SEATTLE — The first 1000 days of a child’s life, from pregnancy to their second birthday, are especially critical. Maternal and childhood intake of micronutrients can impact growth and even have intergenerational effects. The damage done by malnutrition during the first years of a child’s life translates into huge economic burdens for countries due to lost productivity and healthcare costs. By focusing on improving nutrition during the first 1000 days many problems can be prevented. One of the most effective strategies to address malnutrition is large-scale food fortification.
Of all deaths in the under-five age group, 45 percent are linked to malnutrition, more than AIDS, malaria and tuberculosis combined. Malnourished children who survive to early childhood are likely to be stunted, causing immediate and long-term effects on health and wellbeing.
In addition to poor physical growth, children with stunted growth have an increased risk of neurodevelopmental effects and are more susceptible to infections. Stunting can also impact intellectual development and learning capacity, affecting school and work performance. These children often remain shorter and have an increased risk of becoming overweight as they grow older. This, in turn, leads to an increased risk of nutrition-related chronic diseases such as diabetes and heart disease. Many developing countries are thus facing a double burden of malnutrition and increasing rates of obesity and diabetes.
Iron deficiency is especially problematic, with an estimated two billion cases of anemia worldwide. In developing countries, anemia prevalence rates are estimated to be about 50 percent in pregnant women and children under two years of age. Other main deficiencies include iodine, vitamin A, zinc, calcium, vitamin D and folic acid.
Interventions to address the complex causes of malnutrition in children include exclusive breastfeeding during the first six months of life, providing micronutrient supplements to mothers and children, breeding crops for improved nutritional content and fortifying staple foods such as flour, cooking oil and salt. Of these interventions, food fortification is one of the most effective approaches.
If consumed regularly, fortified foods will maintain body stores of nutrients better in the long run than supplements would. This is an important advantage for growing children who need a sustained supply of micronutrients for growth and development, and for pregnant or breastfeeding women who need adequate nutrient stores.
Apart from mass fortification programs that add micronutrients to foods and condiments that are consumed regularly by the population, home fortification is another option. Home fortification of foods consists of single-dose packets of colorless and tasteless multiple micronutrient powders that can be sprinkled on any foods consumed by children between six and 23 months of age. This has the advantage of increasing the micronutrient content of a child’s diet without changing their usual dietary habits.
The Global Alliance for Improved Nutrition (GAIN) estimates that the use of food fortification measures can save the lives of up to 1.5 million children under five every year. While malnutrition in children is one of the most pressing developmental issues, simple interventions like food fortification can have a massive impact, especially during the first few critical years of life.
– Helena Jacobs