According to the Lance, more than one in three low- and middle-income countries face both extremes of malnutrition with twin presence of obesity and undernutrition reflects shifts in food systems.
Undernutrition and obesity can lead to effects across generations as both maternal undernutrition and obesity are associated with poor health in offspring. However, because of the speed of change in food systems, more people are being exposed to both forms of malnutrition at different points in their lifetimes, which further increases harmful health effects.
Lead author of the report Dr Francesco Branca, Director of the Department of Nutrition for Health and Development, World Health Organization said “We are facing a new nutrition reality, We can no longer characterize countries as low-income and undernourished, or high-income and only concerned with obesity.”
“All forms of malnutrition have a common denominator – food systems that fail to provide all people with healthy, safe, affordable, and sustainable diets. Changing this will require action across food systems – from production and processing, through trade and distribution, pricing, marketing, and labelling, to consumption and waste. All relevant policies and investments must be radically re-examined.”
Indonesia is the largest country with a severe double burden of malnutrition. The researchers say changes to the food system have increased availability of ultra-processed foods that are linked to increased weight gain, while also adversely affecting infant and pre-schooler diets. In Australia and other high income countries, the researchers highlight First Nation, Indigenous, and ethnic minority populations as having higher levels of childhood undernutrition than the general population, but also increased risk of obesity.
Globally, estimates suggest that almost 2.3 billion children and adults are overweight, and more than 150 million children are stunted. However, in low- and middle-income countries these emerging issues overlap in individuals, families, communities and countries. The new report explores the trends behind this intersection – known as the double burden of malnutrition – as well as the societal and food system changes that may be causing it, its biological explanation and effects, and policy measures that may help address malnutrition in all its forms.