Even small drops in national income can significantly increase the risk of various forms of childhood malnutrition- not only undernutrition but also overweight and obesity, shows a study led by the Barcelona Institute for Global Health (ISGlobal), an institution supported by "la Caixa" Foundation. The study, published in Lancet Global Health , identifies pregnancy and the first 1,000 days of life as especially vulnerable periods where targeted interventions can make a big difference.
One in four children worldwide lives in severe food poverty. And many low- and middle-income countries (LMICs) now face an increasing double burden of malnutrition, characterised by the coexistence of undernutrition alongside overweight or obesity.
"Given the multiple crises the world is currently facing, we need to better understand how economic shocks and poverty influence malnutrition in children, in order to better design interventions and prevention strategies," says Davide Rasella , ICREA researcher at ISGlobal and coordinator of the study.
A close look at economic downturns and child malnutrition
The authors analysed data from over 1.6 million children across 68 LMICs to understand how early exposure to economic downturns affects nutrition. They combined 230 national household surveys with economic data from the World Inequality Database. This allowed them to track each child from birth to the first 1,000 days of life, and to identify economic downturns across different income groups within each country.
"Our analysis is the first to account for economic heterogeneity within each country and look at critical time windows and different forms of malnutrition, including overweight and obesity," says Natanael Silva, predoctoral researcher at ISGlobal and first author of the study.
The first 1,000 days of life
The researchers used the child's height, weight and age to identify different forms of malnutrition, sometimes combined in the same child: stunting (too short for their age), wasting (too thin for their height), overweight and obesity.
The analysis revealed the following patterns:
A fall in income during the year a child was born raised the risk of stunting, especially when the economic drop was severe. Income shocks at birth were also associated with an increased risk of both wasting and stunting in the same child, suggesting that economic instability during pregnancy can have profound effects on early life.
Income shocks in the year of the interview were mainly associated with child wasting, defined as a rapid loss of weight, reflecting short-term changes in diet quality or quantity, as well as illnesses.
Children who experienced an economic shock during their first 1,000 days of life (a critical period for growth) had a much higher risk of becoming both stunted and overweight — a 30% increase in risk. Even mild economic downturns were linked to increased risks of this double burden of malnutrition.
Finally, the effects varied by income level: income shocks generally had a greater adverse impact on undernutrition among the poorest, while wealthier households also saw an increase in obesity and overweight.
"Our findings show that income shocks can significantly increase the risk of various forms of childhood malnutrition, and help identify critical windows for action," says Rasella . The authors urge policymakers to develop targeted interventions to safeguard maternal and child nutrition, especially during times of economic hardship.
