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1. Sugar-loaded cereals for breakfast


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sugar-loaded cereals for breakfast

2. Drivers of child stunting


Danaei G, Andrews GK, Sudfeld RC, Fink G, McCoy DC, Peet E, Sania A, Fawzi MCS, Ezzati M & Fawzi WW (2016). Risk factors for childhood stunting in 137 developing countries: a comparative risk assessment analysis at global, regional, and country levels. PLOS Medicine, 13(11): 1-18.


Richter LM, Orkin FM, Roman GD, Dahly DL, Horta BL, Bhargava SK, Norris SA & Stein AD (2018) Comparative models of biological and social pathways to predict child growth through age 2 years from birth cohorts in Brazil, India, the Philippines, and South Africa. Journal of Nutrition, 148(8): 1364-1371.


Globally over 149 million children, or 21% of children, under five years of age, are stunted with 91% living in low- and middle-income countries (LMICs).1 Stunting refers to children who experience long-term nutritional deprivation and is defined as height-for-age <-2 standard deviations in the WHO Child Growth Standards median.2 Private sector actors and organizations have been recognized increasingly as critical stakeholders in efforts to achieve the Sustainable Development Goals (SDGs), including ending malnutrition (SDG 2), through investments in the workplace, community and economic market.3−7 The private sector consists of organisations that engage in profit-seeking activities and have a majority private ownership (e.g., not owned or operated by a government). This term includes financial institutions and intermediaries, multinational companies, micro, small and medium-sized enterprises, cooperatives, individual entrepreneurs, and farmers who operate in the formal and informal sectors. It excludes actors with a non-profit focus, such as private foundations and civil society organisations.8−10 The private sector has considerable potential to be engaged in providing direct nutrition (e.g., micronutrient supplements) and indirect nutrition interventions (e.g., technological innovations in agriculture, health or education).

Drivers of child stunting

3. Protein Malnutrition


Richard D. Semba (2016). The Rise and Fall of Protein Malnutrition in Global Health.


“The UN Protein Advisory Group was established in 1955. International conferences were largely concerned about protein malnutrition in children. By the early 1970s, UN agencies were ringing the alarm about a ‘protein gap'. In The Lancet in 1974, Donald McLaren branded these efforts as ‘The Great Protein Fiasco', declaring that the ‘protein gap' was a fallacy. The following year, John Waterlow, the scientist who led most of the efforts on protein malnutrition, admitted that a ‘protein gap' did not exist and that young children in developing countries only needed sufficient energy intake. The emphasis on protein malnutrition waned. It is recently apparent that quality protein and essential amino acids are missing in the diet and may have adverse consequences for child growth and the reduction of child stunting.”

Dror DK, Allen LH: The importance of milk and other animal-source foods for children in low-income countries. Food Nutr Bull 2011;32:227-243.


Hoppe C, Mølgaard C, Michaelsen KF: Cow's milk and linear growth in industrialized and developing countries. Annu Rev Nutr 2006;26:131-173.

Ricardo UAUY, Anura KURPAD, Kwaku TANO-DEBRAH, Gloria E. OTOO, Grant A. AARON, Yasuhiko TORIDE, Shibani GHOSH

Role of Protein and Amino Acids in Infant and Young Child Nutrition: Protein and Amino Acid Needs and Relationship with Child Growth.


“Malnourished children showed poor performance on tests of higher cognitive functions like cognitive flexibility, attention, working memory, visual perception, verbal comprehension, and memory Malnutrition affects brain growth and development and hence future behavioral outcomes [37]. School-age children who suffered from early childhood malnutrition have generally been found to have poorer IQ levels, cognitive function, school achievement and greater behavioural problems than matched controls and, to a lesser extent, siblings. The disadvantages last at least until adolescence.”

Kar et al., 2008. Cognitive development in children with chronic protein energy malnutrition. Behavioural and Brain Functions, 4.

Protein Malnutrition

4. Economic Impact of Child Malnutrition

Social and Economic Impact of Child Undernutrition on Health

“When a child is undernourished, he or she will have an increased chance of experiencing specific health problems.12 Research shows that undernourished children below the age of 5 are more likely to experience cases of anaemia, acute diarrhoeal syndrome, acute respiratory infection, and fever. The treatment of undernutrition and related illnesses is a critical, recurrent cost for the health system. Treating a severely underweight child, for example, requires a comprehensive protocol that is often more costly than the monetary value and effort needed to prevent undernutrition, especially when other diseases are present.13. Research shows that undernourished children below the age of 5 have an increased risk of dying.14 The costs associated with mortality are identified in losses to national productivity. If those children had been able to reach adulthood, they could have contributed to the economy.” 

"There is substantive research that shows that students who were stunted before the age of 5 will have reduced cognitive capacity and will be more likely to underperform in school and to repeat grades.15. Repetitions are costly both to the family of the student and to the education system, as both need to invest resources for an additional year of schooling. Students who are undernourished are also more likely to drop out of school than those who experience healthy childhoods.16 The economic impact of dropouts from school is not incurred immediately. Rather, the economic costs are incurred when the population is of working age, as people may be less productive and earn less as a result of having had fewer years of schooling.17”


12 Amy L. Rice et al., "Malnutrition as an underlying cause of childhood deaths associated with infectious diseases in developing countries," Bulletin of the World Health Organization 78, No. 2000


15 Melissa C. Daniels and Linda S. Adair, "Growth in young Filipino children predicts schooling trajectories through high school," The Journal of Nutrition, March 22, 2004,

Losses in Potential Productivity

Between 40 and 67 per cent of the working-age population in the four countries were stunted as children. Research shows that adults who suffer from stunting as children are less productive than non-stunted workers and are less able to contribute to the economy.18 The impact of this lowered productivity varies, depending on the labour structure of the country and the type of economic activity in which the individual is engaged. Stunted workers engaged in manual activities tend to have less lean body mass10 and are likely to be less productive in manual activities than those who were never affected by growth retardation.21

“For the average stunted worker, the loss in monthly income circumscribes their financial resources and personal/household capacity to purchase and consume adequate nutrients. Estimates from the longitudinal analysis illustrate that most individuals are not “high-income” earners and even small increases in earnings would significantly support their access to essential resources. Reducing stunting during childhood is projected to increase employees’ human capital, improve their employment opportunities, and stimulate economic activity within the private sector, as well as national/global economies.”

Akseer et al., Economic costs of childhood stunting to the private sector in low- and middle-income countries, The Lancet, 2022 (Impact Factor - 168.9 “Excellent”). 

Economic Impact of Child Malnutrition
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