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The Changing Landscape of Children’s Diet and Nutrition: New Threats, New Opportunities

Background: Over the last 30–40 years, we have seen an improvement in global child undernutrition, with major reductions in wasting and stunting. Meanwhile, childhood obesity has dramatically increased, initially in high-income populations and subsequently in the more economically vulnerable. These trends are related to significant changes in diet and external factors, including new environmental threats. Summary: Obesity rates first increased in older children, then gradually in infants. And in the next couple of years, there will be more overweight and obese than moderately or severely underweight children in the world. The changes in childhood nutritional landscape are a result of poor diets. Today, almost 50% of the world’s population consumes either too many or too few calories. Dietary disparities between countries result in disparities of under- and overnutrition and impact the global health landscape. Most children with obesity, wasting, and micronutrient deficiencies live in lower income countries and in lower income families within any country. High energy-low nutrient diets are contributing to the increase in non-communicable diseases, which will manifest later in this generation of children. In 1990, child wasting was the #1 leading risk factor for mortality for all ages, and high BMI was #16; today, they are #11 and #5, respectively. COVID-19 and climate change are new major threats to global nutrition. Current and future efforts to improve the state of child nutrition require multisectoral approaches to reprioritize actions which address current trends and emerging threats.