Global Nutrition Report 2015: Stunting, Obesity, Diabetes trends

By Esther Nakkazi

New information on the global nutrition status has been released in the Global Nutrition Report 2015 which is a report card on the world’s nutrition—globally, regionally, and country by country—and on efforts to improve it.

The Global Nutrition Report is an annual report that assesses progress in improving nutrition outcomes and identifies actions to accelerate progress and strengthen accountability in nutrition. It was called for at the Nutrition for Growth (N4G) Summit, held in London in 2013 and hosted by the Governments of Brazil and the United Kingdom.

The call came on the basis that strong accountability enhances the enabling political environment for nutrition action by giving all stakeholders—existing and new—more confidence that their actions will have an impact, that bottlenecks to progress will be identified and overcome, and that suc- cesses will spread inspiration. The Global Nutrition Report series is thus designed to be an intervention in the ongoing discourses in and governance of global nutrition.

The 2015 report shows countries' progress in improving the nutrition status of their populations and assesses their progress in meeting the targets for reducing undernutrition by 2025, set by the World Health Assembly (WHA) in 2012.

For the first time, the report takes a closer look at how countries are faring in combating overweight, obesity, and noncommunicable diseases. In 2013 the WHA adopted the Non-Communicable Disease (NCD) Monitoring Framework, which monitors nine voluntary global targets for 2025. 

One of these targets is “Halt the rise in diabetes and obesity,” and this year the report uses global and national World Health Organization (WHO) data on adult overweight, obesity, and diabetes to track progress in attaining this target.

For the World Health Assembly nutrition indicators of stunting, wasting, and overweight in children under age 5, the trends in the number of countries meeting global targets are positive, especially for stunting.

• For stunting, 39 of 114 countries with data are on course to meet the global target, compared with 24 in 2014. In 2015, 60 countries are off course but making some progress. The number of countries making no progress on stunting in 2015 is 15, compared with 19 in 2014. 
• For wasting, 67 of 130 countries with data are on course (defined as < 5 percent prev- alence). For countries in both the 2014 and 2015 datasets, the number of countries on course has increased from 59 to 63 and the number off course has declined from 64 to 60. 
• Only 1 country—Kenya—is on course for all five WHA undernutrition targets. Four coun- tries (Colombia, Ghana, Vanuatu, and Viet Nam) are on course for four targets. But only 4 countries are not on course for any target. Seventy-four countries have the required data to make an assessment on their progress on five WHA undernutrition indicators. 
• Less than half of children under age 5 avoid stunting or wasting in five large low-income countries: Bangladesh, Democratic Republic of the Congo, Ethiopia, Nigeria, and Pakistan. 
• Nearly all states in India showed significant declines in child stunting between 2006 and 2014. However, three states with very high rates in 2006—Bihar, Jharkhand, and Uttar Pradesh—showed some of the slowest declines. Changes in wasting rates are more variable across states. 
• For under-5 overweight rates, 24 of 109 countries with data are off course and making no progress toward meeting the WHA target. Thirty-nine are on course and making good progress (compared with 31 in 2014), 24 are on course but at risk of losing that status, and 22 are off course but making some progress. 
• For exclusive breastfeeding, 32 of 78 countries with data are on course, 10 are off course but making some progress, 30 are off course and making no progress, while 6 are off course and show large reversals in rates (Cuba, Egypt, Kyrgyzstan, Mongolia, Nepal, and Turkey). New data from India show that exclusive breastfeeding rates have nearly dou- bled in the past eight years. 
• In 2015, 151 new data points were added to the database on the five undernutrition WHA indicators. The percentage of data points for the 193 countries on the four WHA nutrition indicators (stunting, wasting, overweight, and anemia) increased from 71 percent in 2014 to 74 percent in 2015. Only 9 of these 151 were from OECD countries (Australia, Chile, and Japan). 
• For adult overweight, obesity, and diabetes, very few countries are on course to meet global targets. 
• All 193 countries are off course for the WHA target of no increase in adult overweight and obesity (body mass index ≥ 25); in fact, rates increased in every country between 2010 and 2014. Countries’ rates of increase range from 0.2 to 4.3 percent and average 2.3 percent globally. Country progress varies across regions. 
• Only 1 country out of 193—Nauru—achieved even a small decline in adult obesity (BMI ≥ 30) between 2010 and 2014; prevalence for men there fell from 39.9 to 39.7 percent. The mean population-weighted age-standardized global prevalence of obesity is 15 per- cent among women and 10 percent among men. 
• Only 5 of 193 countries (Djibouti, Iceland, Malta, Nauru, and Venezuela) have halted the rise of the diabetes indicator (raised blood glucose). 
• One hundred and eighty-five countries are off course on all three adult indicators: over- weight and obesity, obesity only, and diabetes. 
• The proposed 2030 WHA nutrition targets from WHO represent a useful basis on which to establish a broader consensus on these targets.