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United States of America
The burden of malnutrition at a glance
The United States is 'on course' to meet three of the global nutrition targets for which there was sufficient data to assess progress.
The United States is 'on course' to meet three targets for maternal, infant and young child nutrition (MIYCN). No progress has been made towards achieving the target of reducing anaemia among women of reproductive age, with 11.8% of women aged 15 to 49 years now affected. Meanwhile, there has also been no progress towards achieving the low birth weight target, with 8.0% of infants having a low weight at birth. Some progress has been made towards achieving the exclusive breastfeeding target, with 34.7% of infants aged 0 to 5 months exclusively breastfed. The United States is 'on course' to meet the target for stunting, with 3.4% of children under 5 years of age affected. The United States is also 'on course' for the target for wasting, with 0.1% of children under 5 years of age affected, which is lower than the average for the North America region (0.2%). The prevalence of overweight children under 5 years of age is 9.4% and the United States is 'on course' to prevent the figure from increasing.
The United States has shown limited progress towards achieving the diet-related non-communicable disease (NCD) targets. The country has shown no progress towards achieving the target for obesity, with an estimated 40.2% of adult (aged 18 years and over) women and 39.0% of adult men living with obesity. The United States' obesity prevalence is higher than the regional average of 39.4% for women and 38.3% for men. At the same time, diabetes is estimated to affect 6.9% of adult women and 8.9% of adult men.
Progress towards the global nutrition targets
Childhood stuntingOn course
AnaemiaNo progress or worsening
Low birth weightNo progress or worsening
Childhood overweightOn course
Exclusive breastfeedingSome progress
Childhood wastingOn course
Sodium intake, women and menOff course
Raised blood pressure, womenOff course
Raised blood pressure, menOff course
Obesity, womenOff course
Obesity, menOff course
Diabetes, womenOff course
Diabetes, menOff course
Source: WHO. Global Health Observatory Data Repository/World Health Statistics. Available at: https://www.who.int/data/gho/data/indicators. Accessed 2 September 2021; UNICEF/WHO. Low birthweight estimates; published online 2019. Available at: https://data.unicef.org/topic/nutrition/low-birthweight. Accessed 24 August 2021; UNICEF. Global databases: Infant and young child feeding; published online July 2020. Available at: http://data.unicef.org/nutrition/iycf. Accessed 24 August 2021; UNICEF/WHO/World Bank. Joint Child Malnutrition Estimates Expanded Database: Stunting, Wasting and Overweight; published online July 2020. Available at: https://data.unicef.org/resources/dataset/malnutrition-data. Accessed 31 August 2021; NCD Risk Factor Collaboration. 2017. Available at: http://ncdrisc.org/data-downloads.html. Accessed 24 August 2021; Tufts University. Global Dietary Database; published online 2019. Available at: https://www.globaldietarydatabase.org/data-download. Accessed 6 September 2021.
Notes: Progress towards the maternal, infant and young child nutrition (MIYCN) and diet-related non-communicable disease (NCD) global nutrition targets is classified as ‘on course’ if the target is met, ‘some progress' or ‘no progress or worsening’. MIYCN targets include anaemia among women of reproductive age (15–49 years), infants with low birthweight, exclusive breastfeeding among infants under 6 months of age, and childhood stunting, wasting and overweight. NCD targets include adult obesity and diabetes, raised blood pressure and sodium intake. Obesity and diabetes are based on age-standardised modelled estimates for adults aged 18 years and older, using the WHO standard population; they are reported by sex due to limitations in data availability. Anaemia and low birthweight are also based on modelled estimates. The specific targets set are: 40% reduction in the number of children under 5 years of age who are stunted; 50% reduction of anaemia in women of reproductive age; 30% reduction in low birth weight; no increase in childhood overweight; increase the rate of exclusive breastfeeding in the first 6 months to at least 50%; reduce and maintain childhood wasting to less than 5%; 30% relative reduction in the mean population intake of salt/sodium by 2025; 25% relative reduction in the prevalence of raised blood pressure or contain the prevalence of raised blood pressure, according to national circumstances; and halt the rise in obesity and diabetes. The methodologies for tracking progress differ across targets. See Methodology for more information on the indicators.
Infant and young child feeding
Prevalence of infant and young child feeding indicators
Source: UNICEF. Global databases: Infant and young child feeding. Published online July 2020. Available at: http://data.unicef.org/nutrition/iycf. Accessed 24 August 2021.
Notes: Prevalence (%) estimates are presented for infants and young children aged 0–23 months (age varies by indicator). Location is classified as ‘urban’ or ‘rural’ (as defined in the survey). Education refers to the educational level of the mother and is classified as ‘none or primary’ or ‘secondary or higher’. Wealth is asset-based wealth scores at the household level, classified as quintiles: ‘lowest’, ‘second lowest’, ‘middle’, ‘second highest’ and ‘highest’. See Methodology for more information on the indicators.
Dietary intakes of key foods and nutrients in adults aged 20 years and over compared against minimum and maximum targets
Source: Tufts University. Global Dietary Database. Published online 2019. Available at: https://www.globaldietarydatabase.org/data-download. Accessed 6 September 2021.
Notes: Intakes are reported in grams per day (g/d) for all dietary factors. Intakes are based on modelled estimates for adults aged 25 years and older. The dietary factors have been selected as those diet components that have a statistically significant relationship with at least one disease endpoint that can be generalisable to all populations. Recommended intake targets were determined by the EAT-Lancet Commission on healthy diets from sustainable food systems. This includes minimum recommended intakes of health promoting food groups (fruits, vegetables, legumes, nuts and wholegrains) and maximum recommended intakes of food groups with detrimental health and/or environmental impacts (red meat, dairy, and fish). Ideal intake for each food is within the shaded area of the graph.
Nutrition strategies and financing
National nutrition policies
Implemented national food and NCD policies
- Food-based dietary guidelines
- Legislation for mandatory salt iodisation
- Sugar-sweetened beverage tax
- Policy to reduce salt/sodium consumption
- Policy to limit saturated fatty acid intake
- Policy to eliminate industrially produced trans fatty acids
- Policy to reduce the impact of marketing of foods and beverages high in saturated fats, trans fatty acids, free sugars, or salt on children
- Operational policy, strategy, or action plan to reduce unhealthy diet related to non-communicable diseases
- Operational, multisectoral policy, strategy or action plan for non-communicable diseases
- Operational policy, strategy or action plan for diabetes
Source: Global Fortification Data Exchange. Available at: https://fortificationdata.org/interactive-map-fortification-legislation. Accessed 31 August 2021; Global Fortification Data Exchange. Available at: https://fortificationdata.org/interactive-map-fortification-legislation. Accessed 24 August 2021; WHO. Global Health Observatory Data Repository. Available at: https://www.who.int/data/gho/data/indicators. Accessed 2 September 2021.
Notes: Country with food-based dietary guidelines in 2018, sugar-sweetened beverage tax in 2017 and all other policies in 2019. 'Policy' is defined as a specific official decision or set of decisions designed to carry out a course of action endorsed by a political body, including a set of goals, priorities and main directions for attaining these goals, including legislation and product reformulation mandates. 'Strategy' is defined as a long-term plan designed to achieve a particular goal. Action plan is defined as a scheme or course of action, which may correspond to a policy or strategy, with defined activities indicating who does what, when, how and with what resources to accomplish an objective. ‘Operational’ describes a policy, strategy or plan of action being used and implemented in the country, with resources and funding available to implement it. ‘Multisectoral’ applies to a policy, strategy or plan of action that involves different sectors (e.g., health, agriculture, education, finance). See Methodology for more information on the indicators.
National policy targets
Inclusion of targets related to the global nutrition targets in national policies
- Reduce anaemia among women
- Reduce number of infants born with low birth weight
- Increase prevalence of exclusive breastfeeding in infants 0–5 months
- Reduce childhood stunting
- Reduce childhood wasting
- Reduce childhood overweight
- Reduce adolescent and adult overweight
- Reduce salt/sodium intake
- Reduce raised blood pressure prevalence
- Reduce blood sugar levels/diabetes prevalence
- Multisectoral comprehensive nutrition plan
Source: WHO GINA. 2nd Global Nutrition Policy Review. 2016–2017.
Notes: Target included in national policies in 2017. Any national government-implemented policy, strategy or plan relevant to improving nutrition and promoting healthy diet was considered for 194 countries. Legislation, codes, regulations, protocols and guidelines, as well as non-governmental policies, were excluded. See Methodology for more information on the indicators.
Nutrition intervention coverage
Population coverage of key supplementation and fortification interventions
|Coverage/practice indicator||Total (%)||Boy (%)||Girl (%)||Year|
|Children aged 0–59 months with diarrhoea in the past two weeks preceding the survey who received zinc treatment||No data||No data||No data||No data|
|Children aged 6–59 months who received two high-dose vitamin A supplements in a calendar year||No data||No data||No data||No data|
|Children aged 6–59 months given iron supplements in the seven days preceding the survey||No data||No data||No data||No data|
|Women with a live birth in the five years preceding the survey who received iron tablets or syrup during antenatal care||No data||NA||NA||No data|
|Households consuming any iodised salt||No data||NA||NA||No data|
Source: UNICEF. Global databases: Child health. Published online August 2020. Available at: https://data.unicef.org/topic/child-health/diarrhoeal-disease. Accessed 24 August 2021; UNICEF. Global databases: Child health. Published online March 2020. Available at: https://data.unicef.org/resources/dataset/vitamin-supplementation. Accessed 31 August 2021; STATcompiler. The DHS Program. Available at: www.statcompiler.com. Accessed 31 August 2021; UNICEF. Global databases: Iodized salt. Published online June 2019. Available at: https://data.unicef.org/topic/nutrition/iodine. Accessed 24 August 2021.
Notes: Estimates are reported as percentages (%). See Methodology for more information on the indicators.
Official development assistance (ODA)
Allocation of ODA for nutrition
Source: Global Nutrition Report based on OECD DAC CRS. 2019.
Notes: Gross official development assistance (ODA) received or disbursed for basic nutrition (CRS code: 12240) reported in US$ millions (constant 2018 prices) and as percentage (%) of the total ODA received/disbursed. Estimates include ODA grants and loans, but excludes other official flows and private grants. See Methodology for more information on the indicators.
Environmental impacts of the food system
Pressure from the food system on environmental factors as a percentage of total pressure
Source: New analysis based on estimates of food demand from the Food and Agriculture Organization (FAO) (FAO. Food Balance Sheets: A Handbook. Rome, Italy: FAO, 2001) and a database of country- and food group-specific environmental footprints (Springmann et al. Nature 2018; 562: 519–25; Poore & Nemecek. Science 2018; 360: 987–92).
Notes: Data on food demand for each country from FAO was paired with a comprehensive database of environmental footprints, differentiated by country, food group, and environmental impact. The footprints take into account all food production, including inputs such as fertilisers and feed, transport, and processing, e.g., of oil seeds to oils and sugar crops to sugars. The displayed total pressure is in the units stated for each environamental domain and has been rounded to the nearest 10 units.
Food system impact on planetary boundaries
Source: New analysis based on estimates of food demand from the Food and Agriculture Organization (FAO) (FAO. Food Balance Sheets: A Handbook. Rome, Italy: FAO, 2001) and a database of country- and food group-specific environmental footprints (Springmann et al. Nature 2018; 562: 519–25; Poore & Nemecek. Science 2018; 360: 987–92). The target values for sustainable food production are in line with Sustainable Development Goals specified by and adapted from the EAT-Lancet Commission (Willett et al.The Lancet 2019; 393: 447–92.; Springmann et al. The British Medical Journal 2020; 370: 2322).
Notes: Planetary boundaries define the threshold related to global environmental processes beyond which humanity should not go. Planetary boundaries align with the targets for sustainable food production as set out by the Sustainable Development Goals. If impacts exceed 100% of the planetary boundary, the dietary pattern of that particular country can be considered unsustainable in light of global environmental targets, and disproportionate in the context of an equitable distribution of environmental resources and mitigation efforts.