Malnutrition among women of reproductive age is concentrated in fifteen countries. More than half of the annual (2019) 10,500 deaths from nutritional deficiencies among women aged 15 to 49 occur in just five countries including India, Pakistan, Bangladesh, Brazil, and Indonesia. Similarly more than half of the 204,000 obesity-related deaths among young women occur in a five countries including India, Indonesia, China, Pakistan, and Brazil.
India, Pakistan, Brazil, and Indonesia appear on both lists as they are part of a growing number of middle-income countries struggling with “double burdens” of malnutrition – high rates of undernutrition and obesity.
For example, in India an estimated 1,900 young women aged 15 to 49 die from nutritional deficiencies each year, while 35,000 die from obesity-related causes. In Pakistan, an estimated 1,600 young women die from undernutrition, while 10,000 die from obesity-related causes. In Brazil, 7,900 women die from obesity compared to 800 women from nutritional deficiencies. And in Indonesia, an estimated 500 young women die from undernutrition, while 20,000 die from obesity-related causes. As deaths from undernutrition fall in most countries, deaths from obesity are rising, often precipitously.
In addition to the risks of underweight and obesity, micronutrient deficiencies cause a large burden of disability, especially anemia, and related deaths. For example, in India, one-half of all women aged 15 to 49 (195 million) are anemic and almost half of all women enter pregnancy underweight, according to research by Diane Coffey. Many western and central African countries are also struggling with anemia prevalence rates of above 50%.
Iron deficiency is a risk factor in 42,000 deaths among women aged 15 to 49, with most deaths in India, Nigeria, Pakistan, the Democratic Republic of Congo, and Ethiopia. In many of these countries, anemia-related deaths among young women are not falling, including in India, Nigeria, Pakistan, and Ethiopia, according to the GBD.