Double

Burden
of
MALNUTRITION
Double Burden of Malnutrition
Coexistence of both undernutrition and overnutrition in the same population at
the same time
Undernutrition, including micronutrient deficiencies, coexisting with
overnutrition: overweight and obesity.
Malnutrition: deficiencies, excesses or imbalances in intake of energy, protein
and/or other nutrients. Contrary to common usage, malnutrition includes both
under-nutrition and over- nutrition.
Undernutrition: result of food intake that is continuously insufficient to meet
dietary energy requirements, poor absorption and/or poor biological use of
nutrients consumed. This usually results in loss of body weight.
Overnutrition: chronic condition where intake of food is in excess of dietary
energy requirements, resulting in overweight and/or obesity.
Micronutrient malnutrition: result of insufficient intake and or
absorption of crucial micronutrients, such as Vitamin A, iron, iodine,
and zinc, which can contribute to life-threatening conditions

Obesity: disease associated with impaired functions related to

alterations in the metabolism of steroid hormones, metabolic
alterations including lipid and glucose levels, and increases in the
turnover of free fatty acids that lead to insulin resistance syndrome
Who does DMB affect?
Affects all countries In most LMICS, overweight seems to be increasing faster
than underweight decreases (Popkin, 2001)
In LMICs, overweight is higher in women compared with men

Consequences
Child mortality
Final adult height compromised
Reduced schooling
Interferes with immunity
Greater propensity for diet related non-communicable diseases such as
diabetes and cardiovascular diseases later in the life.
Causes of DBM
- Related to a series of changes affecting societies which have been
called the ‘nutrition transition.’
- Nutrition transition encompasses changes in the demographic,
economic, behavioral and epidemiological situations of countries and
their populations.

The DBM’s underlying causes are related to a series of historic

changes affecting societies. These changes are known as:
the nutrition transition
the demographic transition, and
the epidemiological transition.

People have gone from being hunters and gatherers to sedentary

consumers. High fertility and early death are being replaced by low
fertility and aging populations. Communicable disease burdens are
being overtaken by non-communicable disease burdens.
Solution for DBM
1. Programmatic and Policy Interventions
2. Health/Biological Environment, Economic/Food Environment
Availability
Distribution
Improving Access to Healthy Food Products
Consumption

3. Physical/Built Environment
Increase opportunities for exercise
Limit the role of automobiles

4. Socio-Cultural Environment
5. Cultural Norms and Beliefs
 References
1. Ford ND, Patel SA, Narayan KM. Obesity in Low- and Middle-Income Countries: Burden, Drivers, and
Emerging Challenges. Annu Rev Public Health. 2017 Mar 20;38:145-164. doi: 10.1146/annurev-publhealth-
031816-044604. Epub 2016 Dec 23. PMID: 28068485.
2. http://www.who.int/nutrition/double-burden-malnutrition/en/
3. https://data.unicef.org/topic/nutrition/malnutrition/
4. http://www.who.int/features/qa/malnutrition/en/
5. https://www.nutriciaresearch.com/wp-content/uploads/2019/04/Double-Burden_Malaysia.pdf