The Rise and Fall of Protein Malnutrition in Global Health

Ann Nutr Metab. 2016;69(2):79-88. doi: 10.1159/000449175. Epub 2016 Aug 30.


Background: From the 1950s to the mid-1970s, United Nations (UN) agencies were focused on protein malnutrition as the major worldwide nutritional problem. The goal of this review is to examine this era of protein malnutrition, the reasons for its demise, and the aftermath.

Summary: The UN Protein Advisory Group was established in 1955. International conferences were largely concerned about protein malnutrition in children. By the early 1970s, UN agencies were ringing the alarm about a 'protein gap'. In The Lancet in 1974, Donald McLaren branded these efforts as 'The Great Protein Fiasco', declaring that the 'protein gap' was a fallacy. The following year, John Waterlow, the scientist who led most of the efforts on protein malnutrition, admitted that a 'protein gap' did not exist and that young children in developing countries only needed sufficient energy intake. The emphasis on protein malnutrition waned. It is recently apparent that quality protein and essential amino acids are missing in the diet and may have adverse consequences for child growth and the reduction of child stunting. Key Messages: It may be time to re-include protein and return protein malnutrition in the global health agenda using a balanced approach that includes all protective nutrients.

Publication types

  • Review

MeSH terms

  • Adult
  • Amino Acids, Essential / deficiency
  • Amino Acids, Essential / therapeutic use
  • Child
  • Child Nutritional Physiological Phenomena*
  • Developing Countries
  • Diet, Healthy
  • Diet, Protein-Restricted / adverse effects*
  • Female
  • Global Health*
  • Health Transition*
  • Humans
  • Infant
  • Kwashiorkor / diet therapy
  • Kwashiorkor / epidemiology
  • Kwashiorkor / etiology
  • Kwashiorkor / prevention & control
  • Male
  • Malnutrition / diet therapy
  • Malnutrition / epidemiology
  • Malnutrition / etiology
  • Malnutrition / prevention & control
  • Maternal Nutritional Physiological Phenomena*
  • Nutritional Requirements
  • Pregnancy
  • Protein-Energy Malnutrition / diet therapy
  • Protein-Energy Malnutrition / epidemiology
  • Protein-Energy Malnutrition / etiology*
  • Protein-Energy Malnutrition / prevention & control
  • United Nations


  • Amino Acids, Essential