Popkin 2020 Lancet

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Popkin BM, Corvalan C, Grummer-Strawn LM (2020) Dynamics of the double burden of malnutrition and the changing nutrition reality. Lancet 395:65-74.

» PMID: 31852602 Open Access

Popkin BM, Corvalan C, Grummer-Strawn LM (2020) Lancet

Abstract: The double burden of malnutrition (DBM), defined as the simultaneous manifestation of both undernutrition and overweight and obesity, affects most low-income and middle-income countries (LMICs). This Series paper describes the dynamics of the DBM in LMICs and how it differs by socioeconomic level. This Series paper shows that the DBM has increased in the poorest LMICs, mainly due to overweight and obesity increases. Indonesia is the largest country with a severe DBM, but many other Asian and sub-Saharan African countries also face this problem. We also discuss that overweight increases are mainly due to very rapid changes in the food system, particularly the availability of cheap ultra-processed food and beverages in LMICs, and major reductions in physical activity at work, transportation, home, and even leisure due to introductions of activity-saving technologies. Understanding that the lowest income LMICs face severe levels of the DBM and that the major direct cause is rapid increases in overweight allows identifying selected crucial drivers and possible options for addressing the DBM at all levels.


Bioblast editor: Gnaiger E

» BME and mitObesity news (2020-02-10)


Selected quotes

  • Increases in overweight are the result of changes in the global food system that make less nutritious food cheaper and more accessible, as well as to the decrease in physical activity due to major technological shifts in the workplace, home, and transportation.
  • We see a trend of 'shifting focus from predominantly undernutrition, or single sides of malnutrition, to all forms of malnutrition.30,31'
  • we use the word malnutrition to refer to both wasting, stunting, and thinness, and overweight and obesity.
  • The DBM at the country level is defined as having a high prevalence of both undernutrition and overweight and obesity in at least one population group.
  • We use a combination of overweight and obesity because extensive epidemiological research associates BMI of 25 kg/m² or higher (or possibly an even lower threshold) with the risks of noncommunicable diseases across LMICs.36–42
  • Ultra-processed, packaged foods rich in refined carbohydrates, fat, sugar, and salt are relatively inexpensive and often ready to eat.67 Evidence suggests these ultra-processed foods play a major role in increased obesity and non-communicable diseases.
  • two large European cohorts have shown a strong positive relation between ultra-processed foods and cardiovascular disease and all-cause mortality.68–70


Labels: MiParea: Gender, Developmental biology, Exercise physiology;nutrition;life style  Pathology: Obesity 

Organism: Human 

Preparation: Intact organism 




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