Nowadays, the double burden of malnutrition (DBM), which occurs as a natural result of

dietary transition, is a growing public health problem. Generally speaking, a nation is said to
be experiencing DBM if undernutrition and overnutrition coexist there among the same
demographic group 1. The challenge of the large number of low- and middle-income
countries (LMICs) dealing with the coexistence of undernourishment (i.e., micronutrient
deficiencies, underweight, and stunting in terms of growth and wasting) and diet-related non-
communicable diseases has been slow to be acknowledged by the global health community.
Around the world in 2020, it was anticipated that 45 million people were wasted 2.

Numerous studies have described the dual burden of nutritional inadequacies (wasting,
stunting in growth, and micronutrient deficiencies) and obesity that affects nations,
households, and people. This study will demonstrate that DBM are still high in LMIC
nations, although income levels in those countries are lower now than they were in the early
to mid-1990s 3,4.

Even though the majority of the required tools and knowledge regarding their prevention,
treatment, and management are available, non-communicable illnesses are nevertheless
challenging to manage, especially in women 5. Although those instruments are efficient and
reasonably priced, they don't really reach the people who require them. Undernutrition is a
significant fundamental risk factor for such illnesses. Human development is also impacted
by undernutrition in numerous ways 6.

Maternal obesity and overweight throughout pregnancy, birth, and the postpartum period
cause a number of harmful consequences for both the mother and the foetus. Since promoting
the healthcare of women and children starts with guaranteeing the nutrition and well-being of
women throughout their lives, it is also considered as being deeply connected to that of their
children.

Most LMICs have seen a significant reduction in the number of underweight women in recent
years, and many of these nations are now seeing an increase in the incidence of overweight in
women more quickly than was previously assumed 7. Several factors that affect both
overweight and underweight in LMICs have also been discovered. For instance, higher
socioeconomic position and higher education are associated with a higher prevalence of
obesity in women 8, but low socioeconomic status and poor education are still significant
predictors of underweight 9. There is, however, no conclusive evidence in South and
Southeast Asia as to which demographic groups are heavily burdened both by the
underweight and obesity in women. Important policy implications result from identifying the
proportional rates of change in the occurrence of underweight and overweight/obesity across
South and Southeast Asia, both generally and within subgroups, as well as from identifying
the causes of these changes.

According to a review of the dynamics of obesity and undernutrition, the rapid rises in
overweight and obesity prevalence that are happening in these lower-income nations are also
causing a slower drop in the occurrence of undernutrition. More recent countries with high
DBM levels than in the 1990s were in the bottom GNP/capita (PPP) quartile of LMICs 10.

Our research will demonstrate that the significant and quick changes in the food system are
what are driving this new nutritional reality. The economy's conversion in the domestic and
international food retail, food service, and agriculture sectors, along with other changes, has
significantly boosted the accessibility of hyper processed foods in LMICs 10. It is vital to
comprehend and solve the factors causing the shift in the food system, as well as to
implement effective DBM-addressing policies 11.

While physical activity is declining as a result of significant technical developments in the

market, home production, and transportation, increases in overweight population are a result
of shifts in the global food system that have made less nutritious food inexpensive and more
available. While in numerous other LMICs the risk is beginning to accumulate among low-
income persons and rural areas, it is larger among greater income households and urban areas
in South Asia 12.

References

1. Hasan, M., Sutradhar, I., Shahabuddin, A.S.M. and Sarker, M., 2017. Double burden
of malnutrition among Bangladeshi women: a literature review. Cureus, 9(12)
2. World Health Organization. Malnutrition Factsheet. 2021. Diunduh dari:
https://www. who. int/news-room/fact-sheets/detail/malnutrition, tanggal, 8.
3. Reardon, T. and Timmer, C.P., 2012. The economics of the food system revolution.
Annu. Rev. Resour. Econ., 4(1), pp.225-264.
4. Popkin, B.M. and Reardon, T., 2018. Obesity and the food system transformation in
Latin America. Obesity Reviews, 19(8), pp.1028-1064.
5. Biswas, T., Townsend, N., Magalhaes, R.S., Islam, M.S., Hasan, M.M. and Mamun,
A., 2019. Current progress and future directions in the double burden of malnutrition
among women in South and Southeast Asian countries. Current developments in
nutrition, 3(7), p.nzz026.
6. Ravishankar, A.K., 2012. Is India shouldering a double burden of malnutrition?.
Journal of Health Management, 14(3), pp.313-328.Badiane, O. and Makombe, T.,
2014. Beyond a Middle Income Africa: Transforming African Economies for
Sustained Growth with Rising Employment and Incomes. ReSAKSS Annual Trends
and Outlook Report, pp.1708-1717.
7. Mamun, A.A. and Finlay, J.E., 2015. Shifting of undernutrition to overnutrition and
its determinants among women of reproductive ages in the 36 low to medium income
countries. Obesity research & clinical practice, 9(1), pp.75-86.
8. Biswas, T., Garnett, S.P., Pervin, S. and Rawal, L.B., 2017. The prevalence of
underweight, overweight and obesity in Bangladeshi adults: Data from a national
survey. PloS one, 12(5), p.e0177395.
9. Kinnunen, T.I. and Neupane, S., 2014. Prevalence of overweight among women of
childbearing age in Nepal: Trends from 2001 to 2011 and associations with socio-
demographic factors. Maternal and Child Health Journal, 18(8), pp.1846-1853.
10. Reardon, T., Chen, K.Z., Minten, B., Adriano, L., Dao, T.A., Wang, J. and Gupta,
S.D., 2014. The quiet revolution in Asia's rice value chains. Annals of the New York
Academy of Sciences, 1331(1), pp.106-118.
11. Srour, B., Fezeu, L.K., Kesse-Guyot, E., Allès, B., Méjean, C., Andrianasolo, R.M.,
Chazelas, E., Deschasaux, M., Hercberg, S., Galan, P. and Monteiro, C.A., 2019.
Ultra-processed food intake and risk of cardiovascular disease: prospective cohort
study (NutriNet-Santé). bmj, 365.