United Nations System
Standing Committee on Nutrition

Thirtieth Session of the Standing Committee on Nutrition

Working Group on Nutrition Throughout the Life Cycle

Main Auditorium, IIT, Chennai, Wednesday 5 March 2003, 0900-1200 hours

Co-Chairs: Ricardo Uauy (UNU) and Ted Greiner (Sweden)

Agenda

Background:
The control and prevention of undernutrition is unfinished work in many countries. At the same time nutrition-related chronic diseases are now the main causes of disability and death, not only globally but also in many developing countries (World Health Report 2002). Nutrition problems of the elderly will also attain greater significance as population growth slows and populations age.

Undernutrition and deficiencies of certain micronutrients in young children have received much attention, and a few programs are aimed at school children, though in most of the world action for prevention of all forms of malnutrition in children has been inadequate. Undernutrition and deficiency diseases in other groups have received so little attention that we often do not know the magnitude of the problems. It is particularly crucial that more attention be given to nutrition problems among adolescent and adult women, not only because of their roles in reproduction, but also because of the limitations malnutrition places on their contributions to production, especially in low-income rural settings, and indeed in development as a whole.

Malnutrition early in life, followed by inappropriate diets and physical inactivity in childhood and adult life, increases vulnerability to chronic diseases. Changes in food systems and patterns of work and leisure, and therefore in diets and physical activity, are causing overweight, obesity, diabetes, high blood pressure, cardiovascular disease including stroke, and increasingly cancer, even in the poorest countries.

Evidence from many developing countries shows that undernutrition in children and nutrition-related adult chronic diseases prematurely disable or kill a large number of people, a preventable loss of precious human capital. Nutrition problems are exacerbated in countries where HIV/AIDS is a dominant problem. Nutrition-related chronic diseases are not diseases of affluence. In transitional economies and in industrialized countries they affect predominantly low socio economic groups who often consume energy-dense fat- and sugar-rich foods, and have limited access/time for recreation and physical activity.

The focus of public health nutritionists must consider the entire life course to avoid unjustifiably neglecting certain groups and certain nutrition problems. Preventing certain problems of undernutrition such as low birth weight may require generations. Life course prevention is also the only feasible approach to nutrition-related chronic diseases. The cost of treatment and management of nutrition problems imposes an intolerable economic burden on developing countries. There is an urgent need for governments, in partnership with all relevant constituencies, to integrate strategies to promote healthful diets and regular physical activity throughout life into all relevant policies and programmes including those designed to combat undernutrition.

There is increasing evidence that many nutrition-related risks begin in fetal life and continue into old age. Taking a life course perspective has great potential and several challenges. It is now generally accepted that the risk of many non-communicable diseases is not just determined by risk factors in mid-adult life, but begins in childhood or adolescence, and likely even earlier i.e. during fetal development. It is thus necessary to consider both ‘critical’ and ’sensitive’ periods throughout the life course where exposures determine increased susceptibility to malnutrition of the young and of adults. It is also necessary to recognize and include the relative role of, and interaction between, earlier and later influences on risk factors, as well as the environments in which populations live and which help to shape the total life experience of health.

Effective programmes and policies to address the double burden of disease (undernutrition and diet related chronic disease) throughout the life course will include not only health promotion and education but community empowerment and action to overcome the environmental, social, and economic constraints to improving dietary quality and maintaining a physically active life. Immediate action to control and prevent nutrition-related chronic diseases from conception throughout the life course [fetal, including maternal influence; infant and child; adolescence; adult; and, the elderly] is not only a public health imperative but also a political, economic, and social necessity. Successful programmes will be multidisciplinary and intersectoral, and may include as partners government, industry, the health professions, the media and other civil society groups as well as international agencies.

Purpose:
1. Share Information on latest scientific advances, programmes, country and regional experiences on how the lifecourse approach to nutrition and food problems is helping or may help to address the double burden of nutritional problems in developing and transitional countries.
2. Focus SCN attention on neglected portions of the life course and ways of addressing the special needs of each.
3. Contribute to harmonizing UN agencies, bilaterals and NGOs actions for effective actions to address undernutrition throughout life and the emerging global epidemic of nutrition-related chronic disease.
4. Identify critical issues and opportunities for SCN members’ involvement in policy, programs and strategies to address nutrition related disease with a life-course perspective
5. Advise the SCN Chair and Secretariat on international level actions using the life course approach to improve nutrition in developing and transitional countries.

Structure:
Organizing Group (T Greiner, P Puska, C Nishida, P Shetty, F Valente, M McLachlan, R Uauy)
Co-Chairs: R. Uauy (UNU) and T. Greiner (Sweden), appointed by the SCN for a two-year period.
Rapporteurs to be proposed and named at the time of the WG session

Proposed Work Plan:
Under discussion by SCN members and discussion by participants in the first WG session March 05