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Poverty, Obesity, and Malnutrition: An International Perspective Recognizing the Paradox

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Abstract

In the year 2000, multiple global health agencies and stakeholders convened and established eight tenets that, if followed, would make our world a vastly better place. These tenets are called the Millennium Development Goals. Most of these goals are either directly or indirectly related to nutrition. The United Nations has led an evaluation team to monitor and assess the progress toward achieving these goals until 2015. We are midway between when the goals were set and the year 2015. The first goal is to “eradicate extreme poverty and hunger.” Our greatest responsibility as nutrition professionals is to understand the ramifications of poverty, chronic hunger, and food insecurity. Food insecurity is complex, and the paradox is that not only can it lead to undernutrition and recurring hunger, but also to overnutrition, which can lead to overweight and obesity. It is estimated that by the year 2015 noncommunicable diseases associated with overnutrition will surpass undernutrition as the leading causes of death in low-income communities. Therefore, we need to take heed of the double burden of malnutrition caused by poverty, hunger, and food insecurity. Informing current practitioners, educators, and policymakers and passing this information on to future generations of nutrition students is of paramount importance.

Section snippets

Poverty and Obesity Are Connected to Hunger and Food Insecurity

Poverty results in food insecurity and often hunger, which can lead to malnutrition. Furthermore, the absence of a diversified, nutrient-dense diet can lead to overnutrition, subsequent obesity, and failure to meet micronutrient requirements. The US Department of Agriculture (5) and the Food and Agriculture Organization (6) have specific language and definitions to describe hunger and food insecurity (Figure 3).

The Paradox of Food Insecurity as a Cause of Obesity

The paradox within these intertwined social and economic relationships is that poverty causes food insecurity, yet one of the overwhelming outcomes of food insecurity is obesity. When food insecurity exists in a community, sufficient or even excessive energy may be provided by the limited foods available, but the nutritional quality and diversity of the foods in the diet may not support a healthy nutritional status due in part to inadequate micronutrients. The number of US residents in

Determinants of Obesity Connected to Poverty

In the Third National Health and Nutrition Examination Survey, conducted between 1988 and 1994, theoretical models of relationships were determined between multiple factors and the risk for being overweight (29). Lack of family resources and food insufficiency were intricately related (ie, no money results in no food), and both factors were associated with obesity. Similar to much of the world, relationships exist between obesity and social (30) and lifestyle (31) factors in Jamaica; BMI is

Programs That Address Food Security

Around the world, poverty is acknowledged as a major cause of food insecurity, and efforts to improve access to food must include poverty eradication (1). According to the World Health Organization, malnutrition is a medical and societal disorder with substantial consequences, including increased risks for morbidity and mortality (36). The World Bank Strategic Objectives are centered on the improvement of Health, Nutrition and Population outcomes for the poor (3).

Multiple programs have been

Our Responsibilities as Professionals

We have several responsibilities as nutrition educators, dietetics professionals, health care providers, researchers, and policymakers to understand and address the consequences of food insecurity, hunger, and malnutrition (49). The eighth Millennium Development Goal is to “develop a global partnership for development” (1). This begins with educating ourselves and others about the complexities of poverty, obesity, and the double burden of malnutrition. Understanding the ramifications of having

S. A. Tanumihardjo is an associate professor in the Department of Nutritional Sciences at the University of Wisconsin-Madison and Extension, Madison.

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    S. A. Tanumihardjo is an associate professor in the Department of Nutritional Sciences at the University of Wisconsin-Madison and Extension, Madison.

    C. Anderson is an assistant scientist in the Department of Epidemiology at Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.

    M. Kaufer-Horwitz is a certified nutritionist by the Mexican College of Nutrition (Colegio Mexicano de Nutriólogos) and a researcher at Fundación Mexicana para la Salud, Mexico City, Mexico, and a member of the International Union of Nutritional Sciences (IUNS) Task Force on Nutrition, Diet and Long-term Health.

    L. Bode is a staff scientist at Burnham Institute for Medical Research, La Jolla, CA.

    N. J. Emenaker is a program director at the National Cancer Institute, Bethesda, MD.

    A. M. Haqq is an assistant professor at Duke University Medical Center, Durham, NC.

    J. A. Satia is an assistant professor in the Departments of Nutrition and Epidemiology at the University of North Carolina at Chapel Hill.

    H. J. Silver is a research assistant professor at Vanderbilt University Medical Center, Nashville, TN.

    D. D. Stadler is a research assistant professor at Oregon Health & Science University, Portland.

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