瘦和体重不足）的地理空间和环境决定因素，我们使用泊松回归和来自印度、孟加拉国、巴基斯坦、尼泊尔、柬埔寨和东帝汶最近一轮人口与健康调查（DHS）的数据。
本研究发现，南亚和东南亚农村地区 0 至 59 个月儿童的发育迟缓、消瘦和体重不足率较高，各国和聚类/初级抽样单位之间存在相当大的差异。结果表明，儿童营养不良与母亲文盲、不安全饮用水和脏燃料等因素呈正相关。印度、巴基斯坦和柬埔寨贫困家庭的儿童受影响程度更高。除了社会经济因素外，气候风险，如温度升高和降雨变化，也成为印度、孟加拉国和东帝汶儿童营养不良的重要决定因素。
本文强调了环境和气候因素对儿童营养的作用，无论社会经济条件如何，这些因素都很重要。随着气候变化的影响继续加剧，农业社会首当其冲，这些因素将在塑造儿童营养结果方面发挥关键作用。因此，在气候变化加剧的情况下，应优先考虑营养安全，考虑空间域，并针对气候困扰地区以及其他社会经济和人口方面。
