Page 56 - Today's Dietitian (March 2020)

News Bites

are overweight and more than 150 mil-
lion children are stunted. However, in
low- and middle-income countries, these
emerging issues overlap in individu-
als, families, communities, and coun-
tries. 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 mea-
sures that may help address malnutri-
tion in all its forms.
The authors used survey data from
low- and middle-income countries in
the 1990s and 2010s to estimate which
countries faced a double burden of mal-
nutrition (ie, in the population, more
than 15% of people had wasting, more
Many Countries Face Both than 30% were stunted, more than 20%
of women had thinness, and more than
Obesity and Undernutrition 20% of people were overweight).
In the 2010s, 14 countries with some
of the lowest incomes in the world had
A new approach is needed denominator—food systems that fail malnutrition, compared with the 1990s.
newly developed a double burden of
to provide all people with healthy,
to help reduce undernutri-
However, fewer low- and middle-income
countries with the highest incomes were
safe, affordable, and sustainable diets.
tion and obesity at the same
time, as the issues become
food systems—from production and pro-
increasingly connected due Changing this will require action across affected than in the 1990s. The authors
say that this reflects the increasing prev-
to rapid changes in countries’ food sys- cessing, through trade and distribution, alence of being overweight in the poor-
tems. This is especially important in low- pricing, marketing, and labeling, to con- est countries, where populations still
and middle-income countries, according sumption and waste. All relevant poli- face stunting, wasting, and thinness.
to a new four-paper report published in cies and investments must be radically High-quality diets reduce the risk
The Lancet. More than one-third of such reexamined.” of malnutrition in all its forms by pro-
countries had overlapping forms of mal- In a Lancet editorial accompanying moting healthy growth, development,
nutrition (45 of 123 countries in the 1990s, the report, Richard Horton, MB, FRCP, and immunity, and preventing obe-
and 48 of 126 countries in the 2010s), par- FRCPCH, FMedSci, editor-in-chief of sity and noncommunicable diseases
ticularly in sub-Saharan Africa, south The Lancet, says, “Today’s publication of (NCDs) throughout life. The components
Asia, and East Asia and the Pacific. the WHO Series on the Double Burden of healthful diets are optimal breast-
Undernutrition and obesity can lead of Malnutrition comes after 12 months feeding practices in the first two years;
to effects across generations, as both of Lancet articles exploring nutrition in a diversity and abundance of fruits and
maternal undernutrition and obesity are all its forms. With these and other arti- vegetables, whole grains, fiber, nuts, and
associated with poor health in offspring. cles across Lancet journals through- seeds; modest amounts of animal-source
However, because of the speed of change out 2019, it has become clear that foods; minimal amounts of processed
in food systems, more people are being nutrition and malnutrition need to be meats and foods and beverages high in
exposed to both forms of malnutrition at approached from multiple perspectives, energy and added amounts of sugar, sat-
different points in their lifetimes, which and although findings have sometimes urated fat, trans fat, and salt.
further increases harmful health effects. converged, there is still work to be done “Emerging malnutrition issues are
“We are facing a new nutrition real- to understand malnutrition’s multiple a stark indicator of the people who are
ity,” says lead author of the report Fran- manifestations. With six years remain- not protected from the factors that
cesco Branca, MD, PhD, director of ing in the [United Nations] Decade of drive poor diets. The poorest low- and
the department of nutrition for health Action on Nutrition (2016–2025), this middle-income countries are seeing a
and development at the World Health Series and Comment define the future rapid transformation in the way people
Organization. “We can no longer char- direction required to achieve the global eat, drink, and move at work, home, in
acterize countries as low-income goal of eradicating hunger and prevent- transport, and in leisure,” says report
and undernourished, or high-income ing malnutrition in all its forms.” author Barry Popkin, PhD, the W. R.
and only concerned with obesity. All Globally, estimates suggest that Kenan Jr. Distinguished Professor in the
forms of malnutrition have a common almost 2.3 billion children and adults department of nutrition at the University

56 TODAY’S DIETITIAN • MARCH 2020