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Commentary
Decade of action on nutrition: our window to act on the double burden of malnutrition
  1. Alessandro Rhyl Demaio1,2,
  2. Francesco Branca1
  1. 1 Department of Nutrition for Health and Development, World Health Organization, Geneva, Switzerland
  2. 2 Copenhagen School of Global Health, University of Copenhagen, Copenhagen, Denmark
  1. Correspondence to Dr Alessandro Rhyl Demaio, Department of Nutrition for Health and Development, World Health Organization, Geneva, Switzerland; demaioa{at}who.int

https://doi.org/10.1136/bmjgh-2017-000492

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    Summary box

    • The double burden of malnutrition is the coexistence of undernutrition with overweight and obesity, or with nutrition-related noncommunicable disease, throughout the life course. This can occur at population, household andindividual levels.

    • With optimal nutrition crucial to achieving the Sustainable Development Goals, the double burden of malnutrition offers an opportunity to consolidate efforts to tackle malnutrition and link established and successful initiatives with emerging nutrition interventions.

    • The United Nations Decade of Action on Nutrition calls for coordinated action to address the double burden of malnutrition through cross-cutting and coherent policies and programmes.

    • There are relatively untapped opportunities for collaborative strategies to encourage healthy diets through public, private and educational institutions, as well as in the home.

    The past half-century has seen a significant shift in the quality and quantity of human diets, and resulting epidemiology, worldwide. 1 2 Nutrition and associated health and demographic transitions were once accepted as near-linear, gradual processes. Heavily influenced by rapid economic and income growth, globalisation, demographic changes and urbanisation, many nations are now experiencing a fast evolving and more complex nutrition reality.

    In 2014, approximately 1.9 billion adults were estimated to be overweight or obese,3 while 462 million were underweight.4 An estimated 41 million children under the age of five were overweight or obese but 155 million were affected by stunting and 52 million by wasting by 20165. In low-income and middle-income countries, almost 5 million children continued to die of undernutrition-related causes; yet, simultaneously many of these same populations now witness an unprecedented rise in childhood overweight and obesity.

    The result is a double burden of malnutrition—the coexistence of undernutrition along with overweight and obesity or with nutrition-related noncommunicable disease.6 At the individual level, the double burden of malnutrition may manifest in two or more forms of simultaneous malnutrition—for …

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