Typically, obesity and being generally overweight are thought of as problems exclusive to higher-income countries, while undernourishment is believed to be only within low- and middle-income (LMI) countries. However, LMI countries disproportionately face both obesity and undernourishment, which is known as the double burden of malnutrition (DBM).

More than one-third of LMI countries are facing the double burden of malnutrition. This rise in the prevalence of DBM is attributed to dramatic changes within our food systems. Globally, our diets have experienced a shift towards greater consumption of ultra-processed and high caloric foods. This includes things such as sugar-sweetened beverages and fast-foods.

The Double Burden and Poverty

LMI countries disproportionately deal with the double burden of malnutrition because they experience this shift in diet on top of pre-existing undernourishment. Poverty creates a tremendous strain on one’s ability to access proper nutrition. Impoverished individuals experiencing food insecurity may resort to purchasing ultra-processed foods because they are cheaper. This means that they are either not getting enough food to begin with causing undernourishment or eating unhealthy foods, which can cause obesity and undernourishment due to micronutrient deficiencies.

Undernourishment and obesity are health risks that interact and lead to one another. For example, mothers that are either underweight or overweight during pregnancy can face health risks themselves, such as anemia or gestational diabetes. They can also put their child at risk; being underweight could lead to a low-birth-weight for the baby, and being overweight could increase the likelihood that the child will be overweight later in life. The DBM directly impacts health and places a strain on the healthcare system, but it affects countries’ economic growth as well.

An Economic Burden

In 2017, the World Food Program (WFP) released a report examining the economic cost of the double burden of malnutrition in Latin America. Undernutrition and obesity undermine individuals’ productivity. Undernourishment hinders physical and brain growth, while being overweight or obesity causes non-communicable diseases like diabetes or heart disease. These health conditions create situations where it may be difficult for adults to work consistently, or children may be too ill to go to school. Losses in productivity can hinder economic growth, which maintains poverty and only worsens the double burden of malnutrition. The report claims that economic losses from productivity are “estimated at 500 million in Chile, 4.3 billion in Ecuador and 28.8 billion in Mexico.”

In Latin America, rates of obesity and undernourishment are increasing significantly. About 25% of adults are obese, and 7.3% of children under five years old are overweight. The Food and Agriculture Organization’s Regional Representative, Julio Berdegué, states that “obesity is growing uncontrollably. Each year we are adding 3.6 million obese people to this region.” Additionally, rates of undernourishment are rising. 39.3 million people in Latin America and the Caribbean are experiencing hunger. In Venezuela, there are 3.7 million people hungry. There are 4.8 million people hungry in Mexico.

Combatting Malnutrition

The double burden of malnutrition is detrimental in this region and is causing great concern. However, many countries have implemented strategies to combat this:

• Chile has approved front-of-pack-labeling (FOPL) that warns consumers if the product is high in sodium, saturated fats or sugars. It has also imposed a tax on sugar-sweetened beverages.
• Brazil has increased infant breastfeeding by 32.3% and reduced children-under-five stunting by 30%.
• Mexico is the first Latin American country to impose a tax on sugar-sweetened beverages. It has also created a social welfare program called conditional cash transfer (CCT), which aims to make families food secure and use education and supplements to improve nutrition.

The double burden of malnutrition is a complex and multifaceted issue, which will require comprehensive interventions. It is crucial to target early-life nutrition, ensure that hunger programs provide nutrient-rich foods, and begin managing the production and distribution within larger food systems. While this task is daunting, it is essential to correctly address all forms of malnutrition in order to make the most impact.

– Paige Wallace
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