This book is the first comprehensive assessment of nutrition in Asia, a region that has the largest concentration of global malnutrition. It reviews a wide array of nutrition-relevant trends, policies, programmes, challenges and opportunities in Asia. The simple fact that every third child born is malnourished at birth represents an enormous drain on human and economic development. The pay-off to turning this tide is both immense and immeasurable. In the long-term, sustainable poverty-reducing economic growth will simply not be possible without dealing with malnutrition. This book describes the main driving forces behind the groundswell of under nutrition. It sheds light on the emerging "double burden" of co-existing underweight and overweight and the linkages between these two different forms of malnutrition.

During the last three years, progress at reducing undernourishment has slowed tremendously in Asia and the Pacific. After years of gains in combatting hunger, progress has stagnated in all parts of this vast region. Despite decades of economic growth, nearly half a billion people remain undernourished. Children, in particular, continue to face the burden of malnutrition – this region is home to more than half of the world’s malnourished children – with one child in every four below the age of five suffering from stunting. This is a colossal human loss, given the association between undernutrition and poor cognitive development, with severe lifelong consequences for these children. At the same time, and almost paradoxically, Asia and the Pacific has witnessed rapid growth in the number of overweight children and the serious consequences that entails for their future health and well-being. This double burden of malnutrition sees undernourished and overweight children living in the same communities and households and it can even occur within the same child. Efforts to fight hunger and malnutrition must go hand in hand with those to build and sustain peace and there is an urgent need to accelerate and scale up actions that strengthen resilience and adaptive capacity of people and their livelihoods to climate variability and extremes. As migration from rural to urban areas continues apace, particularly involving poorer families, urban malnutrition is another challenge facing many countries. In summary, what is becoming increasingly clear is that the world cannot meet the 2030 target of zero hunger if Asia and the Pacific – the world’s most populous region – is not leading the way. It is a hard reality but one that must be faced with a united determination to turn things around. For the first time, four UN agencies have come together to jointly assess the state of food security and nutrition in Asia and the Pacific. Together, we hope that the findings of this report will contribute to a more informed dialogue. Without doubt, all stakeholders must make much greater efforts to accelerate progress toward the goals of a healthy and hunger-free Asia and the Pacific. Action is needed now. The sense of urgency cannot be overstated.

This book is the first comprehensive assessment of nutrition in Asia, a region that has the largest concentration of global malnutrition. It reviews a wide array of nutrition-relevant trends, policies, programmes, challenges and opportunities in Asia.

Global trends indicate that overlapping burdens of undernutrition and overnutrition-the double burden of malnutrition (DBM)-are the new normal (IFPRI 2014); indeed, most East Asia and Pacific (EAP) countries now have a DBM problem. This report explores the nature of nutrition problems affecting EAP countries to understand the sectoral and system-wide actions necessary for a coordinated approach to improving nutrition. The report (i) synthesizes evidence related to the burden of malnutrition in EAP, (ii) identifies the rationale for a multisectoral approach to DBM practitioners working across sectors in EAP, and (iii) provides an overview of the types of actions and interventions needed to address the DBM in a coordinated fashion across the life course. Actions across health and nonhealth sectors-ranging from implementation of national-level policy measures and complemented by interventions at the community and individual levels to support behavior change-are needed to prevent escalation of overweight and obesity. Among sectoral priority actions, the health sector plays an important role in monitoring health and nutrition outcomes, preventing and treating infectious and noncommunicable diseases associated with malnutrition, and providing interventions that affect individuals' nutrient intakes. Similarly, nonhealth sectors have expertise and resources to deliver interventions related to the underlying causes of malnutrition. Further, systems-strengthening efforts are needed to support an environment that addresses the DBM across the life course, including increasing DBM-sensitivity of policy frameworks; leadership, coordination, and accountability; workforce capacity; and knowledge and evidence. Reducing the DBM is fundamental to sustainable development in EAP. EAP countries must shift from dichotomized policies addressing either undernutrition or overnutrition and develop coherent frameworks to address malnutrition in all forms for all life stages. Integrated preventive and curative interventions for undernutrition and overnutrition-implemented across the life course by multiple sectors-can forestall massive economic and human development consequences for future generations.

New evidence this year corroborates the rise in world hunger observed in this report last year, sending a warning that more action is needed if we aspire to end world hunger and malnutrition in all its forms by 2030. Updated estimates show the number of people who suffer from hunger has been growing over the past three years, returning to prevailing levels from almost a decade ago. Although progress continues to be made in reducing child stunting, over 22 percent of children under five years of age are still affected. Other forms of malnutrition are also growing: adult obesity continues to increase in countries irrespective of their income levels, and many countries are coping with multiple forms of malnutrition at the same time – overweight and obesity, as well as anaemia in women, and child stunting and wasting.