North Korea is heading for a new food crisis with drought and floods in various parts of the country exacerbated by cuts in international aid, the United Nations said.
UN chief Ban Ki-moon expressed concern in a grim report to be discussed today "that the acute humanitarian needs" of at least 3.5 million women and children in the isolated nation would worsen.
But despite the looming disaster South Korea said it had no immediate plans to resume large-scale food aid, stressing the importance of an improvement in icy inter-Korean relations.
Mr Ban said in the report that "the global economic crisis is further increasing the levels of hardship" in the isolated nation, adding to "chronic food insecurity".
North Korea, which suffered a devastating famine in the 1990s in which several hundred thousand people died, is heading towards its notoriously long and biting winter.
There has been a shortage of rainfall in some parts of the isolated nation but in August torrential downpours caused floods in the north near the Chinese border.
The United Nations predicted that the cereal yield would be nearly a fifth lower than in 2009.
It said the country needs 3.5 million tons of cereals a year to feed its population and would have to import 1.1m tons.
In addition, UN agencies had raised only 20 per cent of the 492 million dollars they estimated in 2009 would be needed for the North.
Ban quoted the UN Children's Fund (UNICEF) as saying that each year 40,000 children under five become "acutely malnourished" in North Korea, with 25,000 needing hospital treatment.
"The lack of maintenance of water and sanitation systems increases rates of diarrhoea and acute respiratory infections, which are leading causes of child death.
"In addition, one third of women of childbearing age suffer from anaemia, a nutrition deficiency that is also a major cause of maternal mortality."
The poor diet across the country leads to widespread "infectious diseases, physical and mental development disorders, poor labour productivity and an increased risk of premature death," said the report.
A survey carried out by the government with UN support showed that about one third of the population suffer from stunting - below normal body growth. In some regions the figure was 45 per cent.
But South Korean Unification Ministry spokeswoman Lee Jong-Joo said that "in order for the massive government food aid to be resumed, overall inter-Korean relations must be taken into account".
She stressed, however, that Seoul allows smaller-scale "humanitarian aid" to the North.
The UN report was intended to focus on human rights in North Korea. The UN chief said there was an "urgent need" for Kim Jong-Il's regime to take steps to provide the basic right to food, water, sanitation and health.
The UN reported little change in the "comprehensive restrictions" on freedom of speech, religion and opinion in the tightly policed state. "The government's control over the flow of information is strict and pervasive."
Ban highlighted the difficulty in getting reliable information on events in the North.
But he said: "There are a number of reports concerning public executions, the use of torture, forced labour and the ill-treatment of refugees or asylum-seekers repatriated from abroad."
With the North embroiled in a dispute with South Korea over the sinking of a warship and in a nuclear arms standoff with the international community, Ban said humanitarian aid should not be restricted "on the basis of political and security concerns."
Seoul used to ship 400,000 tons of rice a year plus 300,000 tons of fertiliser to its northern neighbor.
But the shipments ended in 2008 as the South's conservative government adopted a tougher stance towards Pyongyang, linking them to progress in multinational talks aimed at persuading the North to give up nuclear weapons.
