Underlying Determinants of and Solutions for Malnutrition in Low-and Middle-Income Countries

Egypt is struggling with the double burden of malnutrition: 21% of children under the age of 5 are stunted, 8% are wasted, and 15% are overweight. 1 This reflects a decline in childhood stunting (down from 35% in 1988), yet the current rates are 20% higher than expected for a country with Egypt’s GDP. 2 These trends also reflect a rapid increase in overweight; 85% of adult women are overweight or obese, compared to 58% in 1992.1 The double burden is present not only at a national scale but also at the household and individual levels: in 2014, 34% of children who were stunted were also overweight. 2 What kind of underlying determinants account for Egypt’s declining yet stubbornly high rates of undernutrition and rising rates of overweight and obesity? Egypt has seen marked improvements in its health systems infrastructure over the past few decades, but some things lag behind. Whereas urban residents have almost universal access to improved toilet facilities, 14% of rural residents lack access. 1 Rural areas are more likely to see childhood stunting, whereas urban residents are more likely to be overweight, 1 have diets higher in fat, 3 and consume more convenience foods. 4 Egyptian diets are trending toward more fats, meat, and dairy. 3 Convenience foods such as sugary cakes and cookies are commonly given to children under 2, and these foods have even been found to be perceived as “ideal” complementary foods by some caregivers. 4Nutrition in Egypt is also interwoven with larger issues of equity, stability, and agricultural production. Egypt is ranked at 134 out of 144 countries on the Global Gender Gap Index. 5 Only 25% of …