COMCEC
Malnutrition in the OIC Member
Countries: A Trap for Poverty
Reduced Educational Attainment
Another longitudinal study by Daniels and Adair (2004) from the Philippines looked at the
relationship between childhood malnutrition and adverse educational outcomes. The authors
estimated the relationship between schooling outcomes of over 2000 children and their
height-for-age z score, while controlling for potential confounding factors such as household
assets and income. They found that a change from a stunting to a non-stunting status, holding
other factors constant, would decrease the likelihood that boys would enrol late in in school by
a factor of three (from 6% to 2%). Additionally, non-stunted boys were 7% less likely to repeat
a year of school and non-stunted girls were 9% less likely to repeat a year of school, compared
to their stunted counterparts (Daniels and Adair 2004).
In Egypt, using data on enrolment in 2009, as well as the prevalence of grade repetition and
the proportion of stunted children, it was estimated that 10% of all repetitions were associated
with stunting in 2009. These repetitions have direct cost implications for both the school
system, which must supply additional resources, as well as families who must pay for an
additional year of school (African Union Commission, NEPAD Planning and Coordinating
Agency, UNand Economic Commission for Africa, and UNWorld Food Programme. 2014).
Increased health care costs
Health risks for the poor are higher than those for the non-poor. But the specific role of
undernutrition in these risk patterns must be underscored, such as substandard housing, poor
sanitation services and reduced access to health care. There is an emerging body of evidence
indicating that individuals who do not receive adequate nutrition in the womb are at increased
risk for developing chronic diseases such as coronary heart disease later in life. The evidence
comes from a study of a cohort of individuals who were in utero during the Dutch famine. The
study found that these individuals suffered from impaired glucose tolerance, high blood
pressure, and obesity as a result of the changes their bodies undertook to adopt to poor
nutrition in utero. It is worth noting that these changes are not necessarily connected to the
size of the baby at birth (Roseboom et al. 2001). Indeed, even in the absence of large shocks,
such as a famine, children while in the womb can still be exposed to a number of subtle
stressors. These stressors will cause the child's body to adapt, a mechanism known as the
predictive adaptive response. This predictive adaptive response is based on the assumption
that the nutritional environment that the child will encounter after birth will be similar to that
experienced in the womb. However, this is often not the case. For example, in many countries,
children who suffered from under-nutrition in utero experience increased calorie consumption
in later years, notably because of the rise of processed foods. This discrepancy between the
expected and the actual nutritional environment can predispose the child to increased risk of
chronic disease (Uauy, Kain, and Corvalan 2011).
Overnutrition, including overweight, obesity and associated non-communicable diseases
(NCD), are also leading to increased health care costs and are of increasing concern in low and
middle income countries. It is estimated that 80% of worldwide deaths due to NCDs occur in
low and middle income countries, a number which is expected to rise in the coming decades
(Uauy, Kain, and Corvalan 2011).
Six of the top eleven causes of the global disease burden are related to diet, with dietary risk,
high systolic blood pressure and maternal and child malnutrition topping the list (Global Panel
on Agriculture and Food Systems for Nutrition. 2016). A recent simulation of a variety of
measures to improve diets and increase physical activity in low and middle income contexts
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