Many countries, including Ethiopia, experience perpetual food shortages and distribution problems leading to chronic and often widespread hunger amongst significant numbers of people.

The body's response to chronic hunger and malnutrition is a decrease in body size. As you will recall from an earlier study session, in small children this is known as stunting, or stunted growth, and is indicated by low weight for height. This process starts as the baby is growing in the uterus, if the mother is malnourished, and continues until approximately the third year of life. It leads to higher infant and child mortality, with rates increasing significantly during famines. Once stunting has occurred, improved nutritional intake later in life cannot reverse the damage. Stunting itself is viewed as a coping mechanism, designed to bring body size into alignment with the calories available during adulthood in the location where the child is born.

Limiting body size as a way of adapting to low levels of energy (calories) adversely affects health in many ways:

• Premature failure of vital organs occurs during adulthood. For example, a 50-year-old individual might die of heart problems because their heart suffered structural defects during early development
• Stunted individuals suffer a far higher rate of disease and illness than those who have not undergone stunting
• Severe malnutrition in early childhood often leads to defects in mental development
• Chronic food insecurity will lead to poor growth, slower development, low educability, school absenteeism or dropout, and increased morbidity and decreased survival impacting on the socioeconomic development through several generations.