By 2025, 43 million children under the age of five will be overweight

The skyrocketing prevalence of obesity is one of the most conspicuous differences between this report and the report from two decades ago. “[Overweightness] is sometimes seen as a problem only in wealthy countries, but it is striking just how much it now also affects low- and middle-income countries and how rapidly the problem is growing,” the report reads.

Brian Keeley, editor in chief of the report, stressed in a phone interview that this uptick should ring alarm bells for policymakers.

“There isn’t much of a track record of countries reversing overweight and obesity,” Keeley said. “You really need to be thinking about prevention if you’re going to deal with this problem. Turning it around is very difficult.”

The rise of overweightness has been well-documented in recent years. Earlier this month, the World Obesity Federation forecasted that 254 million children between the ages of 5 and 19 would be obese by 2030, up from 158 million currently. In September, public health nonprofit Trust for America’s Health reports that obesity has reached historic levels domestically, with nine states seeing adult obesity rates over 35 percent for the first time.

But even as we continue to spill ink over overconsumption, other forms of malnutrition remain a major dietary hurdle for children globally. The report uses a few key measures to illuminate its scope, including conditions known as stunting, wasting, and hidden hunger.

Stunting is a malnutrition issue indicated by below-average height and linked with poor development in the first three years of a child’s life, while wasting is indicated by a child’s relative thinness and is correlated with short-term hunger. The report estimates that 149 million children under the age of five experience stunting, and that 50 million experience wasting, with countries in south Asia and sub-Saharan Africa seeing the highest rates of both. The report also notes that regional averages are likely to obscure even higher rates of undernutrition among certain populations, including indigenous peoples, rural residents, and people living in poverty.

Hidden hunger refers to nutrient deficiencies that, unlike undernutrition, might not manifest through physical symptoms. The problem is primarily linked to diets with little diversity or that are calorie-heavy but lacking in nutrients, leading to low intake of vitamins and minerals. The report notes that it was likely a global issue, but declined to estimate its scope due to the challenge of measuring it on a large-scale.

The report encourages policymakers to increase investment in child and maternal nutrition, or risk failing to meet United Nations’ sustainable development goals—a set of global benchmarks relating to concerns including child nutrition. In 2015, the UN established targets of a 12.2 percent for stunting and 3 percent for wasting and overweightness. Given current projections, the report notes, member nations will almost definitely miss these objectives by their 2030 deadline.

UNICEF partially attributes these changes to the increased globalization of commerce. Multinational food companies have more geographic reach than ever before, it notes, both to sell its products and to advertise them.

“This reflects the reality that child nutrition goals may conflict with economic and political goals,” the report reads. “Modern and industrialized food systems offer production efficiency gains and year-round access to low-cost foods, but they are increasingly oriented toward producing animal feed, industrial inputs for processed foods, and biofuels rather than food for primary consumption. This has both dietary and environmental impacts.”

The report also underscores the impact that environmental degradation will have on child nutrition, from natural disasters increasing disease risks to industrial agriculture’s role in the reduction of biodiversity. Notably, “climate change” didn’t get a single mention in the 1998 UNICEF report on children and nutrition.

“Climate change, in 1998, was an emerging issue,” Keeley says. “It wasn’t something that people really had a grip on. Nowadays, we’re all very aware of … the impact that it’s having already on people’s lives and will have, especially on children, for the simple [reason] that they will be living longer in this climate-changed world than the rest of us.”

In addition, climate change is likely to make crops less nutritious, which can lead to measurable impacts on human health. Increased ocean acidification due to carbon emissions is also changing the way seafood tastes.

The report outlines a handful of potential policy solutions, including taxes on unhealthy foods and investments in sustainable farming practices. However, one of the most important changes to the food system may not involve food at all, but data.

Public health research and anti-hunger advocacy regarding child nutrition has traditionally focused on the first 1000 days of a child’s life, including time since conception. UNICEF wants national governments to collect and share long-term data about diets in order to understand how diet affects people throughout adolescence and into adulthood.

“We have very little data on children over five, we just don’t really understand the full extent of malnutrition,” Keeley says. “Governments, us, everyone is operating a little bit in the dark.”