Spotlight on Global Malnutrition: A Continuing Challenge in the 21st Century.

Malnutrition as undernutrition, overnutrition, or an imbalance of specific nutrients, can be found in all countries and in both community and hospital settings around the world. The prevalence of malnutrition is unacceptably high in all settings and affects children, adolescents, pregnant women, and sick and older adults. Malnutrition has multiple underlying issues (food insecurity, chronic and acute illnesses, sanitation and safety, and aging in the community), which need to be addressed. At the same time, direct nutrition interventions (food supplements and micronutrient supplementation) help support immediate resolution of malnutrition. Awareness of malnutrition issues in the community and in clinical setting must be stimulated in order to provide better care. Different countries have implemented a wide range of interventions to prevent and treat malnutrition. These include nutrition education, engagement of the community, resolution of sanitation problems affecting food and water, routine screening and assessment and diagnosis of malnutrition (when feasible), and food supplements and micronutrients. Such programs are achieving improved outcomes; however, further engagement and training is needed for more community and clinical health workers. Many countries lack qualified nutrition and dietetics practitioners or have low dietitian-to-patient ratios with suboptimal salaries. Thus, an increase in number of and empowerment of nutrition and dietetics practitioners is desperately needed to help prevent and treat malnutrition globally.