The Double Burden of Malnutrition in Countries Passing through the Economic Transition

Abstract

Undernutrition in both its acute and chronic forms (wasting and stunting) is strongly inversely correlated with the wealth of nations. Consequently, as many low- and middle-income countries (LMICs) achieve economic advancement and pass through the so-called “nutrition transition,” their rates of undernutrition decline. Many countries successfully achieved the Millennium Development Goal of halving undernutrition and whole continents have been transformed in recent decades. The exception is Africa where the slower rates of decline in the prevalence of undernutrition has been overtaken by population growth so that the absolute number of stunted children is rising. In many regions, economic transition is causing a rapid increase in the number of overweight and obese people. The rapidity of this rise is such that many nations bear the simultaneous burdens of under- and overnutrition; termed the “double burden” of malnutrition. This double burden, accompanied as it is by the unfinished agenda of high levels of infectious diseases, is crippling the health systems of many LMICs and thus requires urgent attention. Although the prognosis looks threatening for many poor countries, they have the advantage of being able to learn from the mistakes made by other nations that have passed through the transition before them. Concerted action across many arms of government would achieve huge future dividends in health and wealth for any nations that can grasp the challenge.

Artificial Intelligence-Enabled Predictive Insights for Ameliorating Global Malnutrition: A Human-Centric AI-Thinking Approach

“…In the context of a changing global nutrition landscape influenced by globalization, demographic shifts and income growth, diet-related epidemiology has seen a significant shift in recent decades. The double burden of malnutrition now facing many countries worldwide is characterized by the coexistence of undernutrition along with overweight, obesity or diet-related noncommunicable diseases [1,2]. In many countries, these different types of malnutrition co-exist at the national and household levels and across the life course.…”

“…The developmental, economic, social and medical impacts of this global burden of malnutrition are serious and lasting for individuals, their families, and countries. Today, nearly one in three persons globally suffer from at least one form of malnutrition: wasting, stunting, vitamin and mineral deficiency, overweight or obesity and diet-related non communicable diseases [1][2][3]. Nutrition-related factors contribute to approximately 45% of deaths in children aged under 5 years (mainly due to undernutrition), while low-and middle-income countries are now witnessing a simultaneous rise in childhood overweight and obesity [4][5][6].…”

Staple Crops Biofortification Linking Agriculture, Food and Nutrition towards Eliminating Hidden Hunger

“…Undernutrition, overweight, obesity and nutritional non-communicable diseases throughout the life course, coexisting in different countries, communities and household presents malnutrition double burden challenges [20,21]. For instant, Dietz [21], writes: 'increased use of processed complementary food for children could provide calories without micronutrients, and thereby increase the likelihood of obesity, undernutrition, and stunting and obesity in the same children.'…”

Body mass index and movement behaviors among schoolchildren from 13 countries across a continuum of human development indices: A multinational cross‐sectional study

“…Although evidence from high‐income countries suggests that there may be a plateau (Carsley et al, ; Cheung, Cunningham, Narayan, & Kramer, ; Rokholm, Baker, & Sørensen, ), prevalences of childhood obesity remain high in many countries (Rokholm et al, ). In low‐ and middle‐income countries (LMICs), where underweight/thinness still persists (Abrahams, McHiza, & Steyn, ; Prentice, ), childhood obesity is reported to be rapidly increasing (Lobstein et al, ; Tzioumis & Adair, ), creating a double burden of malnutrition (Black et al, ; Prentice, ). Meanwhile, rapid urbanization and the accompanying rural‐urban migration (Day, ; S. W. Ng, Howard, Wang, Su, & Zhang, ) may be exacerbating the physical activity transition (Katzmarzyk & Mason, ) (ie, a change from high physical activity lifestyles to more sedentary and less active lifestyles over time), due to the decrease in utilitarian/chore‐based physical activity.…”

“…Although evidence from highincome countries suggests that there may be a plateau (Carsley et al, 2019;Cheung, Cunningham, Narayan, & Kramer, 2016;Rokholm, Baker, & Sørensen, 2010), prevalences of childhood obesity remain high in many countries (Rokholm et al, 2010). In low-and middle-income countries (LMICs), where underweight/thinness still persists (Abrahams, McHiza, & Steyn, 2011;Prentice, 2018), childhood obesity is reported to be rapidly increasing (Lobstein et al, 2015;Tzioumis & Adair, 2014), creating a double burden of malnutrition (Black et al, 2013;Prentice, 2018). Meanwhile, rapid urbanization and the accompanying rural-urban migration (Day, 2018;S.…”