Poor countries are now facing a severe double burden of both undernutrition and overweight and obesity, according to a new report.
A series of research papers published in The Lancet journal show levels of this double burden of malnutrition (DBM) have shifted to countries in the poorest income quartile, whereas the malnutrition in the form of obesity had typically been seen in higher income brackets.
The changes are a reflection of a shifting global food system that makes less nutritious food cheaper and more accessible, as well as a decrease in physical activity, the researchers say.
The DBM is most prevalent in south Asian and sub-Saharan African countries, east Asia and the Pacific.
According to the World Health Organization: “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.”
Food systems are failing
In a press release WHO director for the Department of Nutrition for Health and Development Francesco Branca says, “All forms of malnutrition have a common denominator – food systems that fail to provide all people with healthy, safe, affordable, and sustainable diets”.
The WHO estimates, globally, almost 2.3million children and adults are overweight, and more than 150 million children are stunted due to undernutrition.
People in the poorest low- and middle-income countries are seeing the fastest changes in the way they eat. Ultra-processed foods are becoming more available while fresh food markets are dwindling.
Intergenerational effects
Exposure to undernutrition in early life followed by becoming overweight from childhood onwards increases the risk of chronic diseases such as type 2 diabetes and heart disease and stroke, the WHO says.
To make things worse, negative effects can pass across generations.
“For example, the effect of maternal obesity on the likelihood of the child having obesity may be exacerbated if the mother was undernourished in early life”, University of North Carolina professor Barry Popkin says.
The WHO Series on the Double Burden of Malnutrition authors say it will take action from multiple perspectives – governments, the private sector, the UN to academics, media, and grass roots organisations – to create the systemic changes needed to end malnutrition in all its forms.
The New Zealand story
New Zealand has the third highest adult obesity rate in the OECD.
The Ministry of Health has in place a list of actions to help address obesity:
• Promoting healthy eating and physical activity in all schools,
• Working with district health boards to implement the National Healthy Food and Drink Policy, across a range of settings
• Updating the Food and Nutrition Guidelines for pregnant women and children 0–2 years (last updated in 2008) and integrating them into the Eating and Activity Guidelines
• Co-leading New Zealand’s response to the World Health Organization’s Global Action Plan on Physical Activity, with Sport New Zealand
• Supporting the implementation of the Clinical Guidelines for Weight Management in New Zealand Children and Young People
• Working with the food and beverage industry sector to identify actions to create healthier food environments.
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